I have been seeing a new trend in the AF clinic. I never thought this would happen, but I’d estimate that at least once daily, often multiple times daily, a patient says they have read this blog before the visit. That is nice. Many of these patients, some who have traveled across the country, or […]
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I do AF ablation. But, similar to my 2015 update, I continue to do fewer of these procedures. What is new in 2016 is more confidence that this is the right approach. My technique for ablating AF has not changed. I do pulmonary vein isolation (PVI) with point-to-point RF. Each burn takes 10-30 seconds, and […]
The news this morning is sobering. Poor, white, middle-aged American men are dying at increasing rates. The report, published in a prestigious medical journal by a recent Nobel Prize winner, has shocked the public health community. It should shock you. NPR covered the story. So did the NY Times. Twitter is abuzz with the news. […]
I wrote yesterday about how a broken healthcare system favors overuse of procedures. Today I will discuss rational care. Remember the goals of the Lown Institute: We think healthcare should be affordable, effective, rational and available to all. Rational means in accordance with reason or logic. Hardly a day goes by that I don’t see […]
It’s time to write an update on AF ablation. Things have changed. The major change is that I am doing many fewer ablations for AF. The reason is we have a better understanding of the disease, or should I say, condition? In the last 2-3 years, good science has changed the way specialists see AF. […]
Premature ventricular complexes (PVCs) remain a common and vexing problem in cardiology. PVCs deserve attention because they often induce fear in both patient and doctor. In US healthcare, fear is bad. Fear sets the stage for over-treatment. The approach to the funny-looking beats has not changed much in the last two decades. That may be […]
Regular exercise is essential for health. I’ve taken to prescribing daily exercise as a drug. I’ve even written it on a prescription pad for effect. I see exercise as medicine, a safe medicine, an effective medicine. That means, like all drugs, exercise can be overdosed. The challenge is knowing the upper limit. How much is […]
I am in San Diego to participate in the Lown Institute Road to Right Care: Engage, Organize, Transform conference. It is an honor to be included in a conference that has “right care” in its title. Tomorrow, Dr. David Martin (Lahey Clinic) and I will co-present a case-based session on the overuse and misuse of […]
Is good health really all that digital? I am not so sure. I am a skeptic. I realize this is a risky thing to say these days. It’s hard to bet against Apple. And It was only seconds after Tweeting such doubt that John Nosta, an expert in digital health technology, tweeted back: @drjohnm Health […]
When the editors at Medscape asked me to put together an essay on the Top 10 stories in cardiology in 2014, I thought it would be an easy project. I was wrong. It turns out there was a lot to say about the happenings in cardiology this year.  In the end, the final essay had 37 references–a […]
The election I am going to watch today is in San Francisco. On the ballot there is Proposition E, an initiative to add a 2-cent tax for every once of sugary beverage. Choose Health SF, a group supporting the tax, estimates it would raise $54 million, which would go towards, get this: “funding active recreation […]