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AF ablation Atrial fibrillation General Ablation Healthy Living

Are women with AF being under-treated with ablation?

This post is an introduction to commentary I made recently over at theHeart.org on Medscape. Gender features in the discussion, but there are lessons for men and women with AF. *** A large study from a group of Stanford researchers made three big observations on AF ablation: Women, compared with men, presented for first AF […]

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General Cardiology General Medicine

The BVS Disappearing Stent: Promise, Hype and the Tension Between Progress and Safety

Medicine does not stand still. You want innovation; you want progress. But you also want safety. Millions of patients have coronary stents placed in the arteries supplying blood to the heart. It’s big business. Metal cages placed in the setting of a heart attack can be life saving. In other settings, however, the strongest quality […]

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AF ablation Atrial fibrillation

AF Ablation Update – 2016

I do AF ablation. But, similar to my 2015 update, I continue to do fewer of these procedures. What is new in 2016 is more confidence that this is the right approach. My technique for ablating AF has not changed. I do pulmonary vein isolation (PVI) with point-to-point RF. Each burn takes 10-30 seconds, and […]

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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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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 Doctoring General Medicine Healthy Living

The right care for patients with atrial fibrillation

I am in San Diego to participate in the Lown Institute Road to Right Care: Engage, Organize, Transform conference. It is an honor to be included in a conference that has “right care” in its title. Tomorrow, Dr. David Martin (Lahey Clinic) and I will co-present a case-based session on the overuse and misuse of […]

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Doctoring Health Care Health Care Reform

Dr. Bernard Lown and the first rule of doctoring

I knock, then enter the exam room. “Hi. My name is John Mandrola.” (Maybe it is my age but I am moving away from calling myself Doctor Mandrola.) “I am a heart rhythm specialist. I have looked at your chart so I know a little about your medical history.” “Can you tell me how you […]

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AF ablation Doctoring Exercise General Medicine Healthy Living Nutrition

Let’s stop the unnecessary treatment of heart disease

There are many reasons doctors suffer from burnout and compassion fatigue. One of the least-mentioned of these reasons is that much of what we do is so damn unnecessary. In the US, the land of excess everything, caregivers, especially cardiologists, spend most of our time treating human beings that didn’t need to have disease. Let’s […]

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AF ablation Atrial fibrillation Doctoring Reflection Social Media/Writing/Blogging

Blaming the patient…and the philosophy of caring for people with atrial fibrillation

More than a few commenters recently noted something disturbing in my writing. They said my words are increasingly taking a blame-the-patient tone. That bothers me. Of all people, I know about making imperfect health choices. These comments got me thinking about striking the right balance in writing about health, say, between apathy and defeatism, (oh […]

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Doctoring Health Care Health Care Reform

A letter to patients and caregivers — Improving US healthcare is a team sport

The thing about US healthcare that bothers me most is the waste: the nuclear stress tests on demented patients in diapers, the MRIs for every case of back and knee pain, the egregious pre-op tests for low-risk surgeries, the mega-workups for simple cases of AF, the disease mongering in the name of prevention, and most […]

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Athletic heart Atrial fibrillation Cycling Stuff Exercise inflammation Uncategorized

Endurance exercise and the heart — a mention in the New Yorker

Do you exercise a lot? Have you been at it for years? Are you the type that rides around the neighborhood to make a 98-mile ride into a century? Do you get squeamish if you can’t exercise for 24 hours? Are you curious about that beautiful machine in your chest? You know, the rhythmic coordinated […]