Welcome to the Afibber’s Forum
Serving Afibbers worldwide since 1999
Moderated by Shannon and Carey
 |
 |
 |
 |
 |
 |
Home
>
AFIBBERS FORUM
>
Topic
Controversy between Dr. Natale & Dr. Mandrola
Posted by fravi
|
Controversy between Dr. Natale & Dr. Mandrola March 02, 2020 02:41PM |
Registered: 7 years ago Posts: 19 |
|
Re: Controversy between Dr. Natale & Dr. Mandrola March 02, 2020 04:36PM |
Registered: 6 years ago Posts: 706 |
Not so sure its controversial. I think its more of contradicting opinions and or personalities.
I have never met Dr. John but have followed him for many years up until a few years ago. Have even had email correspondence with him many years ago. He has become more of an internet celebrity with hints of a pumped up ego than anything else. He has changed vastly over the years.
I have met DR. Natale and he is the exact opposite. Very humble and confident in his abilities.
Twitter is not the best forum for getting your complete thoughts across nor should you try to. Especially in such a forum.
Twitter definitely falls in the realm of a place where Dr. John is going to be more emboldened.
I have never met Dr. John but have followed him for many years up until a few years ago. Have even had email correspondence with him many years ago. He has become more of an internet celebrity with hints of a pumped up ego than anything else. He has changed vastly over the years.
I have met DR. Natale and he is the exact opposite. Very humble and confident in his abilities.
Twitter is not the best forum for getting your complete thoughts across nor should you try to. Especially in such a forum.
Twitter definitely falls in the realm of a place where Dr. John is going to be more emboldened.
|
Re: Controversy between Dr. Natale & Dr. Mandrola March 02, 2020 05:50PM |
Admin Registered: 6 years ago Posts: 5,351 |
Natale simply got tired of coddling Mandrola and quit doing so.
Mandrola seems more interested in recent years in building a following on WebMD by writing adversarial opinions. To hear him tell it, ablations are bad, LAA isolation is bad, isolating the posterior wall is bad, LAA occlusion devices (eg, Watchman) are bad. In fact, to hear him tell it, afib is your fault for leading a bad lifestyle and if you'd just lose weight, eat right, and get more exercise you wouldn't have afib.
I don't think he's taken seriously by the EP community.
Mandrola seems more interested in recent years in building a following on WebMD by writing adversarial opinions. To hear him tell it, ablations are bad, LAA isolation is bad, isolating the posterior wall is bad, LAA occlusion devices (eg, Watchman) are bad. In fact, to hear him tell it, afib is your fault for leading a bad lifestyle and if you'd just lose weight, eat right, and get more exercise you wouldn't have afib.
I don't think he's taken seriously by the EP community.
|
Re: Controversy between Dr. Natale & Dr. Mandrola March 02, 2020 06:48PM |
Registered: 6 years ago Posts: 706 |
"lifestyle and if you'd just lose weight, eat right, and get more exercise you wouldn't have afib."
This is interesting as 3 of the 4 people I know personally with affib, including myself, developed it living just like this. And all but 1 under the age of 45 at onset. One in their 20's.
I don't doubt it can be controlled with extreme adherence to diet, suplimenatation and maybe meditation as some here do. However, those are very rare instances b
This is interesting as 3 of the 4 people I know personally with affib, including myself, developed it living just like this. And all but 1 under the age of 45 at onset. One in their 20's.
I don't doubt it can be controlled with extreme adherence to diet, suplimenatation and maybe meditation as some here do. However, those are very rare instances b
|
Re: Controversy between Dr. Natale & Dr. Mandrola March 02, 2020 09:27PM |
Registered: 8 years ago Posts: 1,102 |
|
Re: Controversy between Dr. Natale & Dr. Mandrola March 02, 2020 09:34PM |
Admin Registered: 6 years ago Posts: 5,351 |
|
Re: Controversy between Dr. Natale & Dr. Mandrola March 02, 2020 10:03PM |
Registered: 11 years ago Posts: 4,226 |
Quote
rocketritch
"lifestyle and if you'd just lose weight, eat right, and get more exercise you wouldn't have afib."
This is interesting as 3 of the 4 people I know personally with afib, including myself, developed it living just like this. And all but 1 under the age of 45 at onset. One in their 20's.
