Atrial fibrillation: new pathophysiological. novel pharmacological approaches: Update on rate control strategies which are the real targets?
|
|
|
- Norman Gibson
- 7 years ago
- Views:
Transcription
1 Atrial fibrillation: new pathophysiological concepts and novel pharmacological approaches: Update on rate control strategies which are the real targets? Federico Lombardi, MD, FESC Cardiologia Osp. San Paolo Dip. Scienze della Salute Università degli Studi di Milano
2 Published today - Advanced Access European Heart Journal
3 Principles of Management
4 Rate and Rhythm Control
5 Principles of Antiarrhythmic Drug Therapy to Maintain Sinus Rhythm 1. Treatment is motivated by attempts to reduce AF-related symptoms 2. Efficacy of antiarrhythmic drugs to maintain sinus rhythm is modest 3. Clinically successful antiarrhythmic drug therapy may reduce rather than eliminate recurrence of AF 4. If one antiarrhythmic drug fails a clinically acceptable response may be achieved with another agent 5. Drug-induced proarrhythmia or extra-cardiac side-effects are frequent 6. Safety rather than efficacy considerations should primarily guide the choice of antiarrhythmic agent
6
7
8
9
10 Choice of Rate Control Medication
11 Optimal Rate Control
12 Van Gelder et al, NEJM 2010
13 Van Gelder et al, NEJM 2010
14 Van Gelder et al, NEJM 2010
15 Smit et al, JACC 2011
16 Groenveld et al, JACC 2011
17 6.2. The cardiac resynchronization therapy patient with atrial fibrillation In patients with atrial fibrillation, it is imperative to ensure a high rate of biventricular pacing for the patient to extract maximum benefit from CRT. Unlike in NSR, in atrial fibrillation patients this task may be challenging. Relying on the per cent biventricular pacing data stored in the CRT device may be misleading as these rates would include fusion and pseudo-fusion between pacing from the device and conduction through the patient s intrinsic conduction system. This is one of the reasons implicated in the improved outcomes of CRT patients with atrial fibrillation with AV nodal ablation compared to rate control with medications. 238 Other mechanisms implicated in the improved outcomes after AV ablation include more complete rate control and regularization without the need for medications that may induce fatigue and tiredness and exacerbate other symptoms of heart failure.329 Heart Rhythm 2012
18
19 Different ventricular response during AF
20 The AV node is subjected to the impact of atrial impulses during AF which leads to summation and/or cancellation of wave-fronts in AV node and, accordingly, a high level of disorganization of the penetrating impulses. Different properties such as intrinsic refractoriness of the AV node and concealed conduction determine the characteristics of the ventricular response. The existence of two pathways through the AV node, each with different electrophysiological properties, also affect ventricular response.
21 Zhang & Mazgalev, Heart Rhythm 2012
22 Zhang & Mazgalev, Heart Rhythm 2012
23 Masè et al, Am J Physiol 2012
24 Transitions between AV coupling patterns at changing atrial cycle length Masè et al, Am J Physiol 2012
25 Corino et al, Biomed Sign Proc & Control in press
26 Corino et al, Biomed Sign Proc & Control in press
27 MADIT II population; at multivariate Cox analysis, pnn20 was associated with HR 3.03; 95% CI ; p= Platonov & Holmqvist, J Electrocardiol 2011
28 Conclusions: Control of ventricular response can be obtained in most patients with atrial fibrillation and is associated with symptoms' reduction. Available evidence suggests that the efficacy of a lenient control strategy is not inferior to the strict one. At variance with rhythm control, available drugs are safe and effective for rate control. Control of ventricular response in CRT patients is still a critical issue, which needs to be properly addressed to reduce the number of non responders. A compete understanding of AV physiology in AF patients is still missing and is now object of investigation of several bio-medical groups.
How to control atrial fibrillation in 2013 The ideal patient for a rate control strategy
How to control atrial fibrillation in 2013 The ideal patient for a rate control strategy L. Pison, MD Advances in Cardiac Arrhythmias and Great Innovations in Cardiology - Torino, September 28 th 2013
COVERAGE GUIDANCE: ABLATION FOR ATRIAL FIBRILLATION
COVERAGE GUIDANCE: ABLATION FOR ATRIAL FIBRILLATION Question: How should the EGBS Coverage Guidance regarding ablation for atrial fibrillation be applied to the Prioritized List? Question source: Evidence
How should we treat atrial fibrillation in heart failure
Advances in Cardiac Arrhhythmias and Great Innovations in Cardiology Torino, 23/24 Ottobre 2015 How should we treat atrial fibrillation in heart failure Matteo Anselmino Dipartimento Scienze Mediche Città
Presenter Disclosure Information
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.
