MedWorm provides a medical RSS filtering service. Over 6000 RSS medical sources are combined and output via different filters. This feed contains the latest medical blog items that have been tagged with 'electrophysiology'. Sat, 03 Sep 2011 02:31:54 +0100 http://www.medworm.com/index.php?rid=4952848&cid=t_170301_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fwhen-a-routine-case-in-the-ep-lab-goes-awry%2F2011.06.20 Easy case. Seen it a hundred times. Old guy (or gal). Comes into ER. Found “down.” “Hey doc, looks like his hearts goin’ slow. I think he (or she) needs a pacer.” “On any meds that might do this?” “Nah.” “How’s his (her) potassium?” “4.3, normal.” And like lots of times, you head in. Glad you can help. Call-team’s on their way, thanks to you. Called the device rep to make sure they can be there just in case, too. Cool as a cucumber. Nothin’ to it. Been here, done this. You arrive to a guy (or gal) that looks pretty good. Maybe has one or two medical problems. Heart rate’s better thanks to the atropine and the fluids they gave him (her) on arrival. The intraosseus line in the tibia is impre... Better Health blogs http://www.medworm.com/rss/comments.php?id=4952848 Mon, 20 Jun 2011 14:00:00 +0100 4952848 http://www.medworm.com/index.php?rid=4820857&cid=t_170301_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fwhy-industry-largesse-is-a-necessary-part-of-good-healthcare%2F2011.05.12 Largesse: (Form thefreedictionary.com): 1. a. Liberality in bestowing gifts, especially in a lofty or condescending manner. b. Money or gifts bestowed. 2. Generosity of spirit or attitude. Two days into last week’s Heart Rhythm Society meeting, Propublica, an independent online investigative journalism-in-the-public-interest endeavor published a series of high profile articles as part of their Dollars for Docs series. Their marquee piece, published prominently in the USA Today, chronicled the strong financial ties (the ‘largesse’) that bind medical societies to industry. Reporters Charlie Ornstein and Tracy Weber highlighted the meeting’s ‘mansion’-sized exhibits, intense advertising, and the fact that most of the opinion leaders, officers of medical societies and guideline wri... Better Health blogs http://www.medworm.com/rss/comments.php?id=4820857 Thu, 12 May 2011 15:30:02 +0100 4820857 http://www.medworm.com/index.php?rid=4789244&cid=t_170301_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fshould-competitive-cyclists-undergo-cardiac-ablation-for-atrial-fibrillation%2F2011.05.06 The number of emails that come from fellow cyclists (and endurance athletes) with heart rhythm issues amazes me. I am more convinced than ever that our “hobby” predisposes us to electrical issues like atrial fibrillation (AF)—that the science is right. Obviously, my pedaling “habit” creates an exposure bias. I hear from many of you because we cyclists understand each other. Like you, I consider not competing a lousy treatment option. As a bike racer, I know things: that prancing on an elliptical trainer at a health club doesn’t cut it, and, that spin classes may look hard, but do not come close to simulating real competition. I know the extent of the inflammation required to close that gap, to avoid getting dropped when one of the local Cancellara-types have you in the gutter i... Better Health blogs http://www.medworm.com/rss/comments.php?id=4789244 Fri, 06 May 2011 08:38:25 +0100 4789244 http://www.medworm.com/index.php?rid=4768118&cid=t_170301_122_f&fid=35068&url=http%3A%2F%2Fbrainwindows.wordpress.com%2F2011%2F04%2F29%2Fjournal-club-classic-single-unit-physiology-in-barrel-cortex%2F This one is for the aficionados. Here is a little review of four classic single-unit physiology papers investigating the response properties and information flow from whisker through thalamus and into cortex.  