New post up on Trials and Fibrillations over at The changing role of AF medicines.

I cheated–a little. I promised to post on some of the ways I use rhythm-control medicines for AF.

I did indeed post about this topic–just not here.

As I wrote and edited and stewed about rhythm medicine for AF, it occurred to me that this would be a great topic to write about on Trials and Fibrillations over at Here’s why: Electrophysiologists alone cannot care for the 3 million Americans and 5 million Europeans with AF. The fact of the matter is that most patients with AF get treated by non-electrophysiologists.

This is surely presumptive, but perhaps my colleagues might find a review of how old-fashioned heart rhythm medicine might fit into the new and changed landscape of AF treatment? Perhaps you might find it helpful too?

In the 900-word piece I focused on five reasons why I recommend these potent and somewhat scary chemicals. (Remember, audience is mostly a medical one. There is some medical speak. Sorry for that.)

Here’s an excerpt:

As an exercise, put yourself in the shoes of a patient safety advocate assigned to study the use of rhythm-control meds for atrial fibrillation. The first thing an outside observer would notice is how poorly these drugs work—in less than half the cases. Then they’d cringe when reading about pro-arrhythmia. A partially effective drug that slows the heart rate so much that a permanent indwelling vascular device must be implanted; this is acceptable? Or worse: AF drugs can perpetuate truly dangerous tachycardia like 1:1 atrial flutter or torsade de pointes. And if inefficacy and dangerous pro-arrhythmia were not enough, there’s also the side effects: metallic taste, fatigue, dyspnea, blurred vision, balance problems and stomach upset, among so many others. Ouch. How did these drugs get approved? What will we think twenty years from now?

Hopefully you will head over to Trials and Fibrillations to read more.

The link again: The changing role of rhythm-control medicines for AF