I use Twitter a lot. Interacting with thoughtful people is fun and I am learning a bunch. I especially love learning from the stats people and the philosophers. But Twitter has downsides. The main one is that it’s ephemeral. You see something and think, gosh, that is great, but It’s hard to go back to find […]
Forgotten Concepts in Medical Practice
A reader asked an excellent question on my last post. Roy wondered if further research in elderly patients would identify a subset of patients that would benefit more from anti-coagulation. My answer is… not likely. The reasons involve three oft-forgotten concepts. See below. To Roy, I say it is unlikely that further research will address […]
How Hubris Impairs the Care of the Elderly
An elderly man with atrial fibrillation (AF) asks whether to continue taking a clot-blocking drug to prevent stroke. This is the gist of a case my colleague Dr Anish Koka recently posted on Twitter. It’s a great thread. Click here to get to the discussion. The first question Anish raised was whether you would keep […]
Musings on the CABANA trial — AF ablation vs Drugs
Last week at the Heart Rhythm Society meeting in Boston, Dr. Douglas Packer from the Mayo Clinic presented results of The Catheter Ablation versus Antiarrhythmic Drug Therapy for Atrial Fibrillation (CABANA) trial. I cannot remember a more consequential HRS (Heart Rhythm Society) meeting. Before and after the presentation, CABANA talk dominated conversations amongst colleagues. I wrote […]
Thoughts on CABANA — The biggest study in AF ablation in years
(The CABANA trial is slated for release in two days at the 2018 HRS Meeting. Here is a preview.) Technology has made modern life easier. This is good for lots of things, but not for avoiding atrial fibrillation (AF). As people in Western society grow older, heavier, less physically active, more distracted, and perhaps more […]
Take-home messages from Western AF 2018
The Western AF symposium may have had corporate sponsors, but it was no boondoggle. The sessions start at 0715 and go through 1830. Your head spins at the end of the conference. I learned a lot. Here are some fast-writing thoughts: New Energy Source for Ablation Electroporation looks to be a promising new energy source […]
Western AF Symposium 2018
Readers interested in atrial fibrillation should know that the world’s best AF meeting starts tomorrow Friday February 23 in Park City Utah. The Western AF symposium features more than 80 faculty from across the globe. These are the leaders in AF. It’s shocking how many stars come to this meeting. I’m honored to serve as […]
Flat-of-the-Curve Cardiology Practices
If you think about it, you can’t get much done. So you don’t think about it. You just shake your head and keep tapping on the computer; the next patient awaits. To avoid moral distress, to remain employed as a doctor, you don’t think about the high cost and waste of cardiac care. Dr. Andrew […]
CASTLE-AF (Ablation) Trial Delivers Benefits — Was I Critical Enough?
Doctors like me have performed AF ablation for more than a decade without knowing whether the major procedure improves outcomes. That sounds crazy but it’s true. Until now, the only evidence we had that doing all these burns or freezes in the heart helped people was that it made people feel better than they did […]
Recap of 2017 in Cardiology
Hi all. TheHeart.org | Medscape Cardiology published my picks for the top stories of 2017. Here is the link: Mandrola’s Top 10 Cardiology Stories of 2017 I called it the year of the medical reversal. Medical reversals occur when a superior study contradicts current practice. I love medical reversals. First, they make you think about history. […]
Thoughts on the Apple Watch and Mobile ECG
Last week I wrote a column on theheart.org | Medscape Cardiology on the new Apple Watch ECG and Kardia Band. The Tweet I sent out on Saturday has done well — 74 Retweets (without any robots) is pretty good. The Apple Watch ECG — The good, the challenges, and the really scary. My thoughts on […]
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