It’s quite interesting comparing this data taken from sedated or anesthetized rats to my own in awake, behaving animals. That’s a story for another time and publication venue though Filed under: electrophysiology, in vivo Tagged: barrel cortex, single unit physiology (Source: Brain Windows) Brain Windows blogs http://www.medworm.com/rss/comments.php?id=4768118 Fri, 29 Apr 2011 20:10:38 +0100 4768118 http://www.medworm.com/index.php?rid=4575055&cid=t_170301_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Funiversal-cardiac-screening-for-all-young-athletes%2F2011.03.11 It’s heart wrenching when young athletes die of sudden cardiac death (SCD). Last week the death of Wes Leonard, a Michigan high school star athlete, was especially poignant since he collapsed right after making the game-winning shot. This sort of tragedy occurs about one hundred times each year in America. That’s a lot of sadness. The obvious question is: Could these deaths be prevented? Let’s start with what actually happens. Most cases of sudden death in young people occur as a result of either hypertrophic cardiomyopathy (HCM), an abnormal thickening of heart muscle, or long QT syndrome (LQTS), a mostly inherited disease of the heart’s electrical system. Both HCM and LQTS predispose the heart to ventricular fibrillation — electrical chaos of the pumping chamber of the he... Better Health blogs http://www.medworm.com/rss/comments.php?id=4575055 Fri, 11 Mar 2011 22:00:35 +0100 4575055 http://www.medworm.com/index.php?rid=4565905&cid=t_170301_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Findependent-peer-reviewed-scientific-journals-just-how-independent-are-they%2F2011.03.09 On September 27, 2010, the peer-reviewed scientific journal Europace published online-before-print a case report entitled “Spontaneous explosion of implantable cardioverter-defibrillator” by Martin Hudec and Gabriela Kaliska. In the pdf of that case report a figure containing a color photo of the affected patient’s chest, chest X-ray, and two pictures of the extracted device (one seen here) were included. The pictures and case presentation were dramatic and the case very rare. Both were perfect reasons to report such an important case to the medical literature. And so these doctors sent the case to Europace on June 29, 2010, and the article was accepted after revision on August 16, 2010, with the article appearing online September 27, 2010. The authors must have felt v... Better Health blogs http://www.medworm.com/rss/comments.php?id=4565905 Wed, 09 Mar 2011 16:00:00 +0100 4565905 http://www.medworm.com/index.php?rid=4324794&cid=t_170301_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fcan-a-bra-interact-with-a-pacemaker-or-defibrillator%2F2011.01.08 This comment [with a specific photo] was posted on my blog earlier: “I was reading one of your old posts about magnets and I was wondering if a magnetic front closure on a bra would be a problem? There’s a warning on the label but I know part of that is just due to liability. What about this bra that has a magnet clasp on the front? If the magnet hits right in between the breasts would it be close enough to the device that it could interfere? Also does having a magnet that close change the settings or turn off a defibrillator/pacemaker early? I’m sure most doctors would say just wear another bra but this bra in particular is very comfy! I’ve tried it on but not worn it for extended periods of time. Luckily this is one of the only major complaints I’ve had abo... Better Health blogs http://www.medworm.com/rss/comments.php?id=4324794 Sat, 08 Jan 2011 20:00:00 +0100 4324794 http://www.medworm.com/index.php?rid=4294630&cid=t_170301_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Ftop-cardiology-stories-of-2010-and-predictions-for-2011%2F2010.12.27 The end of the year marks a time for list-intensive posts. Recently Larry Husten from CardioExchange and CardioBrief asked for my opinion on the three most important cardiology-related news stories of 2010. Additionally, he wanted three predictions for 2011. Here goes: Top Cardiology Stories Of 2010: 1. By far, the #1 heart story of 2010 was the release of the novel blood-thinning drug dabigatran (Pradaxa) for the prevention of stroke in atrial fibrillation. Until this October, the only way to reduce stroke risk in AF was warfarin, the active ingredient in rat poison. Assuming that there aren’t any post-market surprises, Pradaxa figures to be a true blockbuster. Doctors and patients have waited a long time to say goodbye to warfarin. 