There’s very little in Cardiology that isn’t rapidly changing these days.
Treating AF exemplifies this trend. At least my approach to AF has evolved steeply over the past year. Amazingly so, really.
I choose blood-thinners in a different way. Call it a more European perspective.
My threshold to discuss and recommend AF ablation is far lower.
My approach to burning AF moves steadily toward a minimalist approach. You can always burn more, but you can’t take a burn back.
And, as non-medical treatments like catheter ablation become easier (for both me and the patient), safer and perhaps more effective, my views on using rhythm drugs has also changed.
I plan to write about these “evolutions,” if you will, but here’s the thing: it’s hard.
The post on how I’ve changed my views on recommending a blood-thinner has undergone multiple revisions. You just can’t tap out a post on changing trends for preventing stroke in AF without getting the facts down accurately. There’s a lot details.
P.S. One notion–about heart disease in general, and AF in particular–that hasn’t changed: preventing the disease easily trumps any new therapy. You could even call this principle something smart-sounding, like axiomatic.