1 ATRIAL FIBRILLATION IN THE 21 ST CENTURY TIMOTHY DOWLING, D.O. FAMILY PHYSICIAN
2 GOALS AND OBJECTIVES At The end of this talk you should understand: What is Atrial Fibrillation Causes of Atrial Fibrillation The work up for Atrial Fibrillation Treatment of Atrial Fibrillation
3 DISCLOSURES I have no disclosures for this talk today
4 WHAT IS ATRIAL FIBRILLATION? Atrial fibrillation (A fib) is an irregular and often rapid heart rhythm. The irregular rhythm, or arrhythmia, results from abnormal electrical impulses in the upper chambers of the heart that cause the heartbeat to be irregular and usually fast. The irregularity can be continuous, or paroxsymal. Some individuals, especially patients on medications, may have atrial fibrillation constantly but not have a rapid (>100 heartbeats per minute) rate at rest. Variations of A fib may be termed paroxysmal, persistent, or permanent. A fib is the most common heart arrhythmia.
5 ELECTRICAL CONDUCTION OF THE HEART The electrical impulse originates in the SA node of the right atrium. As the impulse travels through the atrium, it produces a wave of muscle contractions. This causes the atria to contract. The impulse reaches the atrioventricular (AV) node in the muscle wall between the two ventricles. There, it pauses, giving blood from the atria time to enter the ventricles. The impulse then continues into the ventricles, causing ventricular contraction that pushes the blood out of the heart, completing a single heartbeat.
6 ATRIAL FIBRILLATION CAN OCCUR IN SEVERAL DIFFERENT PATTERNS Intermittent (paroxysmal): The heart develops atrial fibrillation and typically converts back again spontaneously to normal (sinus) rhythm. The episodes may last anywhere from seconds to days. Persistent: Atrial fibrillation occurs in episodes, but the arrhythmia does not convert back to sinus rhythm spontaneously. Medical treatment or cardioversion (electrical treatment) is required to end the episode. Permanent: The heart is always in atrial fibrillation. Conversion back to sinus rhythm either is not possible or is deemed not appropriate for medical reasons. In most cases, the rate is reduced by medications and the patients are placed on anticlotting medication for their lifetime.
7 ATRIAL FIBRILLATION A COMMON HEART RHYTHM DISORDERS It affects about 4% of the population, mostly people older than 60 years. This amounts to more than 2.6 million people in the U.S. People older than 40 have about a 25% chance of developing A fib in their lifetime. The risk of developing atrial fibrillation increases as we get older. About 10% of people older than 80 years have atrial fibrillation.
8 ATRIAL FIBRILLATION CAUSES Hyperthyroidism Alcohol use Pulmonary embolism Pneumonia
9 ATRIAL FIBRILLATION CAUSES Heart valve disease: This condition results from developmental abnormalities people are born with or can be caused by infection or degeneration/calcification of valves with age. Left ventricular hypertrophy. Coronary heart disease Hypertension Cardiomyopathy
11 ATRIAL FIBRILLATION DIAGNOSIS The ECG can help distinguish A fib from other arrhythmias that may have similar symptoms (atrial flutter, supraventricular tachycardia, or runs of ventricular tachycardia).
13 LAB TESTS Complete blood cell count (CBC) Markers for heart injury or stress (enzymes such as troponins and creatine kinase [CK] and BNP) Digoxin drug level (in patients taking this medication) Prothrombin time (PT) and international normalized ratio (INR) Serum electrolytes to evaluate sodium and potassium levels Thyroid function tests for hyperthyroidism
14 CHEST X-RAY This imaging test is used to evaluate for complications such as fluid in the lungs or to estimate heart size.
15 ECHOCARDIOGRAM OR TRANSESOPHAGEAL ECHOCARDIOGRAM This test is done to identify problems in heart valves or ventricular function or to look for blood clots in the atria.
