Writing about lifestyle modification — and blaming the patient

I was pleased when the editors of the TheHeart.org reposted my recent essay, Let’s Stop the Unnecessary Treatment of Heart Disease. As of this morning, there are 167 comments. The majority of them were positive, and supportive of lifestyle promotion. Negative comments represented a small minority, but were notable in their vigor, and occasionally reached […]

Less is more in atrial fibrillation stroke prevention — please, drop the aspirin

Screen Shot 2014-09-30 at 7.07.47 AM

A recent study in the Journal of the American College of Cardiology shed more light on the commonly used drug combination of aspirin and a vitamin-K antagonist (such as warfarin).  It was a small registry study from one region of France but I believe it offered confirmatory evidence against this dangerous practice. Investigators followed patients […]

Review of the 2014 ESC Sessions in Barcelona

IMG_4207

Hey Everyone, It’s been a few days since I returned home from Spain. The jet leg has resolved and normal sleep patterns have returned. I’ve had time to review the entire ESC program book. What follows is a review of my work and some notes on the past week in Barcelona. The first thing to […]

Is this the most important cardiology study of the last decade?

Screen Shot 2014-08-27 at 6.03.14 AM

In recent years, progress in the field of cardiology has been painfully incremental. We have enjoyed small gains–a better ablation catheter and mapping system, a couple of new anti-platelet drugs, maybe better stents, and even the highly touted anticoagulant drugs are within 99% in efficacy and safety of warfarin. Major breakthroughs, though, are non-existent. (And […]

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 […]

Getting the dabigatran (Pradaxa) story right… Correcting four common mistakes.

This purpose of this post is to clarify misstatements made in a recent New York Times article about the anticoagulant drug dabigatran (Pradaxa). The piece had three major inaccuracies, plus one thought-error from a cardiology leader. I write these words because the most valuable tool in the treatment of AF is knowledge. Getting it right […]

Mexico congress recap — Is it selfish for doctors not to be on Social Media?

Screen Shot 2014-08-18 at 5.34.02 AM

When Dr Eduardo Hernandez Castillo (@CardioLeaks) asked me to come to Mexico to speak with a group of physicians about the power of social media, I paused. Should I go to Mexico? I have been traveling a lot; it was a long trip; I was just starting to get fit again, and the atrial fibrillation/anticoagulation […]

Two AF cases — and my changing view of AF

I receive many emails about AF. I don’t often answer them because it is bad practice to doctor without seeing the person. Recently, however, I received a note with more general questions. The sender suggested I could use the response as a blog post. The reason I am posting these two cases along with my […]

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 […]

Alcohol and the risk of atrial fibrillation — it’s different than you may think

Life overflows with choices. And consequences. You can choose to smoke and then not be surprised to die a difficult death from cancer. You can choose to eat more calories than you burn and then buy bigger belts. You can choose to “need” more stuff and then, surely, remain unfulfilled. The more we learn about […]