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Exercise General Medicine Health Care Reform Healthy Living

The Case for Opening (some) Pools In COVID19 Pandemic

The COVID crisis has decimated water exercise. Can we rethink pool closures? A significant number of my older patients relied on pools for their fitness. During a pandemic, you can stay active or fit only if you have good legs and joints. Walkers, runners, and cyclists have no problem; they play outside in the Spring […]

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AF ablation Atrial fibrillation Dabigatran/Rivaroxaban/Apixaban Doctoring Exercise General Cardiology Healthy Living ICD/Pacemaker Nutrition

A short take of the big stories in cardiology in 2015

Here is my most recent column on theHeart.org | Medscape Cardiology: Mandrola’s Top 10 Cardiology Stories 2015 What follows below is a short-writing summary of my ten picks. The hyperlinks go to earlier columns I wrote on the topic. 1. The FDA approved two new (injectable) cholesterol drugs. The problem with the PCSK9-inhibitors: the study […]

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AF ablation Atrial fibrillation Doctoring Exercise General Cardiology

A cautionary note on AF ablation in 2015

It’s time to write an update on AF ablation. Things have changed. The major change is that I am doing many fewer ablations for AF. The reason is we have a better understanding of the disease, or should I say, condition? In the last 2-3 years, good science has changed the way specialists see AF. […]

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Athletic heart Atrial fibrillation Cycling Stuff Cycling Wed Cyclocross Exercise inflammation

The cardiac dangers of excess exercise

Regular exercise is essential for health. I’ve taken to prescribing daily exercise as a drug. I’ve even written it on a prescription pad for effect. I see exercise as medicine, a safe medicine, an effective medicine. That means, like all drugs, exercise can be overdosed. The challenge is knowing the upper limit. How much is […]

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AF ablation Atrial fibrillation Cycling Stuff Doctoring Exercise General Medicine Health Care Health Care Reform ICD/Pacemaker Reflection Social Media/Writing/Blogging

Update: Baltimore, Safety in AF ablation, Podcasts, and some personal notes

On Baltimore: Human beings rioting in the streets of an American city forced cancellation of an important cardiology meeting. This is a vivid example that doctors do not practice in a vacuum. We are connected to this world. Here in Louisville, just a few miles north, an HIV crisis runs amok because of IV drug […]

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AF ablation Atrial fibrillation Cycling Stuff Exercise Health Care Reform Healthy Living Social Media/Writing/Blogging

An update on cycling and writing and video (gulp)

Hi all, Things have changed for me. I have taken on a larger role at theheart.org | Medscape Cardiology. This means I have less time for hefty original posts here. (This site is not closing–just changing.) I write and read a lot more, though. Almost every day. Writing has morphed into what cycling was: a […]

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Atrial fibrillation Cycling Stuff Exercise Healthy Living

Does exercise have to look a certain way? Can Yoga deliver heart health?

One of my good friends, a guru of sorts, once told me during a ride that things change. He was 50 years-old at the time and the change he was referring to was cycling abilities and priorities. At the time, I was at the peak of my cycling prowess; we were part of strong masters […]

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Cycling Stuff Cycling Wed Cyclocross Exercise General Medicine Health Care Healthy Living

Will wearables and other gadgets make us healthier?

Is good health really all that digital? I am not so sure. I am a skeptic. I realize this is a risky thing to say these days. It’s hard to bet against Apple. And It was only seconds after Tweeting such doubt that John Nosta, an expert in digital health technology, tweeted back: @drjohnm Health […]

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AF ablation Atrial fibrillation Doctoring Exercise General Cardiology General Medicine Health Care Healthy Living

The year in Cardiology 2014 — a top-10 list

When the editors at Medscape asked me to put together an essay on the Top 10 stories in cardiology in 2014, I thought it would be an easy project. I was wrong. It turns out there was a lot to say about the happenings in cardiology this year.  In the end, the final essay had 37 references–a […]

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Doctoring Exercise General Cardiology General Medicine Healthy Living Knowledge

Sudden death and a common antibiotic

The longer I practice medicine, the more nervous I get about medications, especially when patients are already on other drugs for chronic diseases. I much prefer deprescribing. A recent study on the common antibiotic cotrimoxazole, which is a combination of sulfamethoxazole and trimethoprim, and often referred to by its brand name, Bactrim or Septra, lends […]

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Atrial fibrillation Cycling Wed Cyclocross Exercise General Medicine Health Care Healthy Living inflammation Nutrition

Public health is on the ballot this Election Day

The election I am going to watch today is in San Francisco. On the ballot there is Proposition E, an initiative to add a 2-cent tax for every once of sugary beverage. Choose Health SF, a group supporting the tax, estimates it would raise $54 million, which would go towards, get this: “funding active recreation […]