I don't doubt it can be controlled with extreme adherence to diet, supplementation and maybe meditation as some here do. However, those are very rare instances
The issue is there are multiple populations of afibbers. I'm guessing 15% fit the younger, eat right, keep weight down and exercise category you describe (I made up the 15%, but it is likely in the ballpark). A material percentage of the remaining are older and metabolically ill (as are many in the general population). Back in the day when Hans used to do surveys, there were folks who helped their afib by doing what Dr. M suggests. Problem is, that for the fit 15%, more exercise won't fix the problem as it is likely a contributing cause (it was in my case & I was 49). Doing what Dr. M suggests may help some of the others. Of course that depends on how advanced their case is. As I posted here, my 34 year old son-in-law falls in the fit 15%. He's afib is responding to lifestyle modifications, but they include abstaining from alcohol and moderating exercise to mostly be in the Type 2 intensity category.
At one point, years ago, we did a little survey on this forum. It asked if the respondent was fit, tall or both. Almost all the men were both, per their responses.
|
Re: Controversy between Dr. Natale & Dr. Mandrola March 02, 2020 10:54PM |
Registered: 6 years ago Posts: 819 |
Looks like we have a lot to learn about genetics and epigenetics before we can claim what an optimal diet is for any individual?
On a population basis an optimal diet prescription is easier - no or minimal refined sugar/carbs especially in combination with fats. If on a high carb diet then minimize fats. Eat what maintains a healthy gut-biom. Maintain a steady low blood glucose level. Exercise (but not too much) and get adequate sunlight exposure. Avoid long term stress and get enough sleep..
No wonder i got afib because i did very little of the above
On a population basis an optimal diet prescription is easier - no or minimal refined sugar/carbs especially in combination with fats. If on a high carb diet then minimize fats. Eat what maintains a healthy gut-biom. Maintain a steady low blood glucose level. Exercise (but not too much) and get adequate sunlight exposure. Avoid long term stress and get enough sleep..
No wonder i got afib because i did very little of the above
|
Re: Controversy between Dr. Natale & Dr. Mandrola March 03, 2020 05:37AM |
Registered: 6 years ago Posts: 706 |
Quote
GeorgeN
"lifestyle and if you'd just lose weight, eat right, and get more exercise you wouldn't have afib."
This is interesting as 3 of the 4 people I know personally with afib, including myself, developed it living just like this. And all but 1 under the age of 45 at onset. One in their 20's.
I don't doubt it can be controlled with extreme adherence to diet, supplementation and maybe meditation as some here do. However, those are very rare instances
The issue is there are multiple populations of afibbers. I'm guessing 15% fit the younger, eat right, keep weight down and exercise category you describe (I made up the 15%, but it is likely in the ballpark). A material percentage of the remaining are older and metabolically ill (as are many in the general population). Back in the day when Hans used to do surveys, there were folks who helped their afib by doing what Dr. M suggests. Problem is, that for the fit 15%, more exercise won't fix the problem as it is likely a contributing cause (it was in my case & I was 49). Doing what Dr. M suggests may help some of the others. Of course that depends on how advanced their case is. As I posted here, my 34 year old son-in-law falls in the fit 15%. He's afib is responding to lifestyle modifications, but they include abstaining from alcohol and moderating exercise to mostly be in the Type 2 intensity category.
At one point, years ago, we did a little survey on this forum. It asked if the respondent was fit, tall or both. Almost all the men were both, per their responses.
I actually forgot about 1 other person I know. He is actually the on who lead me to this site originally way back then. He was an older gentleman, mid to late 60's. He was controlling his afib with supplementation. He was a cyclist and exercised regularly. I tried everything he was doing back then to no avail. This was also the infancy of my afib journey when my burden was quite low.
|
Re: Controversy between Dr. Natale & Dr. Mandrola March 03, 2020 08:21AM |
Registered: 9 years ago Posts: 182 |
Quote
Carey
Mandrola seems more interested in recent years in building a following on WebMD by writing adversarial opinions. To hear him tell it, ablations are bad, LAA isolation is bad, isolating the posterior wall is bad, LAA occlusion devices (eg, Watchman) are bad. In fact, to hear him tell it, afib is your fault for leading a bad lifestyle and if you'd just lose weight, eat right, and get more exercise you wouldn't have afib.
