Reboot #159 Atrial Fibrillation

Enjoy this Curbsiders classic and stay tuned this Wednesday, August 11, 2021 for a brand new Afib Triple Distilled version.

Take control of atrial fibrillation with expert insights and pearls from cardiologist, Dr. James Furgerson, in this jam-packed episode! You’ll learn why atrial fibrillation is such a big deal, how to diagnose it, how to treat it and when to call in for reinforcements. Dr. James Furgerson, MD  is a cardiologist from San Antonio, Texas with over 20 years in academics. Buckle up – This episode is going to send your heart racing! You might even skip a beat! 

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Credits

Writer and Producer: Cyrus Askin MD

Infographic: Cyrus Askin MD

Cover Art: Cyrus Askin MD

Hosts: Matthew Watto MD, Paul Williams MD, Cyrus Askin MD

Editors: Matthew Watto MD

Guest: James Furgerson MD

Sponsor: American College of Physicians acponline.org/100curb

ACP CME 100 virtual video package includes 100 hours of practice-changing updates by expert faculty from Internal Medicine Meeting 2021 acponline.org/100CURB. Plus enjoy an exclusive: 25 bonus CME sessions and access until June 1, 2024!

Sponsor: Panacea Financial panaceafinancial.com

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Time Stamps*

*Note: Time stamps refer to ad-free version 

00:00 Intro, disclaimer and guest bio

03:45 Guest one liner, a bit on physician well-being and some other randomness

08:15 A case of palpitations; risk factors for atrial fibrillation

12:17 Subclinical atrial fibrillation, overdiagnosis of atrial fibrillation; How much afib burden matters? 

15:08 Case summary and next steps in initial work up

18:48 Counseling patient about atrial fibrillation and its consequences

21:40 Ischemic heart disease and atrial fibrillation

24:17 Recap of diagnosis, initial work up and risk stratification in atrial fibrillation

25:25 Rate versus rhythm control; AFFIRM trial

30:50 Strict versus lenient rate control;  RACE trial

33:30 Deciding on rate versus rhythm control; Downside of antiarrhythmic therapies; When to switch from rate to rhythm control strategy

36:52 Ablation for atrial fibrillation; CASTLE-AF, CABANA trials

40:40 When to refer to cardiology and electrophysiology

42:42 Choice of agent for anticoagulation and latest guidelines for atrial fibrillation; New definition for valvular atrial fibrillation

45:22 DOACs in CKD and some other nuances in choice of agent

52:27 Bleeding and anticoagulation

58:38 Cardioversion for atrial fibrillation (initial versus delayed)

63:32 Anticoagulation before and after cardioversion

67:48 Lifestyles measures for atrial fibrillation

70:45 Atrial fibrillation during critical illness, after CABG and in hyperthyroidism

74:12 Aspirin monotherapy is not appropriate for atrial fibrillation

76:42 Take home points

78:50 Outro