New post up on Medscape/Cardiology: Ablation versus medicine as an intitial strategy for treating AF

Earlier this month I promised to put together teaching points from the Rich Peverley story. His was an interesting case of  sudden collapse that likely occurred as a result of atrial fibrillation therapy rather than atrial fibrillation itself. This was my original report: Important lessons from the collapse of NHL player Rich Peverley (BTW: It […]

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 […]

Prolonged exercise leads to heart damage — pro/con debate

Dr. Larry Creswell, of the Athlete’s heart blog, just posted an interesting debate from the Journal of Physiology. The question of whether longterm endurance exercise leads to heart damage is a hotly contested issue in cardiology. For those who are curious about this intriguing topic, his links lead to very readable prose. Larry suggests paying […]

Day 2 ESC — AF ablation and more bike commuting


Okay, I’m getting the hang of this. The Monday morning and evening commute in Amsterdam is something special. You talk about focus. It requires laser-like focus. You’ve got bikes, narrow lanes, buses, trams, pedestrians and tourists. Still though, traveling 6k by bike took 15 minutes; a cab from the convention center, more than 30. I […]

The most important verb in our health crisis

There was great commentary on my last post. Thank you all. I learned a lot from your words. This is how it’s supposed to work here. One comment in particular has stuck with me. It concerned the formation of a how-to be-healthy booklet. An information manual, if you will. I’ve thought about this many times […]

The state of US health: The truth stings

It’s going to be hard to anesthetize this one with compassion. I’m sorry, but the report card on US health is not good. We aren’t heading in the right direction, and everyone involved knows that it’s because of a failure to accept the truth. You have probably already heard the news concerning the state of […]

Day 2 EuroPace 2013 — Two new posts up over at

Google image from

It must be the time change. Sound sleep is eluding me. The good news about waking at 0330 is you can get serious work done. The bad news is doing the (involuntary) nod during a nice lecture on molecular biologic causes of atrial fibrillation this afternoon. I really did want to get that whole intracellular […]

Think twice before getting an injection for low back pain or sciatica

It’s been a while since I did a Cycling Wednesday topic. As I was skimming thorough the Journal of the American Medical Association last night, I came across this review article on spinal injection therapy for low back pain. It was a shocker. Two factors brought my attention to the article: First, almost all the […]

Long-term endurance increases the risk of arrhythmia — New post up on

The idea that long-term endurance exercise increases the risk of arrhythmia should no longer be considered counterintuitive. The list of published studies confirming this association is long, and this week, it got a little longer. In a study published in the European Heart Journal, researchers from Sweden report a cohort study of more than 52 […]

Do doctors know how to treat high blood pressure and high cholesterol?

Blood pressure and cholesterol problems affect millions. These are the bread, butter and sugary drinks of Internal Medicine and general Cardiology practice. It stands to reason then, that the treatment of these basic maladies would be well agreed upon. Guidelines and expert consensus statements would be clear and up-to-date. But this is far from reality. […]