(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 […]
The Truth on Cancer Screening
This week is Cancer Screen Week. It’s a one-sided campaign sponsored by industry and the American Cancer Society that urges people to get screened. The truth is that the scientific evidence for cancer screening is not convincing. What’s more, screening comes with potential harms. I know; it’s counter-intuitive, but it’s what the evidence says. Benjamin […]
Not Challenging Science is Anti-Science
Freedom of speech is in the news. Intolerance of ideas isn’t just affecting our colleges and universities. I think illiberalism has spread to health and medicine. For many reasons, scientists and clinicians alike have grown weary of debate. This is bad. The philosopher Karl Popper said science advances through falsification. Without the challenge of ideas, […]
On a quest to understand medical evidence …
One of the biggest challenges in medicine and science is understanding correlation and causation. Medicine has become increasingly evidence-based. But what does the evidence really say? Is a study signal or noise? Does enough correlation mean causation (e.g. smoking causes cancer)? How much hope can we put on big data? In the last few years, […]
A Corrosive Force in Medical Care
It comes in a large white envelope each month. It’s marked confidential. When I hold it up to the light, I can see through the envelope. I can’t see the details, but the colored graphs give it away. It’s my monthly productivity report. Most employed doctors get these graphs. These “dashboards” of value include your […]
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