The COVID crisis has decimated water exercise. Can we rethink pool closures? A significant number of my older patients relied on pools for their fitness. During a pandemic, you can stay active or fit only if you have good legs and joints. Walkers, … [Continue reading]
Will the Uncertainties of COVID Science Resurrect Blogs?
Health news was popular before the pandemic. Now, almost all news is health news. It’s not only a rapt audience contributing to the deluge of COVID19 news. Two other factors: 1) the availability of preprint servers, digital archives where a … [Continue reading]
Like Minds on COVID19
At nearly the same time I posted yesterday, The Lancet published this editorial from Swedish epidemiologist Prof Johan Giesecke. Some excerpts: It has become clear that a hard lockdown does not protect old and frail people living in care homes—a … [Continue reading]
Can We Discuss Flatten-the-Curve in COVID19? My Eight Assertions

On Telehealth, an older couple asked me a tough question about COVID19. They asked whether this virus would either be gone or less dangerous in 6 months to a year. It was a curious question. I replied, Why do you ask? Doc, we have a big family … [Continue reading]
The Debacle of Hydroxychloroquine and Azithromycin for COVID19
I discussed the use of hydroxychloroquine and azithromycin for patients with COVID19 on my March 27th edition of This Week in Cardiology Podcast. This is an important topic not only because of the specifics of treating patients but also vital … [Continue reading]
2020 Mandrola Update

Many things have changed in my life. I still practice electrophysiology full-time in Louisville. I still write. And I still love endurance exercise. You haven't seen many blog updates because my writing has taken different forms. One is … [Continue reading]
Change and the Case for Being a Medical Conservative:
When my favorite podcaster, the economist Tyler Cowan, asked Dr. Ezekiel Emanuel what nonobvious advice he would give to medical students today, the answer surprised me. The famous bioethicist said: I do think that this is probably … [Continue reading]
Survey for Athletes with AF
Hey Athletes: My colleague, Professor Rachel Lampert, from Yale, along with the StopAF.org patient group, seek to learn more about how atrial fibrillation (AF) and its treatments affect athletic people. If you are an athlete or if you regularly … [Continue reading]
Still Negative on Watchman

Many readers have contacted me to ask whether my negative viewson left atrial appendage occlusion with Watchman have changed since 2017. The short answer is no. My views are even more negative today. In 2016, I published … [Continue reading]
AF, Ablation, Stents and Five Nuances

Joan has left an excellent comment on my recent 2019 AF ablation update. She brings up many important issues. Let’s dissect it. Q: Joan asks if it is common to see patients who think they are cured after AF ablation but are still in … [Continue reading]
AF Ablation Update 2019
Most years I write an update on any big developments in AF ablation. This year's version will be a short one. I have little new to report. But it's worth reviewing some basic issues. We still do not know the cause of atrial fibrillation (AF). That … [Continue reading]
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