16 ATRIAL FIBRILLATION MEDICAL TREATMENT Treatment for atrial fibrillation traditionally seeks three goals
17 ATRIAL FIBRILLATION MEDICAL TREATMENT Cardiac rate control: The first treatment goal is to slow down the ventricular rate, if it is fast. Beta-blockers: These drugs slow the heart rate by decreasing the rate of the SA node and by slowing conduction through the AV node. Examples include esmolol (Brevibloc), atenolol (Tenormin), propranolol (Inderal), or metoprolol (Lopressor, Toprol XL).
18 CARDIAC RATE CONTROL Cardiac rate control: The first treatment goal is to slow down the ventricular rate, if it is fast. Calcium channel blockers: These drugs also slow heart rate by mechanisms similar to those of beta-blockers.verapamil (Calan, Isoptin) and diltiazem (Cardizem) are examples of calcium channel blockers Digoxin (Lanoxin): This drug decreases the conductivity of electrical impulses through the AV node, but onset of action is slower than beta-blockers and calcium blockers.
19 RESTORE AND MAINTAIN NORMAL CARDIAC RHYTHM About half of the people with newly diagnosed atrial fibrillation will convert to normal rhythm spontaneously in hours. However, atrial fibrillation typically returns in many patients. The frequency with which arrhythmia returns and the symptoms it causes partly determine whether individuals receive rhythm-controlling medication, which is usually termed antiarrhythmia medication. The most commonly used drugs are amiodarone (Cordarone, Pacerone), sotalol (Betapace), propafenone (Rythmol), and flecainide (Tambocor).
20 RESTORE AND MAINTAIN NORMAL CARDIAC RHYTHM Dofetilide (Tikosyn): This is an oral antiarrhythmic drug that must be initiated in the hospital over a three-day period. Hospitalization is needed to closely monitor the heart rhythm during the initial dosing period. If the atrial fibrillation responds favorably during the initial dosing, a maintenance dose is established to be continued at home. Other medications: There are many other drugs in use and they are prescribed to individualize the treatment of A fib. Other drugs can include Ibutilide (Corvert), Dronedarone (Multaq), and Quinidine (Cardioquin, Quinalan, Quinidex, Quinaglute); others may be used rarely. Cardioversion
21 PREVENT CLOT FORMATION (STROKES) Stroke is a devastating complication of atrial fibrillation. Blood clots can form in the atria when their motility is impaired as in A fib. Coexisting medical conditions, such as hypertension, congestive heart failure, heart valve abnormalities, or coronary heart disease, significantly increase the risk of stroke. Age older than 65 years also increases the risk of stroke. The decision to utilize other drugs can be augmented by the CHADS2 score that assigns points to various conditions (congestive heart failure, hypertension, age, diabetes, and previous stroke) in an A fib patient. The higher the points, the more likely the patient is to develop a stroke; some clinicians use this score to help determine what other drugs may help their patients with A fib avoid a stroke.
22 CHADS2 SCORING SCHEME Condition Points C Congestive heart failure 1 H Hypertension 1 A Age > 75 years 1 D Diabetes Mellitus 1 S2 Prior Stroke or TIA 2
23 ANNUAL STROKE RISK WITH RESPECT TO CHADS 2 SCORE CHADS2 Score Stroke Risk % 95% confidence interval
24 ANTICOAGULATION BASED ON THE CHADS2 SCORE Score Risk Anticoagulation Therapy Considerations 0 Low Aspirin Aspirin daily 1 Moderate Aspirin or Warfarin Aspirin daily or raise INR to , depending on factors such as patient risk 2 or greater Moderate or High Warfarin Raise INR to , unless contraindicated
25 ANTICOAGULANTS IN AFIB Warfarin (Coumadin): It reduces the ability of the blood to clot. It lowers the risk of an unwanted blood clot forming in the heart or in a blood vessel. Atrial fibrillation increases the risk of forming such blood clots. It is extremely important to follow the exact dosing prescribed and to have regular blood tests (International Normalized Ratio). Aspirin and clopidogrel (Plavix): These are two commonly prescribed drugs used to reduce the chance of clot development in A fib patients, especially if patients cannot tolerate Coumadin; they also have been used in short-term treatments while a patient is undergoing evaluation for clot formation.
