Thoughts on the Apple Watch and Mobile ECG

Last week I wrote a column on theheart.org | Medscape Cardiology on the new Apple Watch ECG and Kardia Band. The Tweet I sent out on Saturday has done well — 74 Retweets (without any robots) is pretty good. The Apple Watch ECG — The good, the challenges, and the really scary. My thoughts on… Continue reading Thoughts on the Apple Watch and Mobile ECG

Left Atrial Appendage Closure Does Not Prevent Strokes

Our cautionary left atrial appendage occlusion (Watchman) editorial is now published in a prominent medical journal, called Heart Rhythm. My co-authors are Drs. Andrew Foy and Gerald Naccarelli from Penn State. It was a peer-reviewed version of my previous theheart.org | Medscape Cardiology column. Watchman and other similar devices are plugs that occlude the left atrial… Continue reading Left Atrial Appendage Closure Does Not Prevent Strokes

New Data Increase Caution on Left Atrial Appendage Occlusion

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… Continue reading New Data Increase Caution on Left Atrial Appendage Occlusion

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… Continue reading How important are short AF episodes?

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… Continue reading Statins, Like All Medicines, Are Neither Good Nor Bad

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… Continue reading Should You Take an Anticoagulant for AF? — Applying the 4 questions

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.… Continue reading Top-ten 2017 Update on Atrial Fibrillation News

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… Continue reading My latest on the NOAC drugs for AFib

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

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… Continue reading Say No to Watchman

Big Questions with Xarelto Study

The purpose of this post is to introduce my most recent column over at theHeart.org | Medscape Cardiology in which I address recent concerns about the drug rivaroxaban (Xarelto). — In 2014, Rivaroxaban (Xarelto) was the most prescribed new oral anticoagulant (NOAC). Millions of patients have atrial fibrillation, so it’s fair to call it a… Continue reading Big Questions with Xarelto Study