Categories
Atrial fibrillation General Cardiology

An Iphone ECG monitor–Amazing

I want an iPhone 4. I need an iPhone 4. Doctor Wes reported it first, but this futuristic gem shines bright enough for another look. Here is the 4 minute video outlining how an iPhone can be converted to a real-time ECG event monitor. If this works in the real-world–and it looks encouraging–it would be […]

Categories
AF ablation Atrial fibrillation Dabigatran/Rivaroxaban/Apixaban

Can Dabigatran (Pradaxa) be used before and after cardioversion?

Yesterday marked the two-month anniversary of the availability of the novel blood-thinner dabigatran (Pradaxa). It was approved for the use of preventing stroke in patients with non-valvular AF, but it has quickly taken on the inaccurate moniker of “the warfarin-substitute.” Here’s the thinking: If stroke prevention in AF is accomplished by thinning the blood, and […]

Categories
AF ablation Atrial fibrillation Dabigatran/Rivaroxaban/Apixaban General Cardiology

The top three Cardiology stories of 2010…and three predictions for 2011

The end of the year marks a time for list-intensive posts. Recently, Larry Husten, from Cardio-Exchange and Cardiobrief, asked for my opinion on the three most important cardiology-related news stories of 2010.  Additionally, he also wanted three predictions for 2011.  (I assume cardiology predictions.) Here goes… My top three cardiology stories of 2010: —By far, the […]

Categories
Atrial fibrillation Health Care Health Care Reform

A good plan denied…

Smart doctors will take help from wherever it lurks. Today, advice on doctoring came from an unlikely and well-camouflaged source. (I always ask: “where are you talking to me from?”) He was advising me from a warm cubicle in Milwaukee, Wisconsin.  It was a paternalistic male voice—another doctor, he said. Obviously, he was savvy, disguising […]

Categories
AF ablation Atrial fibrillation

AF Ablation: A review of three interesting studies…some real data.

In treating atrial fibrillation (AF), this year has witnessed some real excitement.  And not all the good news has to do with new pills. Recently, there has been a flurry of encouraging and objective news on ablating AF. Here are some comments on three notable studies that address three important questions: What are the ‘long-term’ […]

Categories
AF ablation Atrial fibrillation

AF Ablation: A late-2010 update…Important progress

In atrial fibrillation (AF) ablation, things are changing for the better. And good news makes for good blog posts. How do I know times are changing? Because I heard an EP nurse say something stunning–a sign of a new era in electrophysiology. Recently, during an incredibly difficult PVC ablation, she whispered cautiously to herself, “I’d rather […]

Categories
Atrial fibrillation ICD/Pacemaker

ECG Quiz: Drug-induced torsades de pointes

As the commenters correctly pointed out, this Sunday’s case involving the patient with recurrent syncope is indeed polymorphic ventricular tachycardia–aptly named torsades de pointes (‘twisting of the points’).  TDP is associated with prolongation of the QT interval, and pause-dependent PVCs (and VT).  A serious malady indeed. ICD evaluation showed hundreds of these episodes The initial ECG strengthened […]

Categories
Atrial fibrillation Healthy Living

Happiness: the fourth leg of heart health

He was dressed causally in jeans, a loosely collared shirt and a near perfect tan, as if it was happily acquired outdoors, not in a tanning booth. This Monday morning on GMA, Dan Buettner, a member of the crazed ultra-endurance cycling fraternity sat before millions of viewers, with the perfectly coiffed George Stephanopoulus, and proclaimed […]

Categories
Atrial fibrillation Cycling Stuff Cycling Wed

CW: Pedaling to an AF victory…without a 3D-mapping system

Everyone likes winning. Bike racers like it. So do doctors. When doctors win, lives get better.  That’s the ends. The means, the journey, the race itself, vary from the simple to the complex, from the boring to the eventful, from the free to the obscenely expensive. For instance, lives are enhanced when a complex catheter-based […]

Categories
Atrial fibrillation Dabigatran/Rivaroxaban/Apixaban

What if the (very) young pharmaceutical rep is right?

I loved my old status.  Perhaps, reveled in it would be a better description. I was a crotchety generic-medicine only doctor.** Sadly, my status changed today.  Dabigatran (Pradaxa) was the culprit. It was a little nerve-racking. I wrote the order, looked at it, thought it out again, talking to myself, “John, are you sure you […]

Categories
Atrial fibrillation Dabigatran/Rivaroxaban/Apixaban Health Care

In defense of Multaq…not really

It will not last forever, nothing ever does. Some day I will have to find another big-pharma punching bag. It’s true; our pal dronedarone (Multaq) is back in the news again. This time the Multaq news (as reported on Cardiobrief and Pharmalot) is not about its inefficacy or Sanofi-sponsored professors, but rather concerns about it’s […]