26 ANTICOAGULANTS IN AFIB Heparin and enoxaparin (Lovenox): These similar drugs have been used in short-term treatment of A fib patients; occasionally, Lovenox has been used by some physicians for longer term treatment. Dabigatran (Pradaxa): This thrombin inhibitor is approved for prevention of strokes and thrombus in nonvalvular A fib. There is some controversy about this new drug causing increased heart problems. Rivaroxaban (Xarelto): This factor Xa inhibitor is approved for the prevention of strokes and embolisms associated with nonvalvular A fib; dosing is related to creatinine clearance (CrCl) levels (kidney function).
27 ULIMOEN SR ET AL. COMPARISON OF FOUR SINGLE-DRUG REGIMENS ON VENTRICULAR RATE AND ATRIAL FIBRILLATION. ARRHYTHMIA-RELATED SYMPTOMS IN PATIENTS WITH PERMANENT ATRIAL FIBRILLATION AM J CARDIOL 2013 JAN 15; 111:225.
28 RATE CONTROL FOR ATRIAL FIBRILLATION: WHAT IS THE BEST DRUG TO USE? Ulimoen SR et al. Comparison of four single-drug regimens on ventricular rate and arrhythmia-related symptoms in patients with permanent atrial fibrillation. Am J Cardiol 2013 Jan 15; 111:225. Current guidelines recommend either a beta-blocker or a calcium-channel blocker as first-line rate-control treatment for atrial fibrillation (AF). However, head-tohead trials of the agents in current use are lacking. To compare the effects of four once-daily drug regimens on heart rate and AF-related symptoms in patients with permanent, rapidly conducted AF, investigators in Norway conducted a prospective, randomized, investigator-blind, crossover study.
29 RATE CONTROL FOR ATRIAL FIBRILLATION: WHAT IS THE BEST DRUG TO USE? Sixty adults (mean age, 71; 18 women) with permanent AF and without congestive heart failure or ischemic heart disease received, in randomized order, diltiazem, 360 mg; verapamil, 240 mg; metoprolol, 100 mg; and carvedilol, 25 mg. Each drug was given for 3 weeks to ensure steadystate plasma concentration and adequate washout of the prior treatment. Before the first treatment and on the last day of each treatment protocol, 24-hour Holter recordings were obtained, and patients completed questionnaires on symptom frequency and severity.
30 RATE CONTROL FOR ATRIAL FIBRILLATION: WHAT IS THE BEST DRUG TO USE? The 24-hour mean heart rate was significantly reduced from baseline with all four treatments and was significantly lower with diltiazem than with any other drug: Baseline, 96 beats per minute (bpm) Diltiazem, 75 bpm Verapamil, 81 bpm Metoprolol, 82 bpm Carvedilol, 84 bpm
31 RATE CONTROL FOR ATRIAL FIBRILLATION: WHAT IS THE BEST DRUG TO USE? Deciding which drug to prescribe for heartrate control in patients with atrial fibrillation is a common clinical challenge. In this small, single-center study, diltiazem, at 360 mg per day, appeared to be the best choice. However, these results need confirmation in larger clinical trials and in different populations before any definitive recommendation can be made.
32 INCREASED MORTALITY AMONG PATIENTS TAKING DIGOXIN-ANALYSIS FROM THE AFFIRM STUDY Digoxin was associated with a significant increase in all-cause mortality in patients with AF after correcting for clinical characteristics and comorbidities, regardless of gender or of the presence or absence of HF. These findings call into question the widespread use of digoxin in patients with AF. Eur Heart J (2012) doi: /eurheartj/ehs348 First published online: November 27, 2012
34 IN CONCLUSION Atrial Fibrillation is a common disease The treatments for Afib continue to evolve What is old may be good or it may be bad When in doubt consult Cardiologist!
Current Management of Atrial Fibrillation Mary Macklin, MSN, APRN Concord Hospital Cardiac Associates DISCLOSURES I have no financial conflicts to disclose Book Women: Fit at Fifty. A Guide to Living Long.
