Heart Rhythm Medicine, Health, Cycling, Fitness.
The ultimate goal in medicine: protect the patient from stroke. Even a heart doctor has to admit the dominance of the human brain. Always think about preventing stroke. It’s one of the worst outcomes that can happen to a person. Life as a ‘normal’ human requires a healthy brain. A stroke irreversibly kills off part [...]
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Yesterday afternoon, the FDA finally approved apixaban (Eliquis) for the prevention of stroke in patients with non-valvular atrial fibrillation. I use the words ‘finally approved’ because the markedly positive ARISTOTLE trial was published 15 months ago in the New England Journal of Medicine. The long delay was mysterious. On paper, apixaban looks to be the [...]
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There was a lively debate on this topic at ESC 2012. One of the strategies proposed to reduce stroke in AF involves occlusion of the sack-like structure called the left atrial appendage. Two devices are being evaluated and nearing consideration for approval. There is a great deal of debate on these devices. Here is my [...]
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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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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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I recently came across a very important blog post on the use of the novel new blood-thinner, dabigatran (Pradaxa). Fellow Kentucky cardiologist, and frequent TheHeart.org contributor, Dr. Melissa Walton-Shirley wrote this very detailed case presentation involving a cantankerous non-compliant rural patient with AF (atrial fibrillation) that sustained a stroke while “taking” dabigatran. Dr. Walton-Shirley details [...]
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