2. The Dr. Mark Midei stent story: Whether D... Better Health blogs http://www.medworm.com/rss/comments.php?id=4294630 Mon, 27 Dec 2010 22:00:00 +0100 4294630 http://www.medworm.com/index.php?rid=4272289&cid=t_170301_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fthe-musical-chairs-of-medical-speciality%2F2010.12.19 The consolidation of physician specialty practices into larger corporate healthcare systems in urban areas is creating a new challenge for today’s doctors when the music stops: There might not be a chair available. There are simply many fewer hospital systems in large urban areas than there are specialy practices, so the number of specialist positions a large healthcare system is willing to absorb might be limited. As doctors and hospital systems coalesce into as-yet-to-be-clearly-defined “accountable care organizations,” the cost of too many specialists in an organization is being carefully weighed. (more…) *This blog post was originally published at Dr. Wes* (Source: Better Health) Better Health blogs http://www.medworm.com/rss/comments.php?id=4272289 Sun, 19 Dec 2010 20:00:00 +0100 4272289 http://www.medworm.com/index.php?rid=4265740&cid=t_170301_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fdefibrillators-on-the-top-10-health-technology-hazards-list%2F2010.12.16 In a desperate attempt to reach an even number it seems, hospital defibrillators were added to ECRI.org’s “Top 10 Health Technology Hazards” list of devices that threaten to kill or maim patients: The Top 10 Health Technology Hazards list is updated each year based upon the prevalence and severity of incidents reported to ECRI Institute by healthcare facilities nationwide; information found in the Institute’s medical device problem reporting databases; and the judgment, analysis, and expertise of the organization’s multidisciplinary staff. Many of the items on this year’s list are well-recognized hazards with numerous reported incidents over the years. If one honestly looks at the number of lives saved versus the number of deaths from defibrillators, I wonder how m... Better Health blogs http://www.medworm.com/rss/comments.php?id=4265740 Thu, 16 Dec 2010 23:00:00 +0100 4265740 http://www.medworm.com/index.php?rid=4253138&cid=t_170301_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fthe-heart-and-the-holidays%2F2010.12.12 The human heart resides in a lighltless 98.6-degree chest cavity. Its contracting muscles are further cushioned by the well-lubricated glistening smooth pericardial sac. One wouldn’t think that the heart could sense the time of year. The heart’s rhythm should remain independent of the holiday season. But then there is December in the EP lab. They are as busy as the malls. Is it the depressing weather? Or the short days? Or a post-Thanksgiving hangover? It’s hard to say, but every year for as many as I can remember, the EP lab rocks in November and December. And with the advent of deductible health plans, this holiday phenomenon has only intensified. The I-90 of the heart, the AV node, seems to give out more in the holidays. I’ll never forget the Saturday in Decembe... Better Health blogs http://www.medworm.com/rss/comments.php?id=4253138 Sun, 12 Dec 2010 21:00:00 +0100 4253138 http://www.medworm.com/index.php?rid=4245304&cid=t_170301_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fnot-just-any-joe-smith%2F2010.12.09 DrRich is delighted to note that a very good and longtime friend and former colleague has been named as one of the HealthLeaders 20 for 2010 — that is, as one of 20 people, chosen by HealthLeaders Media, who are changing healthcare for the better. DrRich has known this man for nearly two decades, and from the very beginning he has insisted his real name is Joe Smith. So let’s go with that. Joe’s recognition by HealthLeaders is very well deserved. Joe is chief medical and science officer of the West Wireless Health Institute in San Diego, a non-profit institution whose mission is to bring wireless technologies to the patient, technologies to diagnose, monitor and treat health conditions in the patient’s own home. Joe is uniquely qualified for this role, having earned a PhD in me... Better Health blogs http://www.medworm.com/rss/comments.php?id=4245304 Thu, 09 Dec 2010 16:00:32 +0100 4245304 http://www.medworm.com/index.php?rid=4200560&cid=t_170301_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fthanksgiving-a-heart-attack-for-dessert%2F2010.11.25 It seems the Washington Post, cloaked under an anonymous author, wants to use scare tactics to keep most of us from enjoying Thanksgiving with their ominously titled article, “And for dessert, a heart attack?” They spew all kinds of garbage with very little data about how eating a high-fat diet might give you a heart attack. If you want to know more, consider this article* from some pretty smart folks at Harvard. Then eat, drink, and be merry without guilt (courtesy of Dr. Wes). Happy Thanksgiving! - WesMusings of a cardiologist and cardiac electrophysiologist. *REFERENCE: Renata, M. and Mozaffarian, D. “Saturated Fat and Cardiometabolic Risk Factors, Coronary