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AF ablation Atrial fibrillation Dabigatran/Rivaroxaban/Apixaban

Is dabigatran (Pradaxa) acceptable as a periprocedural anticoagulant for AF ablation?

The safety of AF ablation depends greatly on the adequacy of blood thinning. AF ablation is no cardioversion. The choices of blood thinning regimens include either warfarin or dabigatran (Pradaxa)–and soon perhaps rivaroxaban or apixaban.  The advantages of warfarin include the ability to confirm the level of thinness and its long-acting properties lessen after-procedure gaps […]

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Atrial fibrillation Dabigatran/Rivaroxaban/Apixaban

Is Pradaxa a bad drug?

It’s crazy out there in blood thinner land. The novel blood thinning drug for patients with atrial fibrillation, Dabigatran (Pradaxa) cannot get a break. It’s all over the TV: Pradaxa = Bad Drug. Look at this image: Today, on the prestigious heart news site, theHeart.org, an insignificant 113-patient study presented as a poster at a […]

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Atrial fibrillation Dabigatran/Rivaroxaban/Apixaban General Medicine

Great Discussion on (new and old) Oral Blood Thinners

You may have heard that the new blood thinner, rivaroxaban (Xarelto) made news at the recent ACC meeting in Chicago. The Einstein PE trial showed rivaroxaban equivalent to standard therapy (enoxaparin followed by warfarin) in the treatment of pulmonary embolism (blood-clot in lungs). When the researchers looked at net clinical benefit, a measure that gives […]

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Atrial fibrillation Dabigatran/Rivaroxaban/Apixaban

Pradaxa-related pill esophagitis–A new adverse effect?

It’s well known that the new blood thinner, dabigatran (Pradaxa) can cause stomach pain and reflux symptoms. It occurs in slightly more than one in ten patients who start the drug. Yesterday, I learned of another potential gastrointestinal adverse effect of the new drug. A GI colleague called me about a patient taking dabigatran (Pradaxa) […]

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Atrial fibrillation Dabigatran/Rivaroxaban/Apixaban

Pradaxa versus Xarelto: An e-mail exchange between a cardiologist and an ER doctor

My friend Bill is an ER doctor and a bike racer. He’s like me in that he has rediscovered the beauty of being a learner. His most recent area of inquiry is the blood clotting cascade and the use of reversal agents for the novel new blood thinners, (dabigatran, rivaroxaban and the soon to be […]

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Atrial fibrillation Dabigatran/Rivaroxaban/Apixaban

New post up on Trials and Fibrillation blog: Dabigatran, Rivaroxaban and Apixaban

For 57 years, doctors and patients have eagerly awaited an adequate substitute for the maligned blood thinner, warfarin. Now they are here. Boy are they ever. There has been oodles written about the new blood thinners, dabigatran (Pradaxa), rivaroxaban (Xarelto) and apixaban (soon to be Eliquis). As you might expect, thinning the blood with a […]

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AF ablation Atrial fibrillation Dabigatran/Rivaroxaban/Apixaban

What’s the best blood thinner for AF ablation?

Let’s get off cell biology and back to something I really know. Atrial fibrillation, AF ablation and blood thinners. There was an important study published today in the Journal of the American College of Cardiology concerning the use of the new blood thinner, dabigatran (Pradaxa), around the time of AF ablation. A very concise overview, […]

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AF ablation Atrial fibrillation Dabigatran/Rivaroxaban/Apixaban

My new AF presentation is up

Hey all. I put together an AF-treatment power-point presentation for a group of primary care doctors, ER doctors and others this morning. The title of the talk is 2011 Update in the treatment of AF. The focus of the presentation will be five aspects of AF treatment: The best tool to treat AF A better […]

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Atrial fibrillation Dabigatran/Rivaroxaban/Apixaban Uncategorized

Female gender and stroke risk in atrial fibrillation: Know your CHA2DS2-VASc Score

When it comes to the risk of stroke in atrial fibrillation, it pays to be a boy. Sorry, ladies. An important question came up on my recent post on AF and stroke. Why does being female give you an automatic point on CHADS2-VASc?  I keep seeing it, but I don’t see why that is. It […]

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AF ablation Atrial fibrillation Dabigatran/Rivaroxaban/Apixaban

My most recent AF presentation at Norton Stroke Sympsoium

Here is the pdf version: 2011 AF and Stroke Talk (Norton) And the power point version: 2011 AF and Stroke Talk (Norton) Overview: —We will start with the accepted evidence base for warfarin. —Then move to dispel four myths about using blood-thinners in AF: Myth 1: Rhythm-control strategies prevent stroke. Myth 2: Running the INR […]

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Atrial fibrillation Dabigatran/Rivaroxaban/Apixaban Health Care

Get back in rhythm: just not with Multaq

Did you know September is AFib awareness month? As a believer in education as the first, and best treatment of AF, I think it’s great to enhance the public knowledge of this highly-misunderstood disease. By all means… Tell people about AF’s risks: stroke and heart failure. Tell them that their fatigue, poor exercise tolerance and […]