New post on Medscape/Cardiology: My take of the 2014 Atrial Fibrillation treatment guidelines

Atrial fibrillation affects millions of patients, and its incidence and prevalence are on the rise. It’s a peculiar disease in that it affects people so differently. When populations are studied, AF associates with higher rates of stroke, heart failure and death. But patients aren’t populations. In recent years, the treatment options for this pesky disease […]

A follow-up on the LifeVest…and decision quality

One of the most controversial posts I have ever written concerned Zoll corporation’s wearable cardiac defibrillator, which they have smartly branded the LifeVest. Here is the link to the 2013 post: LifeVest: A Precarious and Unproven Bridge . . . to Somewhere The less-than-glowing assessment brought me a great deal of criticism, both publicly and […]

Dronedarone (Multaq), clinical guidelines and patient safety

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(What follows is a brief introduction for a post I wrote over at Medscape/Cardiology. The link is at the bottom of the page.)  It is appropriate to worry about medical errors and patient safety. Here the low-hanging fruit is plentiful: antibiotic stewardship, automated notification of drug interactions and attention to hand washing all join a […]

NSAIDs — Yet another dubious “health” product at CVS

Now that the ‘healthiness’ of products sold at CVS stores is a matter of public discourse, it seems a perfect time to mention the common pain relievers known as Non-Steroidal Anti-inflammatory Drugs (NSAIDs). It just so happens that two FDA advisory committees are meeting today and tomorrow to discuss the cardiovascular risks of NSAIDs. The […]

New post up on Cardiology Medscape: Lessons learned from the failure of Renal denervation for high blood pressure

Most people come by it honestly. They eat too much, move too little, skimp on sleep, take on too much stress and then succumb to buying larger clothes. The word we use in medicine is insidious. High blood pressure (hypertension – HTN) is one of the leading cardiovascular problems of this time. Some have called […]

2013: Year-end summary of top cardiology stories

When the editors of Medscape asked me to write a Top Ten article on the best Cardiology stories in 2013, I jumped at the chance. I spent a lot of time thinking about Cardiology this year. I was invested. Plus, 2013 was a year for pivoting–big time pivoting. What made news in 2013 was not […]

New post up over at The Atlantic — Improving US healthcare by looking at strategies from India

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Some things are hard to see until one leaves his or her normal surroundings. For American doctors, especially procedure-based doctors, it’s easy to get used to the wastefulness and largesse of delivering care.  Then you travel. You go to another healthcare system and are left to gasp. An AF ablation ‘costs’ 100,000 in the US, […]

First ever invited commentary in a medical journal — JAMA-IM

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I’m going to be proud for a moment. Yesterday, the journal JAMA-Internal Medicine published an invited commentary that I co-wrote with Dr. Dan Matlock (@Dan_Matlock) from the University of Colorado. The title of the piece is The Antidote for Unprepared Patients — A Caring Clinician. It’s available for free. Invited editorials in medical journals are often […]

Recap of 2013 American Heart Association Session

Just a few weeks before the 2013 American Heart Association Sessions, Shelley Wood, the managing news editor of theheart.org emailed to ask if I was up for going to the meeting. With trips to San Francisco, Denver, Athens and Amsterdam already in the books this year, I had counted 2013 as a win. I was […]

New post up over at TheHeart.org-Medscape Cardiology — Part 2 of Progress in Cardiology

Part one of Progress in Cardiology was a sober look at the current lull in innovation. In part 2, as promised, I tell you what is right and optimistic about my field. There is a lot. The post touches on the return of the basics. Basics in doctoring and basics in therapeutics are huge new […]

New post up on theHeart.org/Medscape Cardiology…Where is the progress in Cardiology?

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On the way home from the American College of Cardiology meeting this spring, I wrote a post about the lack of real progress in Cardiology. I got to thinking: Here I was attending major meetings all over the world, and few, if any, studies struck me as game-changers. Everything seemed so painfully incremental. So many […]