I remain concerned about the irrational exuberance among some of my colleagues toward left atrial appendage occlusion devices for the prevention of stroke in patients with atrial fibrillation. In short, these devices are plugs that doctors place into the left atrial appendage. The idea is to stop clots from forming or escaping from the left […]
2017 European Heart Rhythm Meeting Update
I attended the European Heart Rhythm Association meeting last week in Vienna. Here is an update on the stories I found most interesting–the ones I wrote about on the heart.org | Medscape Cardiology. Brain Lesions after AF ablation: Electrophysiologists do not talk much about the small brain lesions that appear after procedures in the left […]
How important are short AF episodes?
A study presented at the recent Heart Rhythm Society meeting in Chicago has added more uncertainty about the significance of short-duration AF episodes. Before I tell you about the study, I need to clarify what I mean by short-duration AF episodes, sometimes called subclinical AF (SCAF). SCAF is AF on a monitor that is often […]
New Policy on Comments
I am changing my policy on comments. In the past, if you had one approved comment then all of your subsequent comments would post without moderation. I changed that. Now I will moderate all comments. That means there may be a delay. Another change is that I am not going to allow personal medical anecdotes. […]
Beta-blockers, Statins, AF, and the Nocebo Effect
Our brains can easily fool us. No experienced doctor would deny the power of the placebo effect. Today I want to discuss the nocebo effect, which occurs when negative expectations of something causes it to have a more negative effect than it otherwise would. Drugs can exert a strong nocebo effect. If your brain thinks […]
Statins, Like All Medicines, Are Neither Good Nor Bad
We have to talk about drugs. No, not illicit drugs, but medications used by doctors and patients. Plaintiff attorneys run ads on TV that fool people into thinking certain meds are bad. The current one I deal with is the clot-blocking drug rivaroxaban (Xarelto.) Before that, it was dabigatran (Pradaxa). If, or when, the makers […]
Should You Take an Anticoagulant for AF? — Applying the 4 questions
Yesterday I posted the four most important questions to ask your doctor. Let’s apply those questions to a typical scenario: Whether or not to take an anticoagulant drug for prevention of stroke in the presence of AF. We need a typical patient. For this example we will pick a typical CHADS-VASC 2 patient. 65 year-old […]
Four Crucial Questions To Ask Your Doctor
I am seeing an increasing number of patients who did not know they had a choice about taking a medicine or having a procedure. Why did you have that heart cath? A: My doctor said I should. Why are you on that medicine? A: My doctor prescribed it. It’s time we re-review the basic four […]
Fake Atrial Fibrillation — A Growing Patient-Safety Issue
Fake atrial fibrillation (AF) is a growing problem. This is when the computer-reading on an ECG calls the rhythm AF, but it is not AF. When the doctor does not recognize the faulty read, the patient is misdiagnosed. Here are three pictures from the last month. (I have a stack of these.) Notice the computer-read […]
Top-ten 2017 Update on Atrial Fibrillation News
I recently served on the faculty of the tenth annual Western AF Symposium in Park City, Utah. Dr. Nassir Marrouche of the University of Utah has grown Western AF into a huge gathering of global experts in atrial fibrillation. During the intense two-day meeting, I took notes and put together a post of top-ten highlights. […]
My latest on the NOAC drugs for AFib
Three weeks ago I wrote about the growing dominance of the new oral anticoagulant (NOAC) drugs for stroke prevention in patients with atrial fibrillation. (Another common name for these drugs is direct acting oral anticoagulants or DOACs.) The post generated many comments–some privately and some on the blog. Your responses induced me to think a […]
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