A new study finds insufficient evidence that AF screening helps more than it harms. It provides an immense opportunity to learn the limits of screening for disease
As an 81 year old woman with a history of SVT & ablation, I totally agree with everything in this article. Dr. Mandrola is a rarity in the medical field....He speaks/writes the truth. Might add I am a retired R.N. with a vast many years (over 55) in a variety of fields of experience, though not in the cardiology field. BUT, me eldest daughter is an RN,NP and was the charge nurse of the cardiac care ICU at the hospital where we both worked. Dr. Mandrola, keep up your great work and writings. Thank you. Granny Beth
Granted, occasionally I've had a little thrombocytopenia and was supplementing with krill oil at the time, but when I had a total knee replacement, I needed four (4) units of blood and was kept in the ICU overnight rather than sent home as the advertisements for the joint (pun intended) all but promise. Then for years I took as prescribed a "reversible" anticoagulant which shall remain nameless because I was diagnosed with A-fib and opted for multiple complicated RF ablations (which worked to eliminate the A-fib). My nearing-the-end-of-his-career cardiologist had proposed a valve replacement and a lifetime of coumadin for a mitral valve prolapse and I insisted on a repair instead. Mind you, I drove a truck into a river almost drowned and then, years later, again suffered the same apparent syncope that resulted in an emergency craniotomy for a bilateral subdural hematoma. Then, a couple of years later, I started having an occasional tonic seizure-- once-a-year and increasing in frequency and severity recently such that a smart cardiologist who had at least read the AHA paper on screening for sleep apnea and ordered it. Surprise: "severe sleep apnea" albeit without snoring but probably lifelong and contributing to the physical cum electrical condition of my heart, syncope, and maybe seizures. This is a long story short but impresses me that physicians not only need to be on top of current knowledge in their field like the sleep apnea connection: they need to have an enquiring mind and good cognitive ability. Screening cardiologists makes sense, with knock-out criteria like not being a good listener. Patient advocates probably save lives passing-along and heading-off what gets yelped about and keeping it internal rather than out-there in public. MacDonalds suggests their franchisees offer a free cheeseburger for timely feedback because its good business; I submit that not being shy about responsible complaining is a public service that probably prolongs lives.
A good friend had a severe ischemic stroke several years ago in his early 60s. Turns out he had undetected AF. After extended physical therapy, warfarin preventive, and a career change, he was back to more-or-less normal. Then he got a severe hemorrhagic stroke. Due to warfarin?? Seems to me a bit of judicious screening might have saved him a bit of trouble.
Patients with stroke, if monitored, are often found after they leave the hospital to have short runs of a- fib that were not detected during their initial hospitalization. Should they receive anticoagulation ?
As an 81 year old woman with a history of SVT & ablation, I totally agree with everything in this article. Dr. Mandrola is a rarity in the medical field....He speaks/writes the truth. Might add I am a retired R.N. with a vast many years (over 55) in a variety of fields of experience, though not in the cardiology field. BUT, me eldest daughter is an RN,NP and was the charge nurse of the cardiac care ICU at the hospital where we both worked. Dr. Mandrola, keep up your great work and writings. Thank you. Granny Beth
Granted, occasionally I've had a little thrombocytopenia and was supplementing with krill oil at the time, but when I had a total knee replacement, I needed four (4) units of blood and was kept in the ICU overnight rather than sent home as the advertisements for the joint (pun intended) all but promise. Then for years I took as prescribed a "reversible" anticoagulant which shall remain nameless because I was diagnosed with A-fib and opted for multiple complicated RF ablations (which worked to eliminate the A-fib). My nearing-the-end-of-his-career cardiologist had proposed a valve replacement and a lifetime of coumadin for a mitral valve prolapse and I insisted on a repair instead. Mind you, I drove a truck into a river almost drowned and then, years later, again suffered the same apparent syncope that resulted in an emergency craniotomy for a bilateral subdural hematoma. Then, a couple of years later, I started having an occasional tonic seizure-- once-a-year and increasing in frequency and severity recently such that a smart cardiologist who had at least read the AHA paper on screening for sleep apnea and ordered it. Surprise: "severe sleep apnea" albeit without snoring but probably lifelong and contributing to the physical cum electrical condition of my heart, syncope, and maybe seizures. This is a long story short but impresses me that physicians not only need to be on top of current knowledge in their field like the sleep apnea connection: they need to have an enquiring mind and good cognitive ability. Screening cardiologists makes sense, with knock-out criteria like not being a good listener. Patient advocates probably save lives passing-along and heading-off what gets yelped about and keeping it internal rather than out-there in public. MacDonalds suggests their franchisees offer a free cheeseburger for timely feedback because its good business; I submit that not being shy about responsible complaining is a public service that probably prolongs lives.
A good friend had a severe ischemic stroke several years ago in his early 60s. Turns out he had undetected AF. After extended physical therapy, warfarin preventive, and a career change, he was back to more-or-less normal. Then he got a severe hemorrhagic stroke. Due to warfarin?? Seems to me a bit of judicious screening might have saved him a bit of trouble.
Thank You Doc. Always appreciate your insight and perspective. You give me great encouragement. Frank C.
Patients with stroke, if monitored, are often found after they leave the hospital to have short runs of a- fib that were not detected during their initial hospitalization. Should they receive anticoagulation ?
Is there any evidence one way or the other?
Thanks
Thank you!!!