This is an exaggeration of Mandrola's views concerning ablation. There is plenty of evidence concerning the association of comorbidities (based on bad lifestyles) and AF, in the general population. Also, adversarial opinions with a factual basis are a good thing. Mandrola reads and understands studies, and moreover attempts to explain them, including their strengths and weaknesses; the same is not true of many EPs. Rebuttals are also fine, they serve a useful purpose to contrast opinions, and not necessarily as is being implied here to ridicule and minimize.
|
Re: Controversy between Dr. Natale & Dr. Mandrola March 03, 2020 10:07AM |
Admin Registered: 6 years ago Posts: 5,351 |
Quote
safib
Also, adversarial opinions with a factual basis are a good thing.
Of course, but maybe you should go read Shannon's rebuttal before you conclude how much of a factual basis Mandrola operates on. He has repeatedly written articles and made statements on twitter that demonstrate a less than thorough understanding of his subjects.
|
Re: Controversy between Dr. Natale & Dr. Mandrola March 03, 2020 11:20AM |
Registered: 9 years ago Posts: 182 |
Quote
Carey
He has repeatedly written articles and made statements on twitter that demonstrate a less than thorough understanding of his subjects.
I have read plenty of his material, and he has a stronger grasp of inferential statistics in epidemiology as it applies to heart disease than many EP's. That doesn't mean he is always correct, but it says a lot. In any case, you have mischaracterized his views on ablation, and you are simply wrong to ridicule his analysis that leading a bad lifestyle (resulting in obesity, etc.) is strongly associated with afib.
|
Re: Controversy between Dr. Natale & Dr. Mandrola March 03, 2020 03:01PM |
Admin Registered: 6 years ago Posts: 5,351 |
We're going to have to agree to disagree.
I wouldn't have a problem with him if he wrote in medical journals where the audience is going to be other EPs, but he doesn't. He writes on WebMD where the audience is primarily patients and the ability of other EPs to dispute or correct him is very limited. Every time he writes a new article I know I'm going to see scared patients asking about it here, stopafib.org, facebook, etc.
I wouldn't have a problem with him if he wrote in medical journals where the audience is going to be other EPs, but he doesn't. He writes on WebMD where the audience is primarily patients and the ability of other EPs to dispute or correct him is very limited. Every time he writes a new article I know I'm going to see scared patients asking about it here, stopafib.org, facebook, etc.
|
Re: Controversy between Dr. Natale & Dr. Mandrola March 03, 2020 04:18PM |
Registered: 11 years ago Posts: 4,226 |
Years ago, I used to read Dr. M's stuff. He was and may still be an avid cyclocross rider. He ended up in afib (2012?) and, as I recall, his wife (an ER MD) gave him flec. Hence he should be well aware of exercise as a trigger for afib. In fact, he coauthored a book about exercise (too much) and afib with Lennard Zinn. I've not read it. I corresponded with Zinn at one point and tried to point him to Natale.
|
Re: Controversy between Dr. Natale & Dr. Mandrola March 03, 2020 09:02PM |
Registered: 6 years ago Posts: 706 |
Quote
GeorgeN
Years ago, I used to read Dr. M's stuff. He was and may still be an avid cyclocross rider. He ended up in afib (2012?) and, as I recall, his wife (an ER MD) gave him flec. Hence he should be well aware of exercise as a trigger for afib. In fact, he coauthored a book about exercise (too much) and afib with Lennard Zinn. I've not read it. I corresponded with Zinn at one point and tried to point him to Natale.
That would be the "Haywire Heart". And you are correct about his own personal experience with AFib. This is what drew me towards him early in my time with AFib. We had correspondence at that time.
I may have even inquire about ablation with him at that time. I know we talked about it but he never offered any direction as to a particular doctor. That was a long long time ago
|
Re: Controversy between Dr. Natale & Dr. Mandrola March 04, 2020 06:45AM |
Registered: 4 years ago Posts: 47 |
|
Re: Controversy between Dr. Natale & Dr. Mandrola March 04, 2020 08:57AM |
Registered: 7 years ago Posts: 19 |
|
Re: Controversy between Dr. Natale & Dr. Mandrola March 04, 2020 10:57AM |
Admin Registered: 6 years ago Posts: 5,351 |
As best I can tell, Mandrola has had precisely one afib episode, years ago, and that was during a bike ride when he very well could have been dehydrated and had electrolytes out of whack. As we all know, electrolyte imbalances can cause afib episodes even in people who don't actually have afib.
Sorry, only registered users may post in this forum.