AF ablation Athletic heart Atrial fibrillation Dabigatran/Rivaroxaban/Apixaban General Cardiology General Medicine

New post on Medscape/Cardiology: My take of the 2014 Atrial Fibrillation treatment guidelines

Atrial fibrillation affects millions of patients, and its incidence and prevalence are on the rise. It’s a peculiar disease in that it affects people so differently. When populations are studied, AF associates with higher rates of stroke, heart failure and death. But patients aren’t populations. In recent years, the treatment options for this pesky disease […]

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New post up on Medscape/Cardiology: Ablation versus medicine as an intitial strategy for treating AF

Earlier this month I promised to put together teaching points from the Rich Peverley story. His was an interesting case of  sudden collapse that likely occurred as a result of atrial fibrillation therapy rather than atrial fibrillation itself. This was my original report: Important lessons from the collapse of NHL player Rich Peverley (BTW: It […]

AF ablation Athletic heart Atrial fibrillation

How successful is AF ablation?

Let’s talk about success. At first glance, knowing whether a medical or surgical intervention achieves success seems quite simple. An antibiotic clears an infection–or it does not. A surgery removes a tumor with clean margins–or it does not. An angioplasty and stent open an artery during a heart attack–or it does not. In the case […]

AF ablation Athletic heart Atrial fibrillation

Atrial fibrillation features prominently in Rich Peverley collapse

Professional hockey player Rich Peverley gave a news conference today in which he and his medical team announced surprising details about his heart condition. We learned that atrial fibrillation and its treatment featured prominently in his collapse during a game earlier this week. “A flare-up last week led Peverley to skip a road game, and […]

Athletic heart Healthy Living ICD/Pacemaker

Important lessons from the collapse of NHL player Rich Peverley

Last night my Twitter stream lit up with the news that NHL player Rich Peverley collapsed from a heart arrhythmia. Fortunately, he was successfully treated, and is reported to be in good condition. Here is a link to the best story I could find. It sounds awfully significant. [Dr.] Salazar said of the treatment, “We […]

Athletic heart Cycling Stuff Healthy Living

100 is the new 80…If you are good to yourself (and lucky)

“There has been a change in your prescription,” said the eye doctor, a wise and bald man, who could have been mistaken for an economics professor at Princeton. “It’s improved?” the 30 year-old cardiologist asked. Better, improved, always the reflex for athletic cardiologists. “Doctor…you have been to the pinnacle and passed it. Your eyes, like […]

Athletic heart Atrial fibrillation Cycling Stuff ICD/Pacemaker Reflection Social Media/Writing/Blogging

Day 3 ESC2013 — Longevity of Tour de France cyclists, meeting old friends, social media, and big plans.

A general rule about writing a story is to lead with the important stuff. I’ve reviewed each of my ESC2013 updates, and as it turns out, each day I have led with the folly. Sorry about that. I’m going to continue the trend. If you had a blog, you could do this too. Before I’m […]

Athletic heart Atrial fibrillation General Ablation General Cardiology Healthy Living inflammation Uncategorized

Heart disease 101: AF and Coronary Artery Disease — related, incidental or both?

There were many good questions raised on my last post. Thanks. One particularly relevant theme concerned the relationship of atrial fibrillation (AF) and coronary artery disease (CAD). There’s a great deal of misunderstanding out there on how these two common disease relate to each other. I thought a few paragraphs might be useful. On the […]

Athletic heart General Cardiology Health Care Healthy Living inflammation

The George W Bush stent case: An incredible teaching opportunity on the basics of heart disease

The wrist artery hardly had time to seal. (Surely it was a radial.) The controversy came that fast. The drumbeat of naysayers seemed to start only minutes after a prideful press release announced that George W Bush had undergone successful cardiac stent placement. The ever-quotable cardiologist from Cleveland Clinic, Dr. Steven Nissen, said, “This is […]

AF ablation Athletic heart

EuroPace 2013 Day 1 — New Post up at

Hey all, I am in Athens Greece covering the European Heart Rhythm Association meeting. It’s called EuroPace 2013. I am here alone, the sole representative of My first post is up over at It concerns the release of a new website for patients with atrial fibrillation called Truth be told, I came […]

Athletic heart General Cardiology General Medicine

Benign PVCs: A heart rhythm doctor’s approach.

Here is an edited email I received from an athletic colleague: John, Quick question…. A 50 year-old male healthy athlete has the new problem of occasional periods of premature beats. He (or she, it doesn’t matter) has visited the doctor and an ECG shows PVCs, or premature ventricular contractions. Otherwise the history, exam, ECG, ECHO […]