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 […]

A Common Error in the Treatment of Atrial Fibrillation

We have got to get back to AF. I enjoyed some fun text messages today–from a really smart primary care doctor out yonder, in the hinterlands of Kentucky. We text and exchange quick pics a lot. Call it iTeleMedicine. PCP: “I have a patient on [AF-drug X] (guess) who has diarrhea.” Me: “Stop the drug…It’s […]

Multaq (and me) in the WSJ

How should one feel about being quoted in the Wall Street Journal? Nervous. That’s how. This morning’s piece, written by award-winning medical journalist, Tom Burton centered around new reviews of the heart rythm drug, Multaq. Louisville cardiologist John Mandrola said, “I’m surprised that the drug has persisted. I don’t know any of my colleagues who […]

Get back in rhythm: just not with Multaq


Did you know September is AFib awareness month? As a believer in education as the first, and best treatment of AF, I think it’s great to enhance the public knowledge of this highly-misunderstood disease. By all means… Tell people about AF’s risks: stroke and heart failure. Tell them that their fatigue, poor exercise tolerance and […]

An update on Atrial Fibrillation: Notes from HRS 2011

Earlier this month, heart rhythm professionals from all over the world met in San Francisco. I found the 2011 version of the Heart Rhythm Society meeting an incredible learning experience–a buffet of knowledge on all matters electric. Here’s a book report of sorts on a few atrial fibrillation (AF) related issues: From above the trees, […]

In defense of Multaq…not really

It will not last forever, nothing ever does. Some day I will have to find another big-pharma punching bag. It’s true; our pal dronedarone (Multaq) is back in the news again. This time the Multaq news (as reported on Cardiobrief and Pharmalot) is not about its inefficacy or Sanofi-sponsored professors, but rather concerns about it’s […]

Big pharma knows your private health matters

He was here for routine follow-up. He has atrial fibrillation. He is, and has been well controlled on generic, well-tolerated anti-arrhythmic medicine for years.  “I feel great, Doc” He is happy, as am I. But he was confused.  Why hadn’t he been switched to the “new” AF medicine. Hmm. Uh-oh.  Here we go again. He […]

See everything…

Do you see anything wrong with this picture? (Hint: right column) It is certainly true that atrial fibrillation management guidelines needed an update; the last comprehensive update was in 2006.  Much has changed in AF therapy, including the expanded role of catheter ablation and the soon-to-be warfarin substitutes. I guess the European electrophysiologists couldn’t wait […]

A real world view of new developments in the treatment of atrial fibrillation…

The patient is anxiously sitting on the exam table.  A notebook, a pencil and many papers from the internet and other doctors are close at hand.  A spouse sits in the accompanying chair with an equally anxious face that says without words, “please help us out here.” The problem at hand is atrial fibrillation.  Paroxysms […]