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Atrial fibrillation Dabigatran/Rivaroxaban/Apixaban Healthy Living Knowledge

Getting the dabigatran (Pradaxa) story right… Correcting four common mistakes.

This purpose of this post is to clarify misstatements made in a recent New York Times article about the anticoagulant drug dabigatran (Pradaxa). The piece had three major inaccuracies, plus one thought-error from a cardiology leader. I write these words because the most valuable tool in the treatment of AF is knowledge. Getting it right […]

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AF ablation Atrial fibrillation Doctoring Healthy Living

Two AF cases — and my changing view of AF

I receive many emails about AF. I don’t often answer them because it is bad practice to doctor without seeing the person. Recently, however, I received a note with more general questions. The sender suggested I could use the response as a blog post. The reason I am posting these two cases along with my […]

Categories
Cycling Stuff Cycling Wed Healthy Living

Is this the bike of the future?

One of the things that I notice every time I return home from a trip to Europe is our lack of bike infrastructure. There are many reasons for this, obviously, but one is surely the lack of bike commuters. Americans mostly use bikes for recreation and exercise, not transportation. This wheel may change that. Oh […]

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Doctoring General Cardiology General Medicine Health Care Healthy Living

Five lessons from the Niacin failure

This week the New England Journal of Medicine published two studies on the role of niacin in preventing future cardiac events. The short story is that niacin was ineffective and associated with significant harm. A number of excellent summary pieces have been written, and I will reference them at the end. The purpose of writing […]

Categories
Atrial fibrillation Healthy Living

Alcohol and the risk of atrial fibrillation — it’s different than you may think

Life overflows with choices. And consequences. You can choose to smoke and then not be surprised to die a difficult death from cancer. You can choose to eat more calories than you burn and then buy bigger belts. You can choose to “need” more stuff and then, surely, remain unfulfilled. The more we learn about […]

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Doctoring General Cardiology General Medicine Healthy Living

Growing doubt on statin drugs — the problem of drug-lifestyle interaction

My mind is changing about statins. I’m growing increasingly worried about the irrational exuberance over these drugs, especially when used for prevention of heart disease that is yet to happen. An elderly patient called my office last week to tell me thank you…not for a successful procedure or surgery, but rather, for helping with a […]

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Health Care Healthy Living Knowledge

We depend on each other…

What is the greatest possible thing that could happen to you today? Is it winning a million dollars? Seeing your children smile? Going to a job you love? Perhaps it is waking up next to a spouse whom you love and is also your best friend? These are all winners, for sure. But what if […]

Categories
AF ablation Athletic heart Doctoring Exercise Healthy Living inflammation

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 […]

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Health Care Healthy Living inflammation Nutrition

Dear Girl Scouts: It’s time to cut out the cookies

It happened while I was leaving a grocery store in the southeastern United States. The young girl who asked me if I wanted to buy Girl Scout cookies was strikingly perfect. She was thin, happy, and well spoken. So were her colleagues. The moms, too, were of healthy weight and cheer. It was as if […]

Categories
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 […]

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Doctoring General Medicine Healthy Living Knowledge

A clear-eyed look at treating the elderly with medicine

A recent case taught me a lot about how people perceive their medicines. I was trying to help a 92-year-old man get off some of his medicine. I can’t go into the details, but suffice to say, there was much opportunity to trim a long list of drugs, many of which were threatening his existence […]