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AF ablation Atrial fibrillation Doctoring General Medicine Health Care ICD/Pacemaker Knowledge

The medical decision is sick but not hopeless…

What follows is my latest post on theHeart.org | Medscape Cardiology. It’s weird; the post is one of my favorites, but it’s not made the most read list–at all, not even fifth place. There are thoughtful comments but it’s simply not popular among doctors. **** Imagine this scenario: A learned professor comes to your office […]

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Doctoring General Ablation General Cardiology

On PVCs, think anew but think slowly

Premature ventricular complexes (PVCs) remain a common and vexing problem in cardiology. PVCs deserve attention because they often induce fear in both patient and doctor. In US healthcare, fear is bad. Fear sets the stage for over-treatment. The approach to the funny-looking beats has not changed much in the last two decades. That may be […]

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Doctoring General Cardiology General Medicine Health Care Healthy Living

Should you get a cardiac stress test?

Heart disease remains the leading killer of humans. People want to be protected. The fast-thinking notion is early detection is good, the more knowledge, the better. I wish it were that easy. What follows is my most recent post on WebMD on the basics of cardiac stress testing: **** A middle-aged surgeon recently asked me […]

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Doctoring General Cardiology Hospice/Palliative Care ICD/Pacemaker

Avoiding a bad death requires preparation

If there was a hashtag for sub-specialty healthcare and ICU medicine in the United States it would be: #WeCanButShouldWe A recent study led by Dr. Harlan Krumholz (Yale University) showed that we have become more efficient at keeping elders alive. This is not surprising. And it’s good news in the sense that technology–if used wisely–can […]

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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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Health Care Health Care Reform

Do not use the Surgeon Scorecard

(I have updated this post with a link below to my essay on Medscape.) No data is better than bad data. The ProPublica Surgeon Scorecard is not ready for prime time. It was a good effort. I support investigative journalism and ProPublica. We need more transparency in Medicine. I despise the utter lack of meritocracy […]

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AF ablation Atrial fibrillation ICD/Pacemaker inflammation

Recap of 2015 European Heart Rhythm Association Meeting — Milan

I recently returned home from Milan, Italy. I was covering the 2015 European Heart Rhythm Association (EHRA) sessions. My favorite part of the congress, as it always is with medical meetings, was connecting with old friends, and making new friends. I had coffee, lunch or dinner with colleagues from Australia, Netherlands, France, Italy, Belgium, Frankfurt, […]

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Doctoring General Cardiology General Medicine Health Care Reform

The PCSK9 Drugs — Epic success or epic failure?

This week, an FDA advisory committee recommended approval for the potent cholesterol-lowering drugs, evolocumab and alirocumab. The funny-sounding medications are called PCSK-9 inhibitor drugs. (Keep reading; I’ll tell you more.) Advisory committee members felt the benefits of the drugs outweighed the potential risks, especially in high-risk patients, such as those with Familial Hypercholesterolemia (FH). The […]

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Atrial fibrillation Healthy Living inflammation Nutrition

Good health does not require an Apple Watch

Social media is awash in news about digital health. I am a skeptic. Health is much simpler. I like this rendering from a kindergarten class. "Kindergarten teacher asked class to create rules for living healthy. Here's what they came up with" via @rickplus3 pic.twitter.com/cRmHfcfjrf — Brad Stulberg (@BStulberg) May 9, 2015 When I was a […]

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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 Doctoring General Medicine Health Care Healthy Living

Why don’t people ask their doctors more questions?

I do not get it. Day in and day out, I ask patients why they take a medicine. Many do not know. “My doctor put me on it,” goes the common response. Take statin drugs, for example. I often ask a person why they are taking the drug? With rare exception, the person says it […]