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General Cardiology General Medicine

The BVS Disappearing Stent: Promise, Hype and the Tension Between Progress and Safety

Medicine does not stand still. You want innovation; you want progress. But you also want safety. Millions of patients have coronary stents placed in the arteries supplying blood to the heart. It’s big business. Metal cages placed in the setting of a heart attack can be life saving. In other settings, however, the strongest quality […]

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AF ablation Atrial fibrillation Doctoring General Medicine Health Care

Should AF ablation require approval from a heart team?

A patient presents with atrial fibrillation (AF) and a rapid rate. He doesn’t know he is in AF; all he knows is that he is short of breath and weak. The doctors do the normal stuff. He is treated with drugs to slow the rate and undergoes cardioversion. During the hospital stay, he receives a […]

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AF ablation Atrial fibrillation Doctoring Health Care Health Care Reform Healthy Living

Wisdom…

…the quality of having experience, knowledge, and good judgment. I read today a collection of words that exude wisdom. I share it with you because the purpose of this blog is to do create value through education. Peggy Girshman was an award-winning health journalist. When ill with a life-limiting illness, she wrote her own eulogy. […]

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General Medicine Health Care Health Care Reform Healthy Living

Access to healthcare does not deliver health

Stanford economist Raj Chetty and coworkers published an important paper in the Journal of the American Medical Association this week. It’s free. They looked at the association between income and longevity in the US. The results will disrupt a lot of what you might have thought about healthcare. The first finding was not surprising: higher […]

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AF ablation Athletic heart General Ablation General Cardiology

AF ablation still has a role

I have been seeing a new trend in the AF clinic. I never thought this would happen, but I’d estimate that at least once daily, often multiple times daily, a patient says they have read this blog before the visit. That is nice. Many of these patients, some who have traveled across the country, or […]

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AF ablation Atrial fibrillation

AF Ablation Update – 2016

I do AF ablation. But, similar to my 2015 update, I continue to do fewer of these procedures. What is new in 2016 is more confidence that this is the right approach. My technique for ablating AF has not changed. I do pulmonary vein isolation (PVI) with point-to-point RF. Each burn takes 10-30 seconds, and […]

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Doctoring General Cardiology General Medicine Health Care Reflection

Do cardiologists prescribe too many drugs?

One of the most common reasons people require medical care is their medical care. This is a distinctly modern problem. In times past, doctors treated disease. Patients saw their doctor when they were sick. They had a problem; doctors offered help. The doctor of today often improves health by removing healthcare. It’s one of my […]

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AF ablation Atrial fibrillation Doctoring Exercise General Cardiology

A cautionary note on AF ablation in 2015

It’s time to write an update on AF ablation. Things have changed. The major change is that I am doing many fewer ablations for AF. The reason is we have a better understanding of the disease, or should I say, condition? In the last 2-3 years, good science has changed the way specialists see AF. […]

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Doctoring General Cardiology General Medicine Health Care Healthy Living

Should you get a cardiac stress test?

Heart disease remains the leading killer of humans. People want to be protected. The fast-thinking notion is early detection is good, the more knowledge, the better. I wish it were that easy. What follows is my most recent post on WebMD on the basics of cardiac stress testing: **** A middle-aged surgeon recently asked me […]

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AF ablation Atrial fibrillation ICD/Pacemaker inflammation

Recap of 2015 European Heart Rhythm Association Meeting — Milan

I recently returned home from Milan, Italy. I was covering the 2015 European Heart Rhythm Association (EHRA) sessions. My favorite part of the congress, as it always is with medical meetings, was connecting with old friends, and making new friends. I had coffee, lunch or dinner with colleagues from Australia, Netherlands, France, Italy, Belgium, Frankfurt, […]

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Atrial fibrillation Healthy Living inflammation Nutrition

Good health does not require an Apple Watch

Social media is awash in news about digital health. I am a skeptic. Health is much simpler. I like this rendering from a kindergarten class. "Kindergarten teacher asked class to create rules for living healthy. Here's what they came up with" via @rickplus3 pic.twitter.com/cRmHfcfjrf — Brad Stulberg (@BStulberg) May 9, 2015 When I was a […]