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AF ablation Atrial fibrillation Cycling Stuff Doctoring Exercise General Medicine Health Care Health Care Reform ICD/Pacemaker Reflection Social Media/Writing/Blogging

Update: Baltimore, Safety in AF ablation, Podcasts, and some personal notes

On Baltimore: Human beings rioting in the streets of an American city forced cancellation of an important cardiology meeting. This is a vivid example that doctors do not practice in a vacuum. We are connected to this world. Here in Louisville, just a few miles north, an HIV crisis runs amok because of IV drug […]

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AF ablation Atrial fibrillation

Ten things to expect after AF ablation

Here is a list of ten things to say about the experience of having an AF ablation. (Note: This list concerns standard radio frequency catheter ablation for AF.) 1. AF ablation is a big deal: The first thing to say about AF ablation is that it is a big procedure. I tell patients to expect […]

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AF ablation Atrial fibrillation Healthy Living Nutrition

Major breakthrough in AF ablation

A study published recently in the Journal of the American College of Cardiology will change a way of thinking about the disease atrial fibrillation. And it’s about time. One word describes AF therapy in the past decade: plateau. Ten years have passed and we have no new drugs and no real breakthrough in AF ablation. […]

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AF ablation Athletic heart Atrial fibrillation

How successful is AF ablation?

Let’s talk about success. At first glance, knowing whether a medical or surgical intervention achieves success seems quite simple. An antibiotic clears an infection–or it does not. A surgery removes a tumor with clean margins–or it does not. An angioplasty and stent open an artery during a heart attack–or it does not. In the case […]

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AF ablation Atrial fibrillation Healthy Living inflammation

AF ablation and the hard truths about AF

Atrial fibrillation is a mysterious disease. We know a lot but surely not enough. We look at AF but are we really seeing it? I believe there are hard truths to this disease. Hard in a way that neither patients nor doctors like. More on that later. First to some news on a major AF […]

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AF ablation Atrial fibrillation Cycling Stuff Doctoring Exercise Healthy Living inflammation

Day 2 ESC — AF ablation and more bike commuting

Okay, I’m getting the hang of this. The Monday morning and evening commute in Amsterdam is something special. You talk about focus. It requires laser-like focus. You’ve got bikes, narrow lanes, buses, trams, pedestrians and tourists. Still though, traveling 6k by bike took 15 minutes; a cab from the convention center, more than 30. I […]

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AF ablation General Cardiology

EuroPace 2013 wrap up — A major study on AF ablation and the limits of gene testing in Cardiology

I’m writing this from home. The travel back was uneventful and I actually got a little caught up in the office Friday. It was a fun trip but getting back to doctoring felt good. Atrial Fibrillation ablation: The Gap-AF trial was released as the lead late-breaker at EuroPace 2013. There were many remarkable (‘they-really-did-that’ sort […]

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AF ablation Atrial fibrillation

Four commonly asked questions on AF ablation

I receive a lot of emails from people afflicted with atrial fibrillation. It is humbling that another person would share such highly personal information with me, a stranger. Thanks for that. It goes without saying that I cannot give specific medical advice. Though it is tempting. I’ll read a detailed story and think to myself…OMG, […]

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AF ablation Atrial fibrillation

New post up over at Trials and Fibrillations–Exciting news in AF ablation

For those interested in atrial fibrillation, there was significant news made last week. Dr. Sanjay Narayan and colleagues, including highly respected Indiana University electrophysiologist, Dr. John Miller (also a JMM), finally published their exciting data on FIRM ablation. The CONFIRM trial (Conventional Ablation for Atrial Fibrillation With or Without Focal Impulse and Rotor Modulation) has […]

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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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AF ablation Atrial fibrillation

Has AF ablation reached first-line status? My Trials & Fibrillations post…

Head over to theHeart.org to read my review of the recently released RAAFT 2 trial–a randomized clinical trial of Radiofrequency Ablation vs. Antiarrhythmic Drugs as First-Line Treatment of Symptomatic AF. The study adds significantly to the growing knowledge of how best to treat AF. JMM