Heart Disease, Stroke, and Diabetes: a Fresh Look at the Evidence.” Lipids, 31 Mar 2010. [Photo credit: La... Better Health blogs http://www.medworm.com/rss/comments.php?id=4200560 Thu, 25 Nov 2010 18:00:00 +0100 4200560 http://www.medworm.com/index.php?rid=4190157&cid=t_170301_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fsudden-cardiac-arrest-how-fast-does-it-cause-unconsciousness%2F2010.11.21 How fast does sudden cardiac arrest cause unconsciousness? In just seconds. Here’s a video of Salamanca soccer player Miguel Garcia’s episode. At the start of the video, Mr. Garcia can be seen in the background of the image kneeling behind the players in the foreground. Watch carefully as he stands after tying his shoes. Although it is difficult to see, it appears an automatic external defibrillator arrives in about two minutes, though given the fact his shirt is still on as he’s taken from the field, we note the device is on his gurney as he’s hurried to a nearby ambulance. Reportedly, he survived this sudden cardiac arrest event: This was NOT a heart attack, but rather a loss of cardiac function caused by a rapid, often disorganized heart rhythm disorder. Compar... Better Health blogs http://www.medworm.com/rss/comments.php?id=4190157 Sun, 21 Nov 2010 19:00:00 +0100 4190157 http://www.medworm.com/index.php?rid=4159239&cid=t_170301_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fis-the-young-pharmaceutical-rep-right%2F2010.11.12 I loved my old status. Perhaps, reveled in it would be a better description. I was a crotchety, generic medicine-only doctor.** Sadly, my status changed today. Dabigatran (brand name Pradaxa) was the culprit. It was a little nerve racking. I wrote the order, looked at it, thought it out again, talking to myself: “John, are you sure you don’t want to do it the old way? [pause to think] No, I am embracing the new.”  And then, I closed the chart and handed it to the nurse. “What’s that? Pradaxa?” asked the nurse. “Stop the Lovenox? You sure?” My face must have told the story. Eight days had passed since dabigatran’s approval. “That’s plenty of time to mourn warfarin’s demise,” I thought. Enough studies, enough bl... Better Health blogs http://www.medworm.com/rss/comments.php?id=4159239 Fri, 12 Nov 2010 19:00:00 +0100 4159239 http://www.medworm.com/index.php?rid=4053292&cid=t_170301_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fwhen-the-body-rights-itself%2F2010.10.09 It’s been a very busy few weeks. Medicine is like that — seldom is “business” steady. Like rainy weeks in the southeast when you think it will never be sunny again, there are weeks when you think everyone’s atria are fibrillating. So there were shocks, and burns, and wires installed. The heart rhythm was rocking, and so were we. But in all this fury two cases stand out as a reminder that in spite of, not always because of, what we doctors do, the human body can right itself — like it did before their were drugs, procedures, and surgery. (Keep this quiet, though.) Case 1: A semi-emergent consultation for atrial flutter (AF’s crazy sister) came in. “Something has to be done, Dr. M,” was the message. She was symptomatic and scared (not nec... Better Health blogs http://www.medworm.com/rss/comments.php?id=4053292 Sat, 09 Oct 2010 16:00:00 +0100 4053292 http://www.medworm.com/index.php?rid=4027158&cid=t_170301_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fthe-ppaca-does-it-pass-the-playground-test%2F2010.10.03 Could understanding the tacit rules which govern play on a neighborhood playground help us explain why some aspects of implementing healthcare reform are unlikely to succeed? Recent news involving McDonald’s Corporation suggests so. On the playground, there are some simple precepts — like the fact that older and stronger kids get to make up the game, and the rules. That’s understood and mostly okay. As if these leaders are considered modestly benevolent and the rules are workable, the game is good and all benefit. And all players on the playground know this basic tenet of fairness: That the rules of the game shouldn’t change in the midst of the competition, and, taking it one step further, if the rules have to be changed they weren’t very good in the first pla... Better Health blogs http://www.medworm.com/rss/comments.php?id=4027158 Sun, 03 Oct 2010 19:00:00 +0100 4027158 http://www.medworm.com/index.php?rid=4013316&cid=t_170301_113_f&fid=39278&url=http%3A%2F%2Fblogsite.mdbuyline.com%2F%3Fp%3D39 Surgical robotics has been around for roughly a decade.  