Cardiology and stewardship — New post up at Medscape|Cardiology

One of the definitions of the noun steward is a person whose responsibility it is to take care of something. Wikipedia calls stewardship an “ethic that embodies the responsible planning and management of resources.” These apply well to cardiologists–who use powerful (and expensive) tools in the care of fellow humankind. The internal cardiac defibrillator, or […]

Important lessons from the collapse of NHL player Rich Peverley

Image from Wikipedia

Last night my Twitter stream lit up with the news that NHL player Rich Peverley collapsed from a heart arrhythmia. Fortunately, he was successfully treated, and is reported to be in good condition. Here is a link to the best story I could find. It sounds awfully significant. [Dr.] Salazar said of the treatment, “We […]

New post up at Medscape/Cardiology — Heart Rhythm Society’s Choosing Wisely List is tentative and cursory

The Choosing Wisely campaign began in 2009 when the American Board of Internal Medicine (ABIM) Foundation invited medical societies to own their role as “stewards of finite healthcare resources.”  The movement aims to promote care that is supported by evidence, not duplicative, free from harm and truly necessary. That sounds delightful, and I wrote enthusiastically […]

ICD and Pacemaker deactivation: It is neither physician-assisted suicide nor euthanasia

The purpose of this post is to clarify important issues about cardiac devices as they relate to deactivation. As I wrote yesterday, Paula Span of the NY Times covered this important issue earlier this week. Her coverage came about because of this Mayo Clinic paper published in JAMA-IM, which showed most patients with cardiac devices […]

ICD deactivation in the NY Times — with a quote from a blogger

The news came via a direct message on Twitter. “You got a plug in the NY times. Congrats.” (Thanks Dr. Jay Schloss.) Paula Span, author of the NY Times’ The New Old Age Blog, reported today on the issue of cardiac device deactivation in patients who are approaching end of life. The role I had […]

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

Screen Shot 2013-11-26 at 5.00.46 AM

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 […]

End of life care – A great American tragedy.

“Why don’t we die the way we say we want to die? In part because we say we want good deaths but act as if we won’t die at all.” Katy Butler, WSJ There is a humanitarian crisis unfolding right now in nearly every hospital in this nation. Aggressive life-prolonging care of the elderly too […]

Day 4 ESC 2013 — Female gender and AF, patient selection for CRT and a Dutch cycling adventure

On the last day of ESC2013 I attended a press conference entitled Update in Rhythmology. The purpose was to highlight four rhythm-related studies released at ESC2103. The most noteworthy of the four abstracts involved gender-related issues in atrial fibrillation therapy. French researchers used a 1.6 million patient database (including 1200 French GPs) to come up […]

Day 3 ESC2013 — Longevity of Tour de France cyclists, meeting old friends, social media, and big plans.

Two EP docs from across the world.

A general rule about writing a story is to lead with the important stuff. I’ve reviewed each of my ESC2013 updates, and as it turns out, each day I have led with the folly. Sorry about that. I’m going to continue the trend. If you had a blog, you could do this too. Before I’m […]

Day 1 ESC — Cardiac Pacing, MRIs and RV lead position

IMG_3286

I thought I loved Germany, but this is ridiculous. I love Amsterdam! Yesterday, Michael O’Riordan and I decided to embrace the Dutch mode of transportation. Mike is a real journalist who works for theHeart.org. He’s also a fellow endurance athlete. We got off the congested tram yesterday and decided to rent bikes. This, my friends, […]