What follows is an OpEd that I co-authored with Andrew Foy, MD, from Penn State University. Andrew is an academic cardiologist who studies the quality of scientific evidence. Two outlets have declined to publish our piece. This is not surprising given that we critique a research letter written by prominent academic leaders. As you read […]
Category: General Ablation
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 […]
Hi all. TheHeart.org | Medscape Cardiology published my picks for the top stories of 2017. Here is the link:Â 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. […]
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 […]
I attended the European Heart Rhythm Association meeting last week in Vienna. Here is an update on the stories I found most interesting–the ones I wrote about on the heart.org | Medscape Cardiology. Brain Lesions after AF ablation:Â Electrophysiologists do not talk much about the small brain lesions that appear after procedures in the left […]
A colleague recently asked me if atrial fibrillation (AF) ablation was overused. Yes it is. AF ablation has become the wild west of electrophysiology. There is essentially no scrutiny of this invasive, expensive and risky procedure. I also include here the add-on “maze-like†procedures done during heart surgery for other conditions. I believe they too […]
This post is an introduction to commentary I made recently over at theHeart.org on Medscape. Gender features in the discussion, but there are lessons for men and women with AF. *** A large study from a group of Stanford researchers made three big observations on AF ablation: Women, compared with men, presented for first AF […]
I have been seeing a new trend in the AF clinic. I never thought this would happen, but I’d estimate that at least once daily, often multiple times daily, a patient says they have read this blog before the visit. That is nice. Many of these patients, some who have traveled across the country, or […]
Premature ventricular complexes (PVCs) remain a common and vexing problem in cardiology. PVCs deserve attention because they often induce fear in both patient and doctor. In US healthcare, fear is bad. Fear sets the stage for over-treatment. The approach to the funny-looking beats has not changed much in the last two decades. That may be […]
Hi all, I have been busy in the last few weeks. Here is an update of my happenings and posts. From March 8-11, I attended and presented at the third annual Lown Institute Conference in San Diego. I have never felt more at home in a conference than I did at the Lown conference. Take […]
Most people come by it honestly. They eat too much, move too little, skimp on sleep, take on too much stress and then succumb to buying larger clothes. The word we use in medicine is insidious. High blood pressure (hypertension – HTN) is one of the leading cardiovascular problems of this time. Some have called […]