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Multaq Simply Does Not Work To Control AF, So Why Is It Still So Over-Hyped?

Did you know September is AFib awareness month?

As a believer in education as the first, and best treatment of AF, I think it’s great to enhance the public knowledge of this highly-misunderstood disease.

By all means…

Tell people about AF’s risks: stroke and heart failure.

Tell them that their fatigue, poor exercise tolerance and breathlessness might not be old age; it might be AF.

Tell them about the importance of early intervention.

Tell them that obesity, inactivity, sleep disturbances, alcohol, and incessantly worrying about everything makes AF more likely to occur, and to stay.

Tell them that Read more »

*This blog post was originally published at Dr John M*

Is The Ironman Triathlon Safe For The Middle-Aged Heart?

Before I even start, let me say this to my triathlete friends…

I really like you all. And…I am sorry for how I feel about your sport’s pinnacle, the Ironman triathlon. But I was poked into writing this post. When asked the question of whether the Ironman is safe for the middle-aged heart, what was I to do? Lie?

Each August, my hometown, Louisville, KY, gets overrun, over-swum and over-ridden with “Iron people.” No, these humans aren’t rust colored, or all that hardened, but they are indeed a determined lot. Triathletes, or iron people if you will, wake up before sunrise to swim, bike or run. Then they eat; some go to work (barely), and then they do the training thing again in the evening. Calling these athletes focused would surely be an understatement.

So it is each summer that I endure the same question: “Dr. Mandrola, did you do the Ironman?”

“No…I just ride bikes.”

But this year was different. Before I could launch into my usual dissertation on how training for Ironman-length triathlons causes excess inflammation, coronary calcium, atrial fibrillation, divorce, etc., etc., another question quickly popped up.

“What did you think of that guy who died during this year’s race?” Read more »

*This blog post was originally published at Dr John M*

Apixaban Finally Showing Superiority Over Warfarin In Clinical Trial

With the publication of “Apixaban versus Warfarin in Patients with Atrial Fibrillation” (the ARISTOTLE trial) in the New England Journal of Medicine, the third drug in a series of medications designed to attack thrombin in the clotting cascade. The study was announced with quite a fanfare in Europe as cardiologists, financial analysts and reporters gushed forth with ‘mega-blockbuster’ praise this past weekend.

And for good reason.

This is the first trial to conclude that Read more »

*This blog post was originally published at Dr. Wes*

Articles Give An In-Depth Analysis Of Multaq

As a patient, you probably see lots of hype-filled reports about various drugs. After a drug is approved, there’s an inevitable blitz of negative publicity which often scares people away from important new solutions that could help them.

There has been so much news lately about Multaq (dronedarone), the drug designed to provide the benefits of amiodarone but with fewer risks. This drug is important to people with afib, especially those with heart disease whose choices are limited, so it’s time to put into context for patients what has transpired in the two years since FDA approval.

These two companion articles provide an in-depth analysis into issues that have been reported about Multaq, including whether it can cause: Read more »

*This blog post was originally published at Atrial Fibrillation Blog*

Omega-3 Fatty Acids: The Science Behind Their Potential Heart Health Benefits

The Biology of Omega-3 fatty acids: (Just a little science:)

When fish, flax-seeds or Brussels sprouts pass through the intestine, pancreatic enzymes transform the fat to free fatty acids. These acids are quickly taken up by the cells. Once in the cell, these fatty acids enter the mitochondria, endoplasmic reticulum and cytosol–places that you might recall because your mom helped you make a Cell sponge cake in 7th grade Biology.

In the cells, the Omega-3 fatty acids (ALA, DHA and EPA) exert their healthy influence in three major ways:

  • in the control of chemical messengers;
  • in the flux of ions—cell electricity;
  • in the smoothness and health of the cell membrane.

That’s enough about cells.

How do these (good) fats help our bodies?

Omega-3 fatty acids reduce Inflammation:

–Omega-3s get in the cellular (not phone) mix and end up competing with chemicals that cause inflammation—medical people say they antagonize bioactive mediators of inflammation.

–Newly-discovered by-products of Omega-3s are important in the resolution phase of inflammation. Biochem people call these chemicals, resolvins. All you have to remember here is this: to resolve (inflammation) is heart-healthy.

–When omega-3s are incorporated into the membranes of cells they do a lot of good: things like making the membrane more fluid and less sticky. For some reason, they even block genes that induce hardening of the arteries. (Genomic effects.)

Omega-3s benefit the heart: They… Read more »

*This blog post was originally published at Dr John M*

Latest Interviews

IDEA Labs: Medical Students Take The Lead In Healthcare Innovation

It’s no secret that doctors are disappointed with the way that the U.S. healthcare system is evolving. Most feel helpless about improving their work conditions or solving technical problems in patient care. Fortunately one young medical student was undeterred by the mountain of disappointment carried by his senior clinician mentors…

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How To Be A Successful Patient: Young Doctors Offer Some Advice

I am proud to be a part of the American Resident Project an initiative that promotes the writing of medical students residents and new physicians as they explore ideas for transforming American health care delivery. I recently had the opportunity to interview three of the writing fellows about how to…

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Latest Book Reviews

Book Review: Is Empathy Learned By Faking It Till It’s Real?

I m often asked to do book reviews on my blog and I rarely agree to them. This is because it takes me a long time to read a book and then if I don t enjoy it I figure the author would rather me remain silent than publish my…

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The Spirit Of The Place: Samuel Shem’s New Book May Depress You

When I was in medical school I read Samuel Shem s House Of God as a right of passage. At the time I found it to be a cynical yet eerily accurate portrayal of the underbelly of academic medicine. I gained comfort from its gallows humor and it made me…

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Eat To Save Your Life: Another Half-True Diet Book

I am hesitant to review diet books because they are so often a tangled mess of fact and fiction. Teasing out their truth from falsehood is about as exhausting as delousing a long-haired elementary school student. However after being approached by the authors’ PR agency with the promise of a…

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