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Atrial fibrillation, or AFib, is one of the most common heart rhythm disorders—and it's not just something to worry about "when you're older." In this episode, Dr. Arfaat Khan, a cardiac electrophysiologist, explains what AFib is, the symptoms you shouldn't ignore, who may be at risk, and why catching and treating it early can make a real difference. We also talk about catheter ablation, a minimally invasive treatment that can help restore a normal heart rhythm, and why more patients may benefit from knowing this option exists. For more information about what Dr. Khan discussed in this episode, go to GetSmartAboutAFib.com Transcript: 06:14:16 --> 06:14:19 Dr. Arfaat Khan: Hi Marijo, thank you for having me on the show. 06:14:18 --> 06:14:23 Marijo Tinlin: Hey, thank you. Absolutely. Let me get started here. 06:14:27 --> 06:14:48 Marijo Tinlin: Hello, this is Marijo Tinlin from the Teaching Your Toddler show. Today we have a great episode. We are recording in September, which is the beginning of AFib Awareness Month, and we have a special guest, Dr. Arfaat Khan, is with us to talk to us about that. So, first of all, doctor, welcome to the show. Tell us a little bit. What is AFib? 06:14:48 --> 06:14:59 Dr. Arfaat Khan: So, thank you, Marijo, for having me on the show today. So, atrial fibrillation, also known as AFib, is a very common heart rhythm disorder in which the top chambers of the heart start to beat periodically. 06:14:59 --> 06:15:10 Dr. Arfaat Khan: It's a very common condition. Over 55 million people globally are affected by it, and if left untreated, it can lead to serious complications. 06:15:10 --> 06:15:14 Marijo Tinlin: Oh, wow. So how do you know that you have it? 06:15:14 --> 06:15:23 Dr. Arfaat Khan: So, patients can present with different types of symptoms. You can have anxiety, palpitations, feeling your heart skipping beats. 06:15:23 --> 06:15:31 Dr. Arfaat Khan: Uh, feeling tired, short of breath, basically having difficulty carrying on the normal routines that you're able to do without any problem. 06:15:31 --> 06:15:44 Dr. Arfaat Khan: You have to understand that AFib is a progressive condition. It starts out in the early stage and then can later progress down to the point where you can't get rid of it, so that's why it's very, very important to identify it and treat it early. 06:15:44 --> 06:15:58 Dr. Arfaat Khan: And it's also important that if you are diagnosed with atrial fibrillation, that you should be referred to a cardiac electrophysiologist, which is actually a specialized cardiologist who are specially trained to identify and manage the different aspects of atrial fibrillation. 06:16:00 --> 06:16:06 Marijo Tinlin: What? Can you explain what an electrophysiologist is? That's you. 06:16:05 --> 06:16:18 Dr. Arfaat Khan: Yeah, so I'm an electrophysiologist, so an electrophysiologist is basically a physician that's actually a cardiologist, but has advanced training in managing different heart rhythm disorders, and AFib is actually one of the most common heart rhythm disorders. 06:16:17 --> 06:16:26 Marijo Tinlin: Oh, wow. Okay, so how old do you tend to see your patients, or how early should a patient start to think about this? 06:16:26 --> 06:16:41 Dr. Arfaat Khan: So, recent studies show that the earlier you diagnose AFib and treat it, the better the outcomes, because AFib is a progressive condition. Um, so within, you know, a month to at least within a year of treatment of AFib actually leads to better patient outcomes. 06:16:42 --> 06:16:47 Marijo Tinlin: Are there any pre-existing conditions that you tend to see with patients? 06:16:47 --> 06:16:58 Dr. Arfaat Khan: So some patients can have, like, hypertension, diabetes, you know, history of heart failure, but generally, the older you get, these are the more common risk factors of development of AFib. 06:16:59 --> 06:17:04 Marijo Tinlin: And so, there are some new options for treatment that you're going to tell us about. 06:17:04 --> 06:17:19 Dr. Arfaat Khan: Yeah, although there are different, many treatment options available, catheter ablation is a very safe, minimally invasive procedure in which we go into the heart and help identify where the faulty electrical signals are, target them, and help restore normal rhythm. 06:17:19 --> 06:17:33 Dr. Arfaat Khan: It's an outpatient procedure. Um, as I said, it's minimally invasive. Most patients are able to go home that same day. They have little to no discomfort after the procedure, and typically they resume their normal activities within a few days after the procedure is done. 06:17:33 --> 06:17:48 Dr. Arfaat Khan: I personally use the Cardo 3D electroanatomical mapping system, and this mapping system helps me reconstruct the patient's heart's anatomy, and also helps me localize where the faulty electrical signals are, so that I can specifically tailor each therapy. 06:17:48 --> 06:17:54 Dr. Arfaat Khan: individual to the patient. And that actually leads to improved patient success and improved patient outcomes. 