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Athletic heart Atrial fibrillation Cycling Stuff inflammation

A cautionary note to my endurance athletic brethren…

Exercise is good for you. It forms one of the triads of health: good nutrition, good movement, and good sleep. However, like in life, too much of anything is counterproductive, even destructive.   I have long struggled to explain the steady stream of hyper-fit, uber-athletic endurance athletes who see me for arrhythmias.  A membership in […]

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Atrial fibrillation Knowledge

Conflicts of interests in medical information…

From the drug rep of the huge pharmaceutical company promoting a new anti-arrhythmic drug:  “Dr Mandrola, you are a leader in the area so we would like you to be on our speakers bureau.  Of course, you are reimbursed for your time” “Really?”  Maybe they know about my blog, I wonder. “Sure, we can send […]

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Atrial fibrillation Dabigatran/Rivaroxaban/Apixaban Health Care

Dabigatran: Finally a substitute for the dreaded coumadin is close…

Much energy in previous posts have centered on the ablation of heart rhythm disturbances.  Navigating a GPS guided catheter through the beating heart, triangulating the source of the ectopic impulse, and then delivering a cautery-like RF lesion is fun to do, gratifying to all involved, and makes for decent writing topics. However cool ablation is […]

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AF ablation Atrial fibrillation General Ablation

Freezing in AF ablation: not so fast you all…

Freezing the heart is in the news.  The STOP-AF trial was presented at ACC, and it sure has generated much excitement about atrial fibrillation ablation.  This is a good thing. However, as is the norm in the era of instantaneous news, the press reports read much differently than reality. The propaganda has an effect. I […]

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Atrial fibrillation Health Care Health Care Reform

How does one treat Atrial Fibrillation in the unmotivated and uninsured?

Gosh, atrial fibrillation can be hard to treat. He lay in the ER bed with a light sweat, and an obvious discomfort from the rapid heart rate and high blood pressure.  He is my age.  The belly protrudes from a too small XL tee shirt, there is week old facial hair, and he looks up […]

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AF ablation Atrial fibrillation General Ablation

In atrial fibrillation therapy, not all the hype is true…

Atrial fibrillation therapy continues to grow in complexity.  Thus far, an easy cure has remained elusive.  The potential of discovering an easy cure of AF –and the resultant immense profits –has provided fertile soil for medical device companies.  But, like in a garden, fertile soil provides for the growth of both beautiful plants and weeds. […]

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AF ablation Atrial fibrillation General Ablation

The challenge of ablating in the human heart…

Some very sad words from the comments section of a previous post on atrial fibrillation… Anonymous said,   Is there anyone out there that has hypertrophic cardiomyopathy and was told to have an ablation? Any problems??? My husband of 45years and I believed that his cardio doctor would not put him in harms way by […]

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AF ablation Atrial fibrillation General Ablation

Atrial fibrillation ablation in women…Are there any real differences?

We all know that women have kinder hearts than do men. That’s an easy one. But what about their cardiac electrical system? The headline in the subject line of the email reads, AFib Ablation in Women: Are We Undertreating? I looked at this study a number of days ago, and initially thought–except for the number […]

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Atrial fibrillation General Medicine

Atrial fibrillation therapy and a disclaimer…

It has come to be evident -although seemingly obvious- writing words on medical matters for all to see requires a disclaimer. Medical information on the internet should serve an informational and supplemental role.  It should increase the knowledge base, provide a scaffolding of a particular problem and serve to enhance the interaction between the doctor […]

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Atrial fibrillation Reflection

Atrial fibrillation strikes an electrophysiologist…

Middle age introduces itself in many ways; one is atrial fibrillation.  Youth, vigor and a medically-problem free life was seemingly right there in the recent past.  A rhythm doctor often hears this suddenness of onset described as “Doc, yesterday, I was fine.”  As is always the case for a first episode of an arrhythmia, yesterday, […]

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AF ablation Atrial fibrillation General Ablation

Visitors to the EP lab: Inventors who aim to help us ablate Atrial Fibrillation…

One of the often sad facts of ablation in the private world of electrophysiology is the lack of “learners,” or visitors who call on our EP lab.  Heck, even Henry David enjoyed the occasional visitor to his cabin in the woods. When an inventor, patent holder and heart surgeon with his engineering wiz kid asked […]