Cardioversion for Atrial Fibrillation Your Heart s Electrical System Cardioversion Living with Atrial Fibrillation When You Have Atrial Fibrillation You ve been told you have a heart condition called atrial
1 of 7 9/14/2011 10:50 AM Current URL: What you need to know about Atrial Fibrillation What is atrial fibrillation? What causes atrial fibrillation? How is atrial fibrillation diagnosed? What are the dangers
Treatments to Restore Normal Rhythm In many instances when AF causes significant symptoms or is negatively impacting a patient's health, the major goal of treatment is to restore normal rhythm and prevent
In the name of God Shiraz E-Medical Journal Vol. 11, No. 3, July 2010 http://semj.sums.ac.ir/vol11/jul2010/89015.htm Recurrent AF: Choosing the Right Medication. Basamad Z. * Assistant Professor, Department
DERBYSHIRE JOINT AREA PRESCRIBING COMMITTEE (JAPC) MANAGEMENT of Atrial Fibrillation (AF) Key priorities Identification and diagnosis Treatment for persistent AF Treatment for permanent AF Antithrombotic
About this guide We have prepared this guide to help you to: learn about atrial fibrillation manage atrial fibrillation and reduce the risk of stroke find out about medicines and other treatment options
Atrial Fibrillation Peter Santucci, MD Revised May, 2008 Atrial fibrillation (AF) is an irregular, disorganized rhythm characterized by a lack of organized mechanical atrial activity. The atrial rate is
Disclosures Atrial Fibrillation Management Across the Spectrum of Illness NONE Barbara Birriel, MSN, ACNP-BC, FCCM The Pennsylvania State University Objectives AF Discuss the pathophysiology, diagnosis,
INFORMATION FOR PATIENTS AND FAMILIES A Patient s Guide to Living with Atrial Fibrillation 30 Bond Street, Toronto, ON M5B 1W8 Canada 416.864.6060 stmichaelshospital.com Form No. XXXXX Dev. XX/XXXX GOALS
Patient Information Treatment Options for Atrial Fibrillation Page 1 of 8 Treatment Options for Atrial Fibrillation Patient Information Emory University Hospital Midtown Cardiac Electrophysiology Service
Dr Arvind Vasudeva Consultant Cardiologist Atrial Fibrillation An update on diagnosis and management Atrial fibrillation (AF) remains the commonest disturbance of cardiac rhythm seen in clinical practice.
Radiofrequency Ablation for Atrial Fibrillation A Guide for Adults Fast Facts n There are different ways to treat atrial fibrillation (A-fib). One kind of treatment involves putting the heart back into
Treatment Guide Atrial fibrillation Atrial fibrillation (AF or AFib) is the most common irregular or abnormal heart rhythm disorder, affecting more than 3 million Americans today. Thankfully, more options
Care Pathway Triage category ATRIAL FIBRILLATION PATHWAY ACCIDENT AND EMERGENCY DEPARTMENT/CARDIOLOGY AF/ FLUTTER IS PRIMARY REASON FOR PRESENTATION YES NO ONSET SYMPTOMS OF AF./../ TIME DURATION OF AF
Management of ATRIAL FIBRILLATION in general practice 22 BPJ Issue 39 What is atrial fibrillation? Atrial fibrillation (AF) is the most common cardiac arrhythmia encountered in primary care. It is often
The Treatment of Atrial Fibrillation University of Michigan Fred Morady, MD; Hakan Oral, MD; Aman Chugh, MD; Frank Pelosi, MD; Frank Bogun, MD; Eric Good, DO; Krit Jongnarangsin, MD; Thomas Crawford, MD;
New Treatments for Stroke Prevention in Atrial Fibrillation John C. Andrefsky, MD, FAHA NEOMED Internal Medicine Review course May 5 th, 2013 Classification Paroxysmal atrial fibrillation (AF) Last < 7
Introduction to Atrial Fibrillation (AFib) Learn About: 1. What is atrial fibrillation? 2. How will I feel? 3. Who gets AFib? 4. Risk of stroke 5. AFib treatment 6. How to live well with AFib 1. What is
PRACTICAL APPROACH TO SVT Graham C. Wong MD MPH Division of Cardiology Vancouver General Hospital University of British Columbia CONDUCTION SYSTEM OF THE HEART SA node His bundle Left bundle AV node Right