The da Vinici, a three-armed remote-controlled device, and the ROBODOC® (orthopedic applications), a tower with clamps and drills, are two of the most common medical robotics currently on the market.  However, under the guidance of Dr. Moll, one of the thought leaders in robotic surgery, Hansen Medical has developed the Sensei™ Robotic Catheter System, which has already been FDA approved to perform clinical trials for the therapeutic treatment of life-threatening arrhythmias. Although millions of Americans are affected by life-threatening arrhythmias, ablation technology delivered by a catheter in the electrophysiology (EP) lab is 80 to 85% effective in keeping these symptoms under control.  However, because advanced physician ... MD Buyline blogs http://www.medworm.com/rss/comments.php?id=4013316 Thu, 23 Sep 2010 13:56:03 +0100 4013316 http://www.medworm.com/index.php?rid=3889174&cid=t_170301_122_f&fid=35068&url=http%3A%2F%2Fbrainwindows.wordpress.com%2F2010%2F08%2F20%2Fsoftware-update-ephus-scanimage-neuroptikon%2F Three excellent pieces of neuroscience software have been recently updated or freshly released.  I have used two of them, Ephus and ScanImage, on a daily basis as primary data collection tools. The third, Neuroptikon, is quite useful for post-hoc illustration of neural circuits. Ephus is a modular Matlab-based electrophysiology program that can control and record many channels of tools and data simultaneously.  Under control of a sophisticated internal looper or external trigger, you can initiate an ephys recording, trigger camera frames, adjust galvo positions, open/close shutters, trigger optical stimulation, punishments, rewards, etc.  It is a workhorse program for non-imaging related in vitro and in vivo electrophysiology experiments.  Ephus is named for the fabled baseball pitch,... Brain Windows blogs http://www.medworm.com/rss/comments.php?id=3889174 Fri, 20 Aug 2010 23:51:53 +0100 3889174 http://www.medworm.com/index.php?rid=3880860&cid=t_170301_87_f&fid=39187&url=http%3A%2F%2Fcovertrationingblog.com%2Fpodpress_trac%2Ffeed%2F883%2F0%2FsucksbeingPCP.mp3 DrRich entered medical school 40 years ago with every intention of becoming a general medical practitioner, and indeed he became one. But after only a year in practice as a generalist, he found himself so frustrated with the frivolous limitations and the superfluous obligations that even then were being externally imposed on these supposedly revered professionals, that DrRich altered course and spent several years retraining to become a cardiac electrophysiologist. (Electrophysiology is a field of endeavor so arcane as to be mystifying even to other cardiologists. DrRich hoped that the officious regulators and stone-witted insurance clerks would be so confused –- and possibly intimidated –- by the mysterious doings of electrophysiologists that they would leave him alone. Happily, this ... Better Health blogs http://www.medworm.com/rss/comments.php?id=3880860 Wed, 18 Aug 2010 18:00:32 +0100 3880860 http://www.medworm.com/index.php?rid=3831467&cid=t_170301_122_f&fid=35068&url=http%3A%2F%2Fbrainwindows.wordpress.com%2F2010%2F08%2F06%2Fbackyard-brains-homebrew-ephys-rigs%2F News of a cool new toy comes from a colleague’s recent trip out to the MBL @ Woods Hole.  It is the perfect gift to spark the curiosity of a budding young (or old) neuroscientist. Backyard Brains makes the world’s best value electrophysiology rigs. The SpikerBox comes pre-assembled for $100 or build your own from a bunch of parts for $50. These rigs are surprisingly powerful. You can go out in the yard, catch a bug (or buy a cockroach), strap one on and start recording neuromuscular potentials. The box interfaces with gorgeous iPhone/iPad so you can hear, see and record the action potentials. They don’t make a big point of this, but you can also wire it up so that the piezo-speaker can drive an electrical stimulator of the cockroach’s leg. You can make the leg twi... Brain Windows blogs http://www.medworm.com/rss/comments.php?id=3831467 Fri, 06 Aug 2010 15:01:44 +0100 3831467 http://www.medworm.com/index.php?rid=3786133&cid=t_170301_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fholding-hands-is-good-for-the-heart%2F2010.07.24 A trained observer is what most electrophysiologists are. And being a trained observer carries over into real life, as would the handiness of a plumber, or the strength of a brick layer, or the wordsmithing of a journalist. Will