Management of Atrial Fibrillation in Heart Failure
Disadvantages of AV Junction Ablation Persistent AFib- no AV synchrony Ongoing risk of thromboembolism Life-long dependency on pacemaker Comparison of LA Ablation vs. AVN Ablation LA Ablation AVN Ablation
ATRIAL FIBRILLATION (RATE VS RHYTHM CONTROL)
ATRIAL FIBRILLATION (RATE VS RHYTHM CONTROL) By Prof. Dr. Helmy A. Bakr Mansoura Universirty 2014 AF Classification: Mechanisms of AF : Selected Risk Factors and Biomarkers for AF: WHY AF? 1. Atrial fibrillation
Atrial Fibrillation: Drugs, Ablation, or Benign Neglect. Robert Kennedy, MD October 10, 2015
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.
Updated Cardiac Resynchronization Therapy Guidelines
The Ohio State University Heart and Vascular Center Updated Cardiac Resynchronization Therapy Guidelines William T. Abraham, MD, FACP, FACC, FAHA, FESC Professor of Medicine, Physiology, and Cell Biology
RATE VERSUS RHYTHM CONTROL OF ATRIAL FIBRILLATION: SPECIAL CONSIDERATION IN ELDERLY. Charles Jazra
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
Atrial Fibrillation Cardiac rate control or rhythm control could be the key to AF therapy
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.
Basics of Pacing. Ruth Hickling, RN-BSN Tasha Conley, RN-BSN
Basics of Pacing Ruth Hickling, RN-BSN Tasha Conley, RN-BSN The Cardiac Conduction System Cardiac Conduction System Review Normal Conduction Conduction QRS QRS Complex Complex RR PP ST ST segment segment
PRACTICAL APPROACH TO SVT. Graham C. Wong MD MPH Division of Cardiology Vancouver General Hospital University of British Columbia
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
UNITED STATES PATENT AND TRADEMARK OFFICE BEFORE THE PATENT TRIAL AND APPEAL BOARD. Ex parte VINOD SHARMA and DANIEL C. SIGG
UNITED STATES PATENT AND TRADEMARK OFFICE BEFORE THE PATENT TRIAL AND APPEAL BOARD Ex parte VINOD SHARMA and DANIEL C. SIGG Appeal 2012-000284 Technology Center 1600 Before ERIC GRIMES, FRANCISCO C. PRATS,
HTEC 91. Topic for Today: Atrial Rhythms. NSR with PAC. Nonconducted PAC. Nonconducted PAC. Premature Atrial Contractions (PACs)
HTEC 91 Medical Office Diagnostic Tests Week 4 Topic for Today: Atrial Rhythms PACs: Premature Atrial Contractions PAT: Paroxysmal Atrial Tachycardia AF: Atrial Fibrillation Atrial Flutter Premature Atrial
Recurrent AF: Choosing the Right Medication.
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
Atrial Fibrillation and Cardiac Device Therapy RAKESH LATCHAMSETTY, MD DIVISION OF ELECTROPHYSIOLOGY UNIVERSITY OF MICHIGAN HOSPITAL ANN ARBOR, MI
Atrial Fibrillation and Cardiac Device Therapy RAKESH LATCHAMSETTY, MD DIVISION OF ELECTROPHYSIOLOGY UNIVERSITY OF MICHIGAN HOSPITAL ANN ARBOR, MI Outline Atrial Fibrillation What is it? What are the associated
Catheter Ablation. A Guided Approach for Treating Atrial Arrhythmias
Catheter Ablation A Guided Approach for Treating Atrial Arrhythmias A P A T I E N T H A N D B O O K This brochure will provide an overview of atrial arrhythmias (heart rhythm problems affecting the upper
Atrial Fibrillation Based on ESC Guidelines. Moshe Swissa MD Kaplan Medical Center
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
How do you decide on rate versus rhythm control?
