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Atrial fibrillation General Cardiology

The Case Against Watchman

Many readers have asked me to update my feelings about Watchman and other percutaneous appendage closure procedures. The short answer is that I remain unconvinced that this is a beneficial procedure. New data has been sparse and unconvincing. I’ve recently started a newsletter on Substack. It’s called Stop and Think. In the latest post, I […]

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Doctoring General Ablation General Cardiology Knowledge

No, Young Adults Should Not Live in Fear from Coronavirus

What follows is an OpEd that I co-authored with Andrew Foy, MD, from Penn State University. Andrew is an academic cardiologist who studies the quality of scientific evidence. Two outlets have declined to publish our piece. This is not surprising given that we critique a research letter written by prominent academic leaders. As you read […]

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Doctoring General Cardiology Knowledge

New column and podcast up:

Last week, I wrote a column on one of the most controversial clinical trials in cardiology. The EXCEL trial pitted stents vs bypass surgery for people who have left main coronary artery disease. The trial has been beset with controversy. The three areas of debate surround the definition of MI (or heart attack), the increased […]

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Doctoring General Cardiology General Medicine Knowledge

Lecture on Scientific Bias in Cardiology

Last month I gave a lecture in Brazil (via my house in Kentucky) on scientific bias in cardiology. It’s about 20 minutes. Dr Bob Kaplan from Stanford also spoke on issues relating to how FDA approves drugs–a timely topic. Many of you know that I espouse a medically conservative approach to medical practice. My lecture […]

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Doctoring General Cardiology General Medicine Knowledge

The Debacle of Hydroxychloroquine and Azithromycin for COVID19

I discussed the use of hydroxychloroquine and azithromycin for patients with COVID19 on my March 27th edition of This Week in Cardiology Podcast. This is an important topic not only because of the specifics of treating patients but also vital because it shows how easily human beings can be misled. Here is a an edited […]

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Doctoring General Cardiology General Medicine Knowledge

Change and the Case for Being a Medical Conservative:

When my favorite podcaster, the economist Tyler Cowan, asked Dr. Ezekiel Emanuel what nonobvious advice he would give to medical students today, the answer surprised me. The famous bioethicist said:  I do think that this is probably the most exciting time in American medicine in a century, since really about 1910, 1920. And it causes a […]

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AF ablation Atrial fibrillation General Cardiology General Medicine

Still Negative on Watchman

Many readers have contacted me to ask whether my negative viewson left atrial appendage occlusion with Watchman have changed since 2017.   The short answer is no. My views are even more negative today.  In 2016, I published an editorial on theHeart.org | Medscape Cardiology arguing that this procedure should stop. One of the rebuttals was that […]

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AF ablation Atrial fibrillation General Cardiology General Medicine

AF, Ablation, Stents and Five Nuances

Joan has left an excellent comment on my recent 2019 AF ablation update. She brings up many important issues. Let’s dissect it. Q: Joan asks if it is common to see patients who think they are cured after AF ablation but are still in AF?  A: The scenario I described in my previous post is […]

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AF ablation Atrial fibrillation General Cardiology General Medicine

AF Ablation Update 2019

Most years I write an update on any big developments in AF ablation. This year’s version will be a short one. I have little new to report. But it’s worth reviewing some basic issues. We still do not know the cause of atrial fibrillation (AF). That makes it hard to fix with ablation. Knowledge Deficits: […]

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General Cardiology General Medicine Health Care Health Care Reform Reflection

Missing an Obvious Cause of Medical Overuse

This post introduces my latest column over at Medscape. I hope you go read the full piece.  Medical overuse bothers me. Consuming medical care that does not improve outcomes makes you poorer, and puts you at risk for being harmed.  I think a lot about why Americans consume more healthcare than our peers in other […]

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Atrial fibrillation Doctoring General Cardiology General Medicine Health Care

Thoughts on the Apple Watch

Apple products are cool. I love them. But (even) Apple will struggle delivering health. Making healthy people healthier is fraught with problems. At the core of this issue are the many snags of screening people for disease. Here are 600 words I wrote for Medium: I’m a Heart Doctor. Here’s Why I’m Wary of the New […]