and I drive past our house. “Where are we going now,” he asks in the exasperated tone of a 13 year old. I need to take a picture. Why? Because middle-aged patients who’ve recently realized that their life is half over often seek clues to longevity. Let’s take stressed-out, middle-aged patients who’ve somehow been rendered free of AF (maybe by a skillful ablation, or more likely just happenstance). Let’s also say they don’t smoke, drink excessively, have normal blood pressure, normal blood sugar, and aren’t obese.... Better Health blogs http://www.medworm.com/rss/comments.php?id=3786133 Sat, 24 Jul 2010 14:00:00 +0100 3786133 http://www.medworm.com/index.php?rid=3733083&cid=t_170301_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fdr-insurance-broker%2F2010.07.07 Call it sweet, delicious vindication. It was clinic day yesterday. No longer had I completed my rant in this blog about UnitedHealthcare’s program to require all cardiac elecrophysiologists to obtain a “notification number” before performing any pacemaker or defibrillator procedure, I discovered my letter from them dated June 3, 2010, on my desk stating that this requirement will begin September 1, 2010, for all Illinois electrophysiologists for “all electrophysiology procedures.” Not longer than an hour later I was seeing a 67-year-old patient in the clinic who asked me: “I just got my Medicare (Part A) card and must decide about which insurer I should use for Part B, C, D, E, and F,” he said jokingly. “Since I have the medical problem and... Better Health blogs http://www.medworm.com/rss/comments.php?id=3733083 Thu, 08 Jul 2010 01:00:00 +0100 3733083 http://www.medworm.com/index.php?rid=3655588&cid=t_170301_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fshort-people-got-no-reason-to-worry-about-higher-heart-risk%2F2010.06.11 “Short people have higher heart risk” screams the headline on CNN.com, treating it as a statement of fact. “Shortness Boosts Heart Disease, Death Risk” is the headline in a HealthDay story seen on BusinessWeek.com. Wrong. Such a study as the one being described can only establish association — it CANNOT prove causation. So it’s wrong to say short people have higher risk. It is wrong to say shortness boosts risk. Blogger and cardiac electrophysiologist Dr. Wes Fisher beat me to the punch by blogging about the continued journalistic confusion between association and causation. He wrote: “About the only thing that can be concluded from this so-called “analysis” is nothing more than maybe we should consider studying if this association actu... Better Health blogs http://www.medworm.com/rss/comments.php?id=3655588 Fri, 11 Jun 2010 17:00:17 +0100 3655588 http://www.medworm.com/index.php?rid=3610329&cid=t_170301_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Ficalipers%2F2010.05.28 Who needs calipers when you have an iPhone? -WesMusings of a cardiologist and cardiac electrophysiologist. *This blog post was originally published at Dr. Wes* (Source: Better Health) Better Health blogs http://www.medworm.com/rss/comments.php?id=3610329 Sat, 29 May 2010 00:00:00 +0100 3610329 http://www.medworm.com/index.php?rid=3549342&cid=t_170301_105_f&fid=38964&url=http%3A%2F%2Fdrwes.blogspot.com%2F2010%2F05%2Fdoctors-are-woefully-unprepared-for.html Never has there been a better example of the failure of cardiac electrophysiology training programs to teach the business of medicine to our fellows than this story of a cardiac electrophysiologist from Tennessee who opened his own practice, only to be later evicted when he couldn't pay his rent:Evaluation and management billing codes will never support electrophysiologists in such a setting, since the majority of a cardiac electrophysiologist's revenue is generated from procedural volume. Payments from Medicare (our primary patient population) comes in two forms for care delivered to patients: (1) professional and (2)technical. Technical revenue provided from Medicare for our procedures is ten times the professional payment paid to doctors.Hospitals know this, hence why I'm employed by on... Dr. Wes blogs http://www.medworm.com/rss/comments.php?id=3549342 Mon, 10 May 2010 11:24:00 +0100 3549342 http://www.medworm.com/index.php?rid=3363663&cid=t_170301_105_f&fid=38964&url=http%3A%2F%2Fdrwes.blogspot.com%2F2010%2F03%2Ftracking-medical-procedures-via-iphone.html If it's free, it's for me.Especially if it's an iPhone app to track medical procedures:That’s why Dr. Shanti Bansal developed a free iPhone application — “app” in Apple-talk — that lets doctors keep a record of each case and which procedure, from a cardiac MRI to a biopsy, they perform.