Heart Rhythm Congress 2014 How do you decide on rate versus rhythm control? Dr Ed Duncan Consultant Cardiologist & Electrophysiologist Define Rhythm Control DC Cardioversion Pharmacological AFFIRM study
Il destino dei pazienti dopo ablazione della fibrillazione atriale
Tigullio Cardiologia 2014 La terapia della fibrillazione atriale: Il destino dei pazienti dopo ablazione della fibrillazione atriale N. Bottoni Responsabile U.O.S. Aritmologia Interventistica, Az. Ospedaliera
Current Management of Atrial Fibrillation DISCLOSURES. Heart Beat Anatomy. I have no financial conflicts to disclose
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.
Atrial Fibrillation 2014 How to Treat How to Anticoagulate. Allan Anderson, MD, FACC, FAHA Division of Cardiology
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
Management of Symptomatic Atrial Fibrillation
Management of Symptomatic Atrial Fibrillation John F. MacGregor, MD, FHRS Associate Medical Director, Cardiac Electrophysiology PeaceHealth St. Joseph Medical Center, Bellingham, WA September 18, 2015
Tachyarrhythmias (fast heart rhythms)
Patient information factsheet Tachyarrhythmias (fast heart rhythms) The normal electrical system of the heart The heart has its own electrical conduction system. The conduction system sends signals throughout
The Emerging Atrial Fibrillation Epidemic: Treat It, Leave It or Burn It?
The Emerging Atrial Fibrillation Epidemic: Treat It, Leave It or Burn It? Indiana Chapter-ACC 17 th Annual Meeting Indianapolis, Indiana October 19, 2013 Deepak Bhakta MD FACC FACP FAHA FHRS CCDS Associate
DISCLOSURE. Atrial Fibrillation Management An Evidence-based Approach OBJECTIVES BACKGROUND AFFIRM 9/16/2015
Death (%) Mortality (%) 9/16/2015 DISCLOSURE Atrial Fibrillation Management An Evidence-based Approach Jonathon Adams, MD, FHRS Relevant Financial Relationship(s) None Off Label Usage None OBJECTIVES What
Introduction to Electrophysiology. Wm. W. Barrington, MD, FACC University of Pittsburgh Medical Center
Introduction to Electrophysiology Wm. W. Barrington, MD, FACC University of Pittsburgh Medical Center Objectives Indications for EP Study How do we do the study Normal recordings Abnormal Recordings Limitations
Addendum to the Guideline on antiarrhythmics on atrial fibrillation and atrial flutter
22 July 2010 EMA/CHMP/EWP/213056/2010 Addendum to the Guideline on antiarrhythmics on atrial fibrillation and atrial flutter Draft Agreed by Efficacy Working Party July 2008 Adoption by CHMP for release
Atrial Fibrillation Peter Santucci, MD Revised May, 2008
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
Unrestricted grant Boehringer Ingelheim
ED Management of Recent Onset tat Atrial Fibrillation and Flutter (RAFF) Canadian Cardiovascular Society Guidelines 2010 CAEP St John s 2011 Ian Stiell MD MSc FRCPC Professor and Chair, Dept of Emergency
Who, when and how to rate control for atrial fibrillation Michiel Rienstra and Isabelle C. Van Gelder
Who, when and how to rate control for atrial fibrillation Michiel Rienstra and Isabelle C. Van Gelder Department of Cardiology, University Medical Center Groningen, University of Groningen, Groningen,
Atrial Fibrillation: Do We Have A Cure? Raymond Kawasaki, MD AMG Electrophysiology February 21, 2015
Atrial Fibrillation: Do We Have A Cure? Raymond Kawasaki, MD AMG Electrophysiology February 21, 2015 Disclaimer I have no relationships to disclose Do we have a cure for Atrial Fibrillation? The short
Equine Cardiovascular Disease
Equine Cardiovascular Disease 3 rd most common cause of poor performance in athletic horses (after musculoskeletal and respiratory) Cardiac abnormalities are rare Clinical Signs: Poor performance/exercise
How do you decide on rate versus rhythm control?