Atrial Fibrillation Patient Information 828361 Dec 19-12 Contents Introduction 1 Treatment & decrease stroke options 2 Information for people who are taking warfarin (Coumadin ) 5 Information for people
Anticoagulation Therapy Update JUDY R. WALLING, FNP-BC ARRHYTHMIA MANAGEMENT MUSC CARDIOLOGY Outline Who do we anticoagulate? Review classes of Anticoagulants Review examples of Anticoagulants Review CHADS2
Atrial Fibrillation and Ablation Therapy: A Patient s Guide ATRIAL FIBRILLATION CENTER AT UNIVERSITY OF ROCHESTER MEDICAL CENTER www.heart.urmc.edu 585-275-4775 INTRODUCTION Our goal at the Atrial Fibrillation
Antiplatelet and Antithrombotic Therapy Dr Curry Grant Stroke Prevention Clinic Quinte Health Care Disclosure of Potential for Conflict of Interest Dr. F.C. Grant Atrial Fibrillation FINANCIAL DISCLOSURE:
Patient s Guide to Antithrombotic Therapy in Atrial Fibrillation A Patient s Guide to Antithrombotic Therapy in Atrial Fibrillation PATIENT EDUCATION GUIDE What is atrial fibrillation? Atrial fibrillation
AF A Atrial fibrillation (AF) patient information Providing information, support and access to established, new or innovative treatments for Atrial Fibrillation www.atrialfibrillation-au.org Glossary Antiarrhythmic
Atrial fibrillation: Slow(er), even if not steady, wins the race Balanced data about medications www.rxfacts.org Copyright 2011 by The Alosa Foundation www.rxfacts.org February 2011 Authors: Leslie Jackowski,
Arrhythmia Facts During a 24-hour period, about 20% of healthy adults are likely to have frequent or multiple types of premature ventricular heartbeats. Heart arrhythmias are very common and nearly everyone
Page 1 of 40 Atrial Fibrillation and Atrial Flutter Page 2 of 40 Introduction Page 3 of 40 Atrial fibrillation is an irregular heart rhythm that starts in the heart s upper chambers (atria). When it occurs,
written by Harvard Medical School Atrial Fibrillation Coping With a Chaotic Heartbeat www.patientedu.org What Is Atrial Fibrillation? Atrial fibrillation is a fast and irregular heartbeat. It occurs in
Clinical Practice Guidelines for the Management of Patients With Atrial Fibrillation Deborah Ritchie RN, MN, Robert S Sheldon MD, PhD Cardiovascular Research Group, University of Calgary, Alberta Partly
Practical Rate and Rhythm Management of Atrial Fibrillation pocket guide UPDATED FEBRUARY 2013 Adapted from the ACCF/AHA/HRS 2011 Focused Updates Incorporated into the ACC/AHA/ESC Guidelines for the Management
Palpitations & AF Richard Grocott Mason Consultant Cardiologist THH NHS Foundation Trust & Royal Brompton & Harefield NHS Foundation Trust Palpitations Frequent symptom Less than 50% associated with arrhythmia
Balanced information for better care Atrial fibrillation Anticoagulation: a key strategy Slow(er), even if not steady, wins the race Atrial fibrillation increases the risk of stroke and other important
358 Clinical Pharmacist November 2010 Vol 2 Treatment of atrial fibrillation usually involves controlling ventricular rate or restoring sinus rhythm. Equally important is thromboembolic risk assessment
Living with Atrial Fibrillation U nderstanding Atrial Fibrillation An estimated 2.7 million Americans are living with atrial fibrillation (AF). That makes it the most common heart rhythm abnormality in
Atrial Fibrillation The Basics Family Practice Symposium Tim McAveney, M.D. 10/23/09 Objectives Review the fundamentals of managing afib Discuss the risks for stroke and the indications for anticoagulation
www.irishheart.ie ATRIAL FIBRILLATION AND YOU An information booklet for people living with Atrial Fibrillation (a type of irregular heart beat). Contents Introduction 5 Produced by the Irish Heart Foundation
UW MEDICINE PATIENT EDUCATION Supraventricular Tachycardia (SVT) and Ablation Treating your abnormal heart rhythm This handout describes a type of abnormal heart rhythm called supraventricular tachycardia.
