About the Author

Dr. Edgar H. Tan finished his Bachelor of Science (major in Biology) degree in Silliman University where he graduated with honors (cum laude) in 1982. He earned his medical degree at Cebu Doctors' College of Medicine. He was a consistent honor student, received a Faculty Silver Medal Award and graduated with honors (cum laude) in 1986. He did his Post Graduate Internship at the Philippine General Hospital from 1986-1987. He passed his Philippine Medical Licensure Exam rank #15 in August of 1987. He decided to pursue further studies in the United States and did his Internal Medicine Residency Training at Lincoln Medical and Mental Health Center in New York, a program affiliated with the New York Medical College in Westchester, New York from 1989-1992. He served as the Administrative Chief Medical Resident (ACMR) in the same program from 1992-1993 and received an award recognizing his excellent performance as ACMR by the graduating residents of that year. He subsequently pursued his Three-year Fellowship Training in Clinical and Invasive Cardiology at Metropolitan Hospital and Westchester County Medical Center Consortium, affiliated with New York Medical College Program from 1993-1996. He practiced in the State of South Carolina after his training in New York with privileges in Marlboro Park Hospital in Bennettsville SC and McLeod Regional Hospital in Florence SC from 1996-1997. He holds an active medical license in the State of Carolina since 1996 until present. He came home to start his own medical practice in Cebu in February of 1998 at Cebu Doctors' University Hospital. His US training, expertise and active medical licensure in the State of South Carolina remain handy not only to the locals but also to the American retirees knowing that the expertise of an American-trained and licensed physician is available right in the heart of Cebu City. Dr. Tan is board certified by the American Board of Internal Medicine and American Board of Cardiovascular Disease. He is also trained and certified in the field of Nuclear Cardiology. He is Board Certified by the Philippine College of Physicians as well. As a Fellow of the American College of Physicians and American College of Cardiology, he regularly travels abroad for his continuing medical education in the field of cardiology. His practice includes General Internal Medicine, Clinical as well as Interventional Cardiology i.e. diagnostic coronary angiography, percutaneous coronary intervention (stenting/angioplasty), permanent pacemaker implantation (single chamber & dual chamber pacers) etc. etc. He is affiliated with Cebu Doctors' University Hospital /Cebu Cardiovascular Center where he was the former Section Head of the Cardiac Catheterization Laboratory & currently appointed as the Section Head of the Department of Cardiology. Dr. Tan received recognition and was awarded the Presidential Medal Award given at Cebu Doctors' University Hospital on Sept. 2, 2020 for his contribution using a radical approach in the treatment of a critically ill Covid-19 infected patient with the combined use of Therapeutic Plasma Exchange and Convalescent Plasma Therapy which was first in the Philippines. His office is located at Cebu Doctors' University Hospital Medical Arts Building 1, Suite 303-A, Osmeña Blvd. Cebu City Philippines. Office hours are 9am-12pm Mon-Sat. Tel: 032-511-2857 Mobile/Viber: 0918-457-4762 . By appointment only.

Email: mailto://EdgarTan62@yahoo.com/ (Primary) or mailto://EdgarTanMD@gmail.com/ (Secondary)

A Paradime Shift in Atrial Fibrillation Management

Almost 10yrs ago in 2014,  I started my own AF/Stroke Prevention protocol and reported  my own observation in my own blog that I published in  July 24, 2019.  I reported  my personal thoughts about how to unmask AF and prevent its ugly twin called stroke. Our society in cardiology did not have any guideline and data was replete on how we detect and manage the high risk patients with occult Atrial Fibrillation. I wrote about  how I screen my high risk patients for stroke with the use of a simple legacy equipment called Holter Monitor. When I started to discover short bursts of SVT's (Supraventricular Tachycardia)  called Micro-AF, my dilemna started as if I may have inadvertently opened the pandora's box. A decision needs to be made as to whether to ignore and leave it as what our guideline  would suggest or should I intervene and nip it at the bud with anti-arrhythmic medication. The decision did not come easy but, with a reasonable logic and being upfront with my patients, I decided to share the decision regarding intervention with them. Most if not all of my patients would want me to proceed. I discussed and sometimes argue my findings with my colleagues and try to defend my protocol including the so called experts in the field. Almost everyone would look at my thought process as off, scary and outright potentially dangerous considering the paucity of data to defend it. They are absolutely correct  in their own right because my protocol did not have the necessary data to back it up. We doctors, have always been wired to follow guidelines and data in our day to day practice. I am not saying that it is bad but, if we get 100% dependent on data that may  never be available in all of our every day encounter with patients, then we should start using our God-given gift called common sense. 

 Fast forward 10yrs later, the EAST AFNET-4 was published by the American College of Cardiology in Oct. 11, 2024. This landmark clinical trial proved to be the beginning of a paradigm shift in the way we handle and manage our AF patients. This trial was terminated early in favor of  the Early Rhythm Strategy,  a strategy  I employed since 2014 which was not embraced by many is now the "in thing " and very much the way to go. I felt vindicated and thankful for the over 10yrs that my patients have benefited from an intervention that nobody would readily accept at that time. This proves over and over again that guidelines will always be a work in progress and we doctors need to open our minds and think outside the box. We should always remember and  not lose sight of the fact that sharing the decision with the patient is of paramount importance when untested protocols are being implemented.  Fear is normal, but what I can say is if you follow science it is difficult to go wrong and when you add knowledge into that critical thinking, reason will overcome whatever apprehension you may have and  fear will slowly ease away.