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Atrial fibrillation Dabigatran/Rivaroxaban/Apixaban Doctoring

2017 update on the changing use of “blood thinners” for AF

Times have changed in the treatment of patients with atrial fibrillation (AF). First some background: The first of the four pillars of AF care is stroke prevention. The only proven means to protect patients with AF from stroke is use of drugs that block clotting factors–or anticoagulants. Some people call these drugs blood thinners. I […]

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Doctoring Healthy Living Social Media/Writing/Blogging

I am changing…

Seven years have passed since I started this blog. In that time… I have learned some basics about writing. (I almost wrote, “I have learned to write,” which would have been foolish, since, writing-wise, I have plenty to learn.) I have learned to stay upright on the bicycle. Concussions made me understand that the joys […]

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Athletic heart Social Media/Writing/Blogging

Graduation Day… From Blogger to Author

Hi all, I have graduated from blogger to author. My first book is now available. It’s called the Haywire Heart. I co-wrote it with Chris Case and Lennard Zinn. VeloPress is the publisher. The book deals with one of my favorite themes: heart conditions in endurance athletes. Although exercise is a key component of health, […]

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AF ablation Atrial fibrillation Dabigatran/Rivaroxaban/Apixaban General Cardiology

Say No to Watchman

Cardiology is on the brink of making a big mistake. We have embraced a new procedure called left atrial appendage occlusion. You may be seeing the ads for a device called Watchman. Like this one> The appendage-closure idea was a good one: during atrial fibrillation (AF), blood can pool in the left atrial appendage, and […]

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Healthy Living

Give Local Louisville — Have A Heart

Folks — I’ve written more than 1000 essays on this blog over the past 6 years. I have no ads. I don’t write to make money. (I have a good job.) I don’t ask for anything on this site. You have been supportive in your comments and emails. Thank you. This week, in Louisville, is […]

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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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Atrial fibrillation Doctoring Knowledge Reflection

Politics and Understanding the Human Condition

I recently received this message: This is not the first time I’ve been scolded for straying from medical topics. Last October, during the Lown Institute’s RightCare Action Week, I wrote about our ailing healthcare system. This prompted a different reader to send a similar message: Stick with topics about atrial fibrillation–went the gist of that […]

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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 Doctoring General Medicine Health Care

Should AF ablation require approval from a heart team?

A patient presents with atrial fibrillation (AF) and a rapid rate. He doesn’t know he is in AF; all he knows is that he is short of breath and weak. The doctors do the normal stuff. He is treated with drugs to slow the rate and undergoes cardioversion. During the hospital stay, he receives a […]

Categories
AF ablation Atrial fibrillation Doctoring General Cardiology Health Care Knowledge

Is AF ablation a big placebo?

Turkish authors boldly raised this question in a recent editorial. They likened AF ablation to renal denervation, a procedure in which RF ablation in the kidneys was felt to reduce BP. Many studies showed kidney ablation markedly lowered BP. Then a trial was done with a sham control (people got part of the procedure but […]

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AF ablation Atrial fibrillation Doctoring

Big news in AF ablation from HRS 2016

I have recently returned from the 2016 Heart Rhythm Society Sessions in San Francisco. I wrote three articles for Medscape. I also did two podcasts from HRS. I will link these below. You need to sign up for Medscape (free) to read the essays and listen to the podcast. In the first article, I discussed […]