Atrial Fibrillation: Drugs, Ablation, or Benign Neglect Robert Kennedy, MD October 10, 2015 Definitions 2014 AHA/ACC/HRS Guideline for the Management of Patients With Atrial Fibrillation: Executive Summary.
A Patient s Guide To with Atrial Fibrillation (AFib) CAUSES RISK FACTORS SYMPTOMS DIAGNOSIS TREATMENTS INSIDE The Healthy Heart... 2 Your Heart In AFib... 4 How Do You Get It?... 6 How Do You Know If You
Atrial Fibrillation What to Know About Atrial Fibrillation Understanding Afib Atrial fibrillation, or Afib, is a condition in which the heart beats irregularly speeding up or slowing down, or beating too
Nursing Care and Considerations for Patients with Atrial Fibrillation Kris Kinghorn RN, MSN, ANP-BC Case Study 66 y/o female (Mrs. Olus A. Blader) Admitted with c/o palpitations and lightheadedness PMH:
Atrial Fibrillation BRIEFLY, HOW DOES THE HEART PUMP? The heart has four chambers. The upper chambers are called atria. One chamber is called an atrium, and the lower chambers are called ventricles. In
Name: generic (trade) Rivaroxaban (Xarelto ) HERTFORDSHIRE MEDICINES MANAGEMENT COMMITTEE (HMMC) RIVAROXABAN RECOMMENDED see specific recommendations for licensed indications below What it is Indications
Atrial fibrillation About the British Heart Foundation The British Heart Foundation (BHF) is the nation s heart charity, saving lives through pioneering research, patient care and vital information. What
Quick reference guide Issue date: June 2006 Atrial fibrillation The management of atrial fibrillation Developed by the National Collaborating Centre for Chronic Conditions Contents Contents Patient-centred
Ngaire has Palpitations David Heaven Cardiac Electrophysiologist/Heart Rhythm Specialist Middlemore, Auckland City and Mercy Hospitals Auckland Heart Group MCQ Ms A is 45, and a healthy marathon runner.
Living with Atrial Fibrillation A Guide for Patients and Families UOHI 77 40 RUSKIN STREET, OTTAWA ON K1Y 4W7 T 613.761.5000 WWW.OTTAWAHEART.CA PLEASE BRING THIS BOOK WITH YOU TO THE HEART INSTITUTE Patient
PATIENT INFORMATION BOOKLET FOR ATRIAL FIBRILLATION Prepared by Karen Jones MBA and Nancy Marco NP for the Complex Arrhythmia Clinic Toronto General Hospital Peter Munk Cardiac Centre University Health
Episode 20 Atrial fibrillation Prepared by Dr. Lucas Chartier Most common dysrhythmia seen in ED, and incidence increasing with ageing population Presentation Common presentations: younger patients often
P a g e 1 Dorset Cardiac Centre Patients with Atrial Fibrillation/Flutter undergoing DC Cardioversion or Ablation procedures- Guidelines for Novel Oral Anti-coagulants (NOACS) licensed for this use February
CATHETER ABLATION for ATRIAL FIBRILLATION Atrial Fibrillation Clinic Dr. Richard Leather, Dr. Larry Sterns, Dr Paul Novak, Dr. Chris Lane Royal Jubilee Hospital Block 3 rd floor, Rm 343 1952 Bay Street
What Are Arrhythmias? Many people have questions about what the word arrhythmia means, and arrhythmias can be a difficult subject to understand. The text below should give you a better understanding of
Atrial Fibrillation 2014 How to Treat How to Anticoagulate Allan Anderson, MD, FACC, FAHA Division of Cardiology Projection for Prevalence of Atrial Fibrillation: 5.6 Million by 2050 Projected number of
RATE VERSUS RHYTHM CONTROL OF ATRIAL FIBRILLATION: SPECIAL CONSIDERATION IN ELDERLY Charles Jazra NO CONFLICT OF INTEREST TO DECLARE Relationship Between Atrial Fibrillation and Age Prevalence, percent
A Patient Guide to Atrial Fibrillation and Catheter Ablation Al-Sabah Arrhythmia Institute 1111 Amsterdam Avenue New York, NY 10025 Phone: 212-523-2400 Fax: 212-523-2571 www.stlukescardiology.org Printed
STROKE PREVENTION IN ATRIAL FIBRILLATION OBJECTIVE: To guide clinicians in the selection of antithrombotic therapy for the secondary prevention of ischemic stroke and arterial thromboembolism in patients
DISCLAIMER: These guidelines were prepared by the Department of Surgical Education, Orlando Regional Medical Center. They are intended to serve as a general statement regarding appropriate patient care
Cardiac rate control or rhythm control could be the key to AF therapy Recent studies have proven that an option of pharmacologic and non-pharmacologic therapy is available to patients who suffer from AF.
