Categories
Cycling Stuff Exercise inflammation

Just because the rigors of endurance athletics may be inflammatory doesn’t mean it isn’t fun…

A patient asks, “Doc, do you ride your bike to prevent heart disease.” I reply, “Heck no, I am hoping to live long enough to get heart disease.” The non-athletic patient looks quizzically at me as if trying to decipher what I mean, or whether I am serious.  Too long a story, so we move […]

Categories
General Medicine Health Care Healthy Living

A milestone in medical achievement…

Wow. Congratulations to Dr Melissa Walton-Shirley for her leadership role in achieving a smoking ban in Glasgow, KY.   That’s right, Glasgow KY, deep in the heart of one of America’s largest tobacco producing counties. Ablating atrial fibrillation, implanting ICDs and “squishing” blockages are procedures that help the singular few.  They can often prove challenging, […]

Categories
Athletic heart Atrial fibrillation Cycling Stuff inflammation

A cautionary note to my endurance athletic brethren…

Exercise is good for you. It forms one of the triads of health: good nutrition, good movement, and good sleep. However, like in life, too much of anything is counterproductive, even destructive.   I have long struggled to explain the steady stream of hyper-fit, uber-athletic endurance athletes who see me for arrhythmias.  A membership in […]

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Atrial fibrillation Knowledge

Conflicts of interests in medical information…

From the drug rep of the huge pharmaceutical company promoting a new anti-arrhythmic drug:  “Dr Mandrola, you are a leader in the area so we would like you to be on our speakers bureau.  Of course, you are reimbursed for your time” “Really?”  Maybe they know about my blog, I wonder. “Sure, we can send […]

Categories
Doctoring ICD/Pacemaker

What to do when a chronically ill patient reaches the end of battery life of their cardiac defibrillator…

Years ago at the time of the original cardiac defibrillator implant (ICD), he was a vibrant active man who had suffered from an arrhythmia related to scar from a remote heart attack. Things change.  Life has chapters. It is amazing what can happen to a person during the 5-7 year battery life of an ICD. […]

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General Medicine Health Care Health Care Reform

Let’s be clear on why most doctors are skeptical of the recent healthcare bill…

My infinitely more famous colleague, Dr Wes has a very nice summary piece on how the recent healthcare reform bill will affect doctors. It is very well written, concise and instructive. I get it. I don’t here Fox news. There is good in the bill, like the pre-existing condition clause, and prohibiting an insurance company […]

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Health Care Health Care Reform Reflection

Simplify healthcare: A good start would be minimizing the uninformed and profit conflicted third parties…

Here is an example of how increased regulation from third parties attempts to control costs, but actually does the opposite. A middle aged patient whom I have seen in the past for benign palpitations called today because of atypical chest pain.  Although I have criticized the overuse of nuclear imaging studies, and probably order the fewest of […]

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Health Care Reform

The Healthcare bill has passed. On future realities from the “real” world…

It looks like the Obama health care bill will survive the House vote.  It was really close.  It took a last-minute executive order to placate a small number of congressmen.  A small band of anti-abortion congressmen required an executive order to garner their support. Seriously? Politics amaze me. It is done.  So be it. The […]

Categories
Atrial fibrillation Dabigatran/Rivaroxaban/Apixaban Health Care

Dabigatran: Finally a substitute for the dreaded coumadin is close…

Much energy in previous posts have centered on the ablation of heart rhythm disturbances.  Navigating a GPS guided catheter through the beating heart, triangulating the source of the ectopic impulse, and then delivering a cautery-like RF lesion is fun to do, gratifying to all involved, and makes for decent writing topics. However cool ablation is […]

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Doctoring Knowledge Reflection

Inspiration to doctor, from a dear friend passed…

Nearly eight weeks have passed since young Vincent Nold suddenly left us.  His passage from life on Earth was as tragic as can be imagined.  The grief invaded the biology of our existence bringing a palpable tension to our hearts.  Such sadness was previously unknown to me. Staci and I coached Vincent in running, and […]

Categories
AF ablation Atrial fibrillation General Ablation

Freezing in AF ablation: not so fast you all…

Freezing the heart is in the news.  The STOP-AF trial was presented at ACC, and it sure has generated much excitement about atrial fibrillation ablation.  This is a good thing. However, as is the norm in the era of instantaneous news, the press reports read much differently than reality. The propaganda has an effect. I […]