Today was a great day. There was a gratifying ablation, a silky-smooth BiV defibrillator implant, (evidenced-based of course), a few consults (always a few consults), and as a bonus, I even eked out some severe learning about the novel, though not yet approved, AF-drug, vernakalant. (Any time you re-learn the ion channels of the cardiac […]
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Recent news in AF ablation
Only a few days had passed before the emails began arriving in earnest. The recently reported study in the Journal of the American College of Cardiology revealed “sobering” long-term results in atrial fibrillation ablation. That the seemingly negative results came from the highly-respected AF-ablation center in Bordeaux, France, made it more newsworthy. On first glance […]
I was up, the paperwork done, and my hand on the door. “Doc, I have just one more question.” Uh-oh. “My grandson is in medical school, and he wanted me to ask which field of medicine he should go into.” Before I could answer the patient added this zinger: “He wants a field that has […]
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Are ICDs overused?
The medical news of the week nearly shocked me off my bike trainer. It isn’t often that electrophysiology makes the major-network evening news broadcast. The teaser proclaimed…“thousands of heart patients have unnecessary expensive cardiac devices…Should they be removed?” They were talking about ICDs (internal cardiac defibrillators), and were referring to the widely publicized JAMA study […]
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 […]
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 […]
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Welcome to the new Dr John M
Hi all. Welcome to my new Word Press platform. It’s a a work in progress. I have already learned a lot, but have a long way to go. There are a number of new features: A brighter, whiter platform. A much smaller number of categories (see the drop down bar in the right sidebar.) Hopefully […]
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On Vacation…
I am in Phoenix, AZ with family. It’s dumping rain and cold here. To a Kentucky resident it looked like just another rainy day. “This is really rare,” my nephew told me. I realized he spoke the truth when we saw the waitresses in the restaurant staring out the window at the rain as if […]
This evening, it was around dinner time when I finished seeing the last patient on the card that said, “Morning Rounds.” On the way out, I ran into an old colleague. Back in the 1990s, he was the experienced real-world clinician and I the youngster just out of fellowship. As it often does with old […]
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Merry Christmas
“Shh,” I think to myself, walk softly as not to disturb that beautiful pre-dawn quiet. I sit nestled on the couch with only the hum of the heater coming through the heat ducts, The heavy blanket and wool socks keep me warm as I jettison the haze from a long night’s sleep. There are flashing […]
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Cycling Wed: Life’s too short to…
My topic for cycling Wednesday changed abruptly this afternoon. It was to be a report on yet another scientific publication (and editorial) about the deleterious cardiac effects of long-term endurance athletics. The paper was published recently in the scientifically-rigorous journal, Circulation. (In fact, I went so far as to spend an hour on the phone with […]