These guidelines have been withdrawn MOH clinical practice guidelines are considered withdrawn five years after publication unless otherwise specified in individual guidelines. Users should keep in mind
The three P s of atrial fibrillation outline I. Objectives At the end of the presentation, the audience will be able to: Understand the phases of atrial fibrillation Understand risks for stroke Understand
Atrial Fibrillation Based on ESC Guidelines Moshe Swissa MD Kaplan Medical Center Epidemiology AF affects 1 2% of the population, and this figure is likely to increase in the next 50 years. AF may long
2:15 3 pm Managing Arrhythmias in Primary Care Presenter Disclosure Information The following relationships exist related to this presentation: Raul Mitrani, MD, FACC, FHRS: Speakers Bureau for Medtronic.
Anticoagulation: How Do I Pick From All the Choices? Jeffrey H. Neuhauser, DO, FACC BHHI Primary Care Symposium February 28, 2014 Atrial Fibrillation 2 Atrial Fibrillation The most common arrhythmia encountered
Protocol for the management of atrial fibrillation in primary care Protocol for the management of atrial fibrillation in primary care Contents Page no Definition 2 Classification of AF 2 3 Identification
Survey of Canadian Physicians Use of anti-thrombotic therapy for Atrial Fibrillation On the following pages are a number of questions asking about the conditions under which you would prescribe anticoagulation
Service Notification in response to DHSSPS endorsed NICE Technology Appraisals NICE TA 275: Apixaban for the prevention of stroke and systemic embolism in people with non-valvular atrial fibrillation 1
Devang M. Desai, MD, FACC, FSCAI Chief of Interventional Cardiology Director of Cardiac Catheterization Lab St. Mary s Hospital and Regional Medical Center A.Fib affects 2.2 million Americans. The lifetime
HEART SERIES H9 UNDERSTANDING ATRIAL FIBRILLATION Chest Heart & Stroke Scotland improves the quality of life for people in Scotland affected by chest, heart and stroke illness, through medical research,
Optimizing Anticoagulation Selection for Your Patient C. Andrew Brian MD, FACC NCVH 2015 Who Needs to Be Anticoagulated and What is the Patient s Risk? 1. Atrial Fibrillation ( nonvalvular ) 2. What regimen
Mary Bradbury, PharmD, BCPS Clinical Pharmacy Specialist, Cardiac Surgery September 18, 2012 Mary.email@example.com This presentation will discuss unlabeled and investigational use of products The author
This handout will help you learn about atrial fibrillation ablation, also called pulmonary vein isolation. 2 Atrial Fibrillation Ablation How does the heart work? To understand atrial fibrillation, you
THE INTERNET STROKE CENTER PRESENTATIONS AND DISCUSSIONS ON STROKE MANAGEMENT Stroke Prevention in Atrial Fibrillation Gregory Albers, M.D. Director Stanford Stroke Center Professor of Neurology and Neurological
COVER ARTICLE PRACTICAL THERAPEUTICS Acute Management of Atrial Fibrillation: Part I. Rate and Rhythm Control DANA E. KING, M.D., LORI M. DICKERSON, PHARM.D., and JONATHAN L. SACK, M.D. Medical University