Categories
Atrial fibrillation Dabigatran/Rivaroxaban/Apixaban

Let there be three…

You can mark August 2011 as an amazing month for news in the treatment of atrial fibrillation (AF). In this post, I will attempt to share what I have learned about the two new blood-thinning drugs, apixaban and rivaroxaban–both Factor Xa inhibitors. (Disclaimer: this is not a book chapter, rather a blog post from a […]

Categories
AF ablation Atrial fibrillation Dabigatran/Rivaroxaban/Apixaban

Some real-world challenges faced by Dabigatran (Pradaxa)

Doctors that treat atrial fibrillation (AF) are getting close to celebrating the one-year anniversary of having a substitute for warfarin. As an early adopter of the novel new blood-thinner, I would like to share some (almost) one year-old observations on dabigatran (Pradaxa). First, the science behind dabigatran is stellar. The landmark RE-LY trial studied 18,000 […]

Categories
Atrial fibrillation Dabigatran/Rivaroxaban/Apixaban General Cardiology

The new blood thinners and personal accountability

I recently came across a very important blog post on the use of the novel new blood-thinner, dabigatran (Pradaxa). Fellow Kentucky cardiologist, and frequent TheHeart.org contributor, Dr. Melissa Walton-Shirley wrote this very detailed case presentation involving a cantankerous non-compliant rural patient with AF (atrial fibrillation) that sustained a stroke while “taking” dabigatran. Dr. Walton-Shirley details […]

Categories
Atrial fibrillation Dabigatran/Rivaroxaban/Apixaban General Medicine

Rivaroxaban: The next non-warfarin oral blood thinner

The unrelenting epidemic of inactivity and excessive eating wreaks havoc on more than just the heart and blood vessels. Lugging around extra weight also breaks down the joints and back. For evidence, look no further than the waiting room of any orthopedist; the people waiting for joint replacements look the same as those waiting to […]

Categories
Atrial fibrillation Dabigatran/Rivaroxaban/Apixaban

An update on AF: New blood thinners

It’s been awhile since I have written about the treatment of atrial fibrillation (AF). I would like to remedy this by sharing a few thoughts on three recent stories about AF: one involved a soon-to-be-approved blood-thinning drug; the second highlighted a potentially exciting new device for ablating AF, and the third story irresponsibly sensationalized the […]

Categories
AF ablation Atrial fibrillation Dabigatran/Rivaroxaban/Apixaban

An update on Atrial Fibrillation: Notes from HRS 2011

Earlier this month, heart rhythm professionals from all over the world met in San Francisco. I found the 2011 version of the Heart Rhythm Society meeting an incredible learning experience–a buffet of knowledge on all matters electric. Here’s a book report of sorts on a few atrial fibrillation (AF) related issues: From above the trees, […]

Categories
Atrial fibrillation Dabigatran/Rivaroxaban/Apixaban General Medicine

More Dabigatran (Pradaxa) news

I have become an AF-doctor. That means my most exciting aspect of medicine is terminating AF with watts delivered through a catheter. “Got it.” In that beautiful moment, the take-the-fun-out-of-medicine people seem far away. Huge grin! Though all that high-tech stuff is exhilarating, it’s fair to say that the most remarkable thing in AF medicine […]

Categories
Atrial fibrillation Dabigatran/Rivaroxaban/Apixaban General Cardiology

More news on dabigatran (Pradaxa)

Almost everything about the new blood-thinning drug, dabigatran (Pradaxa) is novel. In February, I wrote about the drug’s unusually short (thirty-day) expiration time. This week, the FDA has released a new communication concerning dabigatran. It included practical safety tips for patients, pharmacists and doctors, and is nicely summarized by Larry Husten, on Cardiobrief. Here are […]

Categories
Atrial fibrillation Dabigatran/Rivaroxaban/Apixaban

More on Pradaxa

I hope we are right. Dabigatran (Pradaxa) use in my community has taken off. It’s not just AF-doctors, it’s all doctors, internists and cardiologists alike. Honestly, it’s a little scary. That’s why I read with great interest anytime other practicing doctors speak about how they use the 4-month-old blood-thinner. Remember, this is not a just […]

Categories
Atrial fibrillation Dabigatran/Rivaroxaban/Apixaban General Cardiology

The first four months of a new era.

My iPhone vibrated with an urgent message that read: Please call…The INR on your atrial fibrillation patient scheduled for cardioversion is too low.  He is on that new blood thinner, Pradaxa.  What do you want to do?” I responded, sounding like an expert:  “It’s Ok.  Pradaxa thins the blood adequately, it just doesn’t change the […]

Categories
Atrial fibrillation Dabigatran/Rivaroxaban/Apixaban General Medicine

Pradaxa may expire after thirty days

There was important news concerning the short shelf-life of the novel new blood-thinner, dabigatran (Pradaxa) reported today. Once dispensed, most medicines expire after a year.  Dabigatran, however, is far from the usual pill.  It’s packaged in pellet form within a capsule. These pellets are highly susceptible to water and humidity.  So when dispensed in a […]