“The goal is to help physicians in training be the best physicians they can,” said Bansal, who practices at Yale-New Haven Hospital. “One of the reasons I came up with this is that I’m a cardiologist and in cardiology we do a lot of procedures. I lost track of hundreds of procedures during my first and second year” of residency.Now, in about 30 seconds, each procedure can be entered into the iPhone.Here's the link to ProcedureTracker.com-WesMusings of a cardiologist and cardiac electrophy... Dr. Wes blogs http://www.medworm.com/rss/comments.php?id=3363663 Sun, 14 Mar 2010 01:24:00 +0100 3363663 http://www.medworm.com/index.php?rid=2912217&cid=t_170301_105_f&fid=38964&url=http%3A%2F%2Fdrwes.blogspot.com%2F2009%2F10%2Ferratum.html Click to enlargeWhat's wrong with the cover from this week's Heart Rhythm journal. (Hint: arrow).This is why I don't think I'd ever like to be a copy editor because some smart a** will point out things like this.-Wesh/t: A fellow colleague in crimeMusings of a cardiologist and cardiac electrophysiologist. (Source: Dr. Wes) Dr. Wes blogs http://www.medworm.com/rss/comments.php?id=2912217 Wed, 21 Oct 2009 02:51:00 +0100 2912217 http://www.medworm.com/index.php?rid=2851800&cid=t_170301_105_f&fid=38964&url=http%3A%2F%2Fdrwes.blogspot.com%2F2009%2F10%2Felectricity-and-heart.html The heart is an amazing organ - incredibly strong as it beats over 31 million times a year while generating enough pressure to eject a column of blood over 5 feet high with each beat, yet incredibly fragile as it can degenerate into a quivering, disorganized lump of muscle with little more than the current from a 9-volt battery. We've all done it at one time or another: touched a 9-volt battery to our tongue. If that little tingling sensation on the tongue is strong enough, well then, there's probably enough power left in the battery to use it in a smoke detector or transistor radio.But there is probably enough energy remaining to fibrillate the heart, too. Fortunately for those lingual testers, the not enough energy passes toward the heart as the electrons flow between the closely-approxi... Dr. Wes blogs http://www.medworm.com/rss/comments.php?id=2851800 Thu, 01 Oct 2009 17:45:00 +0100 2851800 http://www.medworm.com/index.php?rid=1270538&cid=t_170301_82_f&fid=34667&url=http%3A%2F%2Flaryngoscope.blogspot.com%2F2008%2F03%2Fsoaked-to-skin-iii.html Now to help the patient you have to relieve the pressure around the heart. Usually this is (relatively) easy. You use a sternal saw and cut through the sternum. (middle of the chest where the ribs come together).In this case it was more difficult. He's had cardiac surgery before. Which means they've already sawn (sawed?) through his sternum in the past. This is problematic because there's sometimes lots of scar tissue there now, so if you try to get in through the sternum quickly, you make have to go through scar tissue. And in that scar the patient's aorta, which is the biggest artery in the body, may be scarred together. The other option is to go in through the side of the rib cage. Since he hadn't had any surgery on his chest from the side, there's less chance of scar tissue and bleedin... i'm so sleepy blogs http://www.medworm.com/rss/comments.php?id=1270538 Sat, 01 Mar 2008 12:48:00 +0100 1270538 http://www.medworm.com/index.php?rid=1240171&cid=t_170301_82_f&fid=34667&url=http%3A%2F%2Flaryngoscope.blogspot.com%2F2008%2F02%2Fsoaked-to-skin-ii.html anyway, sorry for the delay.. where was I...So they're doing CPR on the patient. I went up to the anesthesiologist and asked what was going on. Apparently they were doing an ablation in the ventricle and they had starting getting low blood pressure during the case, then a cardiac arrest.Now you see some people have irregular rhythms in their hearts. Usually these are cause for little areas of abnormal tissue in the heart, they can burn these areas and usually the irregular rhythms will go away. This is called an ablation. Sometimes they burn through too much and they can get into trouble. It's known to happen, but usually rare.The problem they have here is now they have a hole in the heart and it starts to bleed. That in and of itself isn't great, but the main problem is that the heart sit... i'm so sleepy blogs http://www.medworm.com/rss/comments.php?id=1240171 Mon, 18 Feb 2008 22:54:00 +0100 1240171