06:17:54 --> 06:18:05 Dr. Arfaat Khan: But it's important to understand that although 55 million people globally are affected by atrial fibrillation, only 5% of eligible patients are actually getting this catheter ablation procedure done. 06:18:05 --> 06:18:13 Marijo Tinlin: Is that just because they don't know or is it because doctors don't know to refer this or what's causing that? 06:18:12 --> 06:18:26 Dr. Arfaat Khan: I think it's a common, you know, it's a multitude of different things, right? With September being AFib Awareness Month, our goal is to help increase awareness about what AFib is, and what therapies are actually available to treat atrial fibrillation, such as catheter ablation. 06:18:26 --> 06:18:32 Marijo Tinlin: Excellent. So is it usually referred from a PCP then? Sorry, a primary care physician? 06:18:32 --> 06:18:49 Dr. Arfaat Khan: Yeah, primary care physician, ER physicians, cardiologists, anyone can actually refer to a cardiac electrophysiologist. But as a patient, there are multiple different resources available too. So if you think you have AFib, Johnson & Johnson actually has a website called GetSmartAboutAFib.com. 06:18:49 --> 06:18:57 Dr. Arfaat Khan: Which actually has a lot of educational videos, testimonials, and even a questionnaire to see if you qualify for a catheter ablation procedure. 06:18:57 --> 06:19:12 Marijo Tinlin: Oh, excellent. Well, thank you. Of course, I was going to ask you for more information, so we'll make sure that that link is available for the listeners. Thank you so much. This is a fascinating topic, and I'm glad that you brought it. And thank you so much for joining us today. 06:19:11 --> 06:19:14 Dr. Arfaat Khan: Thank you very much for having me. Appreciate it. 06:19:13 --> 06:19:15 Marijo Tinlin: Absolutely. Dr. Arfaat Khan's biography: Dr. Arfaat Khan is a board-certified cardiac electrophysiologist specializing in the diagnosis and treatment of heart rhythm disorders, including atrial fibrillation, supraventricular tachycardia, ventricular arrhythmias, cardiac device implantation, and complex catheter ablation procedures. He is also an Assistant Professor of Medicine at Wayne State University and Michigan State University, where he is actively involved in teaching the next generation of physicians.
Could retirement actually become the beginning of your most meaningful work? In this personal solo episode, Dr. Gillian Lockitch shares how spinal surgery, ballroom dancing, entrepreneurship and podcasting transformed her understanding of healthy longevity. You'll discover why curiosity, consistency and a renewed sense of purpose can help you remain mentally sharp, physically engaged and excited about the future at any age. For most of her professional life, Dr. Gillian Lockitch was a physician, medical biochemist, researcher, university professor and department head. She expected retirement to bring more travel, reading, dancing and time with her family—not a new career as an entrepreneur, author, podcast host and healthy longevity advocate. Her journey changed when severe spinal stenosis led to emergency surgery and a lengthy recovery. Faced with the challenge of regaining her strength, mobility and independence, Gillian began exploring healthy aging not simply as a scientist, but as someone personally determined to age differently. That shift in perspective became the foundation of Growing Older Living Younger. In this episode, Gillian describes how curiosity led her from exploring a Wellness Trade Show into entrepreneurship at 70. She explains how her scientific training shaped the way she evaluated wellness products and opportunities, why she remained committed to evidence, and how she discovered that people were looking for trusted guidance rather than another sales presentation. She also shares the lessons she learned from ballroom dancing, building a business, adapting during the COVID-19 pandemic, writing a book and launching a podcast on her 76th birthday. Each new undertaking required her to become a beginner again, develop unfamiliar skills and learn that consistency is more important than occasional intensity. Finally Gillian reflects on the setbacks and opportunities that have shaped her purpose. Her message is simple but powerful: your purpose has no expiry date, retirement does not have to mean withdrawal from action, and reinvention is possible for anyone who remains curious. Although we inherit our genetic blueprint, everyday lifestyle choices can affect how our genes are expressed—and ultimately help us live gracefully as we grow older. Episode Timeline: 00:00 — Introduction: How did a physician and scientist become an entrepreneur at 70? 06:00 — Spinal stenosis, emergency surgery and the decision to reclaim an active life 08:15 — A visit to the Vancouver Wellness Show changes the direction of retirement 11:22 — Scientific skepticism, personal experimentation and the beginnings of entrepreneurship 16:19 — Becoming a beginner again and the lessons learned from ballroom dancing 19:05 — Adapting during COVID-19 and discovering the possibilities of podcasting 21:52 — Launching Growing Older Living Younger and finding a new mission 24:00 — Atrial fibrillation, patience and the lessons hidden within setbacks 26:53 — Purpose, legacy and the promise of epigenetics 30:15 — Why reinvention belongs to anyone who remains curious Connect with Your Host: Dr. Gillian Lockitch