How do you decide on rate versus rhythm control? Dr. Mark O Neill Consultant Cardiologist & Electrophysiologist Assumptions Camm et al. EHJ 2010;Sept 25 epub Choice of strategy: Criteria for consideration
Projected Number of Adults With AF in the US. Review the growing incidence and importance of AF in the population
Atrial Fibrillation Troy E. Rhodes, MD, PhD Division of Cardiovascular Medicine, Electrophysiology Ohio State University Medical Center Learning Objectives Review the growing incidence and importance of
Rome, Italy December 4-7, 2012 Rome Cavalieri TIMETABLE
Rome, Italy December 4-7, 2012 Rome Cavalieri Monday, December 3 ROOM Terrazza Monte Mario PATIENT MANAGEMENT CONCEPTS AND CONTROVERSIES IN ELECTROPHYSIOLOGY BIOTRONIK International Fellows Program (IFP)
Atrial Fibrillation The Basics
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
Managing the Patient with Atrial Fibrillation
Pocket Guide Managing the Patient with Atrial Fibrillation Updated April 2012 Editor Stephen R. Shorofsky, MD, Ph.D. Assistant Editors Anastasios Saliaris, MD Shawn Robinson, MD www.hrsonline.org DEFINITION
CCAD Training Manual. Cardiac Rhythm Management (CRM)
CCAD Training Manual Cardiac Rhythm Management (CRM) Version 1.0 A D Cunningham 19/3/2008 Introduction This manual is intended to assist users of the Notes Client version of the CCAD Cardiac Rhythm Management
Electrophysiology Heart Study - EPS -
Electrophysiology Heart Study - EPS - What is an EPS? EPS is short for ElectroPhysiology heart Study. This procedure looks at the electrical system of your heart. An EPS will show if you have a heart rhythm
Atrial Fibrillation and Ablation Therapy: A Patient s Guide
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
SECTION I: Request. SECTION II: Need. Program Description
SECTION I: Request This is a formal request for the Utah CARMA Center to be formally recognized by the University of Utah as a large, collaborative medical and academic center whose focus is on comprehensive
ARIZONA ARRHYTHMIA CONSULTANTS
Page 1 BUSINESS ADDRESS Arizona Arrhythmia Consultants, PLC Clinical Research Department 7283 East Earl Drive Scottsdale, Arizona 85251 (602) 234-2800 License Adult Nurse Practitioner with Prescriptive
UCSF Anesthesia Resident Pearls: Cardiac Implantable Electronic Devices: Pacemakers and ICDs Table of Contents
UCSF Anesthesia Resident Pearls: Cardiac Implantable Electronic Devices: Pacemakers and ICDs Table of Contents Page 1 Intro Indications for Pacers and ICDs Page 2 Differentiating between Pacers and ICDs
Danish Cardiovascular Research Academy and Faculty of Health Sciences University of Copenhagen
Danish Cardiovascular Research Academy and Faculty of Health Sciences University of Copenhagen PhD course: Cardiac arrhythmias - Aim and content: Cardiac arrhythmia represents a wide spectrum of abnormalities
Atrial Fibrillation and Heart Failure: A Cause or a Consequence
Atrial Fibrillation and Heart Failure: A Cause or a Consequence Rajat Deo, MD, MTR Assistant Professor of Medicine Division of Cardiology, Electrophysiology Section University of Pennsylvania November
CURRICULUM VITAE Prof. ANTONIO CURNIS
CURRICULUM VITAE Prof. ANTONIO CURNIS I. Personal Informations - Born in February 11 th 1958 in Bergamo (Italy). - Graduated by University of Brescia 23.10.88 - Division of Cardiology of Civil Hospital
Palpitations & AF. Richard Grocott Mason Consultant Cardiologist THH NHS Foundation Trust & Royal Brompton & Harefield NHS Foundation Trust
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
POLICY PRODUCT VARIATIONS DESCRIPTION/BACKGROUND RATIONALE DEFINITIONS BENEFIT VARIATIONS DISCLAIMER CODING INFORMATION REFERENCES POLICY HISTORY
Original Issue Date (Created): July 1, 2002 Most Recent Review Date (Revised): November 25, 2014 Effective Date: February 1, 2015 POLICY PRODUCT VARIATIONS DESCRIPTION/BACKGROUND RATIONALE DEFINITIONS
Does intensity of rate-control influence outcome in atrial fibrillation? An analysis of pooled data from the RACE and AFFIRM studies
Europace (2006) 8, 935 942 doi:10.1093/europace/eul106 Does intensity of rate-control influence outcome in atrial fibrillation? An analysis of pooled data from the RACE and AFFIRM studies Isabelle C. Van
Atrial Fibrillation (AF) March, 2013
Atrial Fibrillation (AF) March, 2013 This handout is meant to help with discussions about the condition, and it is not a complete discussion of AF. We hope it will complement your appointment with one
2014: nowadays the one shot technologies and the injectable monitor allow a wide and complete AF patient management. Why shouldn t we use them?
2014: nowadays the one shot technologies and the injectable monitor allow a wide and complete AF patient management. Why shouldn t we use them? Gaetano Senatore DIVISION OF CARDIOLOGY HOSPITAL OF CIRIE
ATRIAL FIBRILLATION RATE VS RHYTHM CONTROL NCVH BIRMINGHAM 2014
ATRIAL FIBRILLATION RATE VS RHYTHM CONTROL NCVH BIRMINGHAM 2014 Facts 4 million or so people have atrial fibrillation 16 billion dollars spent yearly in USA 30% of strokes attributable to AF and AFL 3-5
CARDIAC ELECTROPHYSIOLOGY, ARRHYTHMIAS AND PACING. Medical Knowledge. Goals and Objectives PF EF MF LF Aspirational
Know the histology and gross anatomy of the normal sinoatrial node, atrial conduction pathways, atrioventricular (AV) junction and nod, His bundle, conduction fascicles and terminal intra-ventricular conduction
QRS Complexes. Fast & Easy ECGs A Self-Paced Learning Program
6 QRS Complexes Fast & Easy ECGs A Self-Paced Learning Program Q I A ECG Waveforms Normally the heart beats in a regular, rhythmic fashion producing a P wave, QRS complex and T wave I Step 4 of ECG Analysis
ATRIAL FIBRILLATION: Scope of the Problem. October 2015
ATRIAL FIBRILLATION: Scope of the Problem October 2015 Purpose of the Presentation Review the worldwide incidence and prognosis associated with atrial fibrillation (AF) Identify the types of AF, clinical
Management of Pacing Wires After Cardiac Surgery
Management of Pacing Wires After Cardiac Surgery David E. Lizotte, Jr. PA C, MPAS, FAPACVS President, Association of Physician Assistants in Cardiovascular Surgery Conflicts: None Indications 2008 Journal
Atrial fibrillation (AF) patient information
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
TABLE 1 Clinical Classification of AF. New onset AF (first detected) Paroxysmal (<7 days, mostly < 24 hours)
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
A 35 yo female presents increasing fatigue and shortness of breath for several days. She is found to be in atrial fibrillation.
Ryan G. Aleong Cardiology Department University of Colorado A 35 yo female presents increasing fatigue and shortness of breath for several days. She is found to be in atrial fibrillation. 1. Initiation
21st Annual OSF Cardiovascular Symposium
21st Annual OSF Cardiovascular Symposium new waves in cardiac electrophysiology saturday 18 october 2014 7:00 a.m. 4:00 p.m. embassy suites conference center east peoria, illinois OBJECTIVES Overall Program:
Diagnostic and Therapeutic Procedures
Diagnostic and Therapeutic Procedures Diagnostic and therapeutic cardiovascular s are central to the evaluation and management of patients with cardiovascular disease. Consistent with the other sections,
«Δυσλειτουργία βηματοδότη. Πως μπορούμε να την εκτιμήσουμε στο ιατρείο.» Koσσυβάκης Χάρης Καρδιολογικό Τμήμα Γ.Ν.Α. «Γ. ΓΕΝΝΗΜΑΤΑΣ
«Δυσλειτουργία βηματοδότη. Πως μπορούμε να την εκτιμήσουμε στο ιατρείο.» Koσσυβάκης Χάρης Καρδιολογικό Τμήμα Γ.Ν.Α. «Γ. ΓΕΝΝΗΜΑΤΑΣ Diagnostic tools History: symptoms, physical examination 12 leads ECG,
Blood thinning (anticoagulation) in atrial fibrillation (AF)
AF A Blood thinning (anticoagulation) in atrial fibrillation (AF) Providing information, support and access to established, new or innovative treatments for atrial fibrillation www.afa.org.uk Registered
Treating AF: The Newest Recommendations. CardioCase presentation. Ethel s Case. Wayne Warnica, MD, FACC, FACP, FRCPC
Treating AF: The Newest Recommendations Wayne Warnica, MD, FACC, FACP, FRCPC CardioCase presentation Ethel s Case Ethel, 73, presents with rapid heart beating and mild chest discomfort. In the ED, ECG
Atrial Fibrillation The High Risk Obese Patient
Atrial Fibrillation The High Risk Obese Patient Frederick Schaller, D.O.,F.A.C.O.I. Professor and Vice Dean Touro University Nevada A 56 year old male with a history of hypertension and chronic stable
Difficult Cases in Atrial Fibrillation. Ascot Cardiology GP Symposium April 2014
Difficult Cases in Atrial Fibrillation Ascot Cardiology GP Symposium April 2014 Atrial Fibrillation 1-2% general population 40-50yrs
Clinical Trials In Cardiac Rhythm Management
Clinical Trials In Cardiac Rhythm Management Stuart Allen Principal Cardiac Physiologist Manchester Heart Centre HRUK Council Physiologist Representative stuart.allen@cmft.nhs.uk Clinical Trials Pacemakers
The Decision Tree for Ablation Therapy in Atrial Fibrillation Colin Movsowitz, MD, FACC Cardiology Consultants of Philadelphia Director of Electrophysiology Einstein Medical Center Montgomery Co-Director
Traditionally, the goal of atrial fibrillation (AF)
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
Atrial Fibrillation: Rate Control Strategies
Atrial Fibrillation: Rate Control Strategies Olshansky, Brian Sbaity, Salam Summary The safest long-term management strategy for elderly patients with persistent or permanent and some patients with paroxysmal
MULTIPLE CHOICE. Choose the one alternative that best completes the statement or answers the question.
Exam Name MULTIPLE CHOICE. Choose the one alternative that best completes the statement or answers the question. 1) What term is used to refer to the process of electrical discharge and the flow of electrical
Medical management of CHF: A New Class of Medication. Al Timothy, M.D. Cardiovascular Institute of the South
Medical management of CHF: A New Class of Medication Al Timothy, M.D. Cardiovascular Institute of the South Disclosures Speakers Bureau for Amgen Background Chronic systolic congestive heart failure remains
CATHETER ABLATION for ATRIAL FIBRILLATION
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
9/5/14. Objectives. Atrial Fibrillation (AF)
Novel Anticoagulation for Prevention of Stroke in Patients with Atrial Fibrillation Objectives 1. Review current evidence on use of warfarin in individuals with atrial fibrillation 2. Compare the three
Medical Policy An independent licensee of the Blue Cross Blue Shield Association
Catheter Ablation as Treatment Page 1 of 29 Medical Policy An independent licensee of the Blue Cross Blue Shield Association Title: Catheter Ablation as Treatment Professional Institutional Original Effective
Atrial Fibrillation: The heart of the matter
Atrial Fibrillation: The heart of the matter This booklet has been written especially for people with atrial fibrillation (AF), a heart condition often described as an irregular heartbeat (also known
Michael Hartman, CRNA, DNP, MSN, BSN, BA
Michael Hartman, CRNA, DNP, MSN, BSN, BA Intrinsic Conduction Automaticity-cardiac cells ability to spontaneously depolarize and initiate impulse Depolarization-cardiac cells go to a+ intracellular and
Atrial Fibrillation An update on diagnosis and management
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.
NICE TA 275: Apixaban for the prevention of stroke and systemic embolism in people with non-valvular atrial fibrillation
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
STANDARDS FOR IMPLANTATION AND FOLLOW-UP OF CARDIAC RHYTHM MANAGEMENT DEVICES IN ADULTS January 2013
1. INTRODUCTION STANDARDS FOR IMPLANTATION AND FOLLOW-UP OF CARDIAC RHYTHM MANAGEMENT DEVICES IN ADULTS January 2013 This document replaces the previous Heart Rhythm UK documents Clinical Guidance by Consensus
Feature Vector Selection for Automatic Classification of ECG Arrhythmias
Feature Vector Selection for Automatic Classification of ECG Arrhythmias Ch.Venkanna 1, B. Raja Ganapathi 2 Assistant Professor, Dept. of ECE, G.V.P. College of Engineering (A), Madhurawada, A.P., India
Name of Policy: Transcatheter Ablation of Arrhythmogenic Foci as a Treatment of Atrial Fibrillation
Name of Policy: Transcatheter Ablation of Arrhythmogenic Foci as a Treatment of Atrial Fibrillation Policy #: 283 Latest Review Date: June 2015 Category: Medical Policy Grade: A Background/Definitions:
Treatments to Restore Normal Rhythm
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
Cardiovascular System & Its Diseases. Lecture #4 Heart Failure & Cardiac Arrhythmias
Cardiovascular System & Its Diseases Lecture #4 Heart Failure & Cardiac Arrhythmias Dr. Derek Bowie, Department of Pharmacology & Therapeutics, Room 1317, McIntyre Bldg, McGill University derek.bowie@mcgill.ca
Catheter Ablation of Arrhythmogenic Foci as Treatment for Atrial Fibrillation
Catheter Ablation of Arrhythmogenic Foci as Treatment for Atrial Fibrillation Policy Number: Original Effective Date: MM.06.011 09/01/2009 Line(s) of Business: Current Effective Date: HMO; PPO; QUEST Integration
INFORMATION FOR PATIENTS AND FAMILIES A Patient s Guide to Living with Atrial Fibrillation
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
Normal Sinus Rhythm. Sinus Bradycardia. Sinus Tachycardia. Rhythm ECG Characteristics Example (NSR) & consistent. & consistent.
Normal Sinus Rhythm (NSR) Rate: 60-100 per minute Rhythm: R- R = P waves: Upright, similar P-R: 0.12-0.20 second & consistent P:qRs: 1P:1qRs Sinus Tachycardia Exercise Hypovolemia Medications Fever Hypoxia
None. Dual Antiplatelet Therapy Plus Systemic Anticoagulation: Bleeding Risk and Management. 76 year old male LINGO 1/5/2015
Financial Disclosure Information Dual Antiplatelet Therapy Plus Systemic Anticoagulation: Bleeding Risk and Management Robert D. McBane, M.D. Division of Cardiology Mayo Clinic Rochester Dual Antiplatelet
Pacemaker Counter and Histogram Operation and Interpretation. Percentage of total count. Figure 2. Detailed ALTRUA Paced and Sensed Event Counters
A Closer Look SUMMARY This article provides information regarding the operation and interpretation of Event Counters and Histograms available in ALTRUA, INSIGNIA, PULSAR MAX II, and DISCOVERY II pacemakers.
These guidelines have been withdrawn
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
Atrial fibrillation (AF) care pathways. for the primary care physicians
Atrial fibrillation (AF) care pathways for the primary care physicians by University of Minnesota Physicians Heart, October, 2011 Evaluation by the primary care physician: 1. Comprehensive history and
New in Atrial Fibrillation
New in Atrial Fibrillation September 2011 Stroke prevention more options Rhythm Control -drugs - alternatives to drugs; ablation Rate Control - pace + ablate A-FIB Dell Stroke Risk AFib Two Principles
Atrial Fibrillation Centre
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
Managing Mitral Regurgitation: Repair, Replace, or Clip? Michael Howe, MD Traverse Heart & Vascular
Managing Mitral Regurgitation: Repair, Replace, or Clip? Michael Howe, MD Traverse Heart & Vascular Mitral Regurgitation Anatomy Mechanisms of MR Presentation Evaluation Management Repair Replace Clip
Patient Information Leaflet about Pradaxa for Atrial Fibrillation. You Have Been Prescribed Pradaxa
Patient Information Leaflet about Pradaxa for Atrial Fibrillation You Have Been Prescribed Pradaxa Your doctor has prescribed Pradaxa for you. The purpose of the medication is to minimise the risk that
Inpatient Heart Failure Management: Risks & Benefits
Inpatient Heart Failure Management: Risks & Benefits Dr. Kenneth L. Baughman Professor of Medicine Harvard Medical School Director, Advanced Heart Disease Section Brigham & Women's Hospital Harvard Medical
Patient Information Sheet Electrophysiological study
Patient Information Sheet Electrophysiological study Your doctor has recommended performing an electrophysiological study (also called EPS). EPS is a diagnostic procedure designed to test and evaluate
GERIATRYCZNE PROBLEMY KLINICZNE/GERIATRICS MEDICAL PROBLEMS
65 G E R I A T R I A 2011; 5: 65-69 GERIATRYCZNE PROBLEMY KLINICZNE/GERIATRICS MEDICAL PROBLEMS Otrzymano/Submitted: 24.02.2011 Poprawiono/Corrected: 01.03.2011 Zaakceptowano/Accepted: 06.03.2011 Akademia
ACLS PHARMACOLOGY 2011 Guidelines
ACLS PHARMACOLOGY 2011 Guidelines ADENOSINE Narrow complex tachycardias or wide complex tachycardias that may be supraventricular in nature. It is effective in treating 90% of the reentry arrhythmias.