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AF ablation Atrial fibrillation General Ablation General Medicine ICD/Pacemaker

2017 European Heart Rhythm Meeting Update

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:  Electrophysiologists do not talk much about the small brain lesions that appear after procedures in the left […]

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AF ablation Atrial fibrillation Doctoring General Medicine Healthy Living Knowledge

Four Crucial Questions To Ask Your Doctor

I am seeing an increasing number of patients who did not know they had a choice about taking a medicine or having a procedure. Why did you have that heart cath? A: My doctor said I should. Why are you on that medicine? A: My doctor prescribed it. It’s time we re-review the basic four […]

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AF ablation Doctoring General Ablation General Cardiology

AF Ablation is Overused in the US

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 […]

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

Top-ten 2017 Update on Atrial Fibrillation News

I recently served on the faculty of the tenth annual Western AF Symposium in Park City, Utah. Dr. Nassir Marrouche of the University of Utah has grown Western AF into a huge gathering of global experts in atrial fibrillation. During the intense two-day meeting, I took notes and put together a post of top-ten highlights. […]

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AF ablation Atrial fibrillation Dabigatran/Rivaroxaban/Apixaban General Cardiology

Say No to Watchman

Cardiology is on the brink of making a big mistake. We have embraced a new procedure called left atrial appendage occlusion. You may be seeing the ads for a device called Watchman. Like this one> The appendage-closure idea was a good one: during atrial fibrillation (AF), blood can pool in the left atrial appendage, and […]

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AF ablation Atrial fibrillation General Ablation Healthy Living

Are women with AF being under-treated with ablation?

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 […]

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AF ablation Atrial fibrillation Doctoring General Medicine Health Care

Should AF ablation require approval from a heart team?

A patient presents with atrial fibrillation (AF) and a rapid rate. He doesn’t know he is in AF; all he knows is that he is short of breath and weak. The doctors do the normal stuff. He is treated with drugs to slow the rate and undergoes cardioversion. During the hospital stay, he receives a […]

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AF ablation Atrial fibrillation Doctoring General Cardiology Health Care Knowledge

Is AF ablation a big placebo?

Turkish authors boldly raised this question in a recent editorial. They likened AF ablation to renal denervation, a procedure in which RF ablation in the kidneys was felt to reduce BP. Many studies showed kidney ablation markedly lowered BP. Then a trial was done with a sham control (people got part of the procedure but […]

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AF ablation Atrial fibrillation Doctoring

Big news in AF ablation from HRS 2016

I have recently returned from the 2016 Heart Rhythm Society Sessions in San Francisco. I wrote three articles for Medscape. I also did two podcasts from HRS. I will link these below. You need to sign up for Medscape (free) to read the essays and listen to the podcast. In the first article, I discussed […]

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AF ablation Atrial fibrillation Doctoring Health Care Health Care Reform Healthy Living

Wisdom…

…the quality of having experience, knowledge, and good judgment. I read today a collection of words that exude wisdom. I share it with you because the purpose of this blog is to do create value through education. Peggy Girshman was an award-winning health journalist. When ill with a life-limiting illness, she wrote her own eulogy. […]

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AF ablation Athletic heart General Ablation General Cardiology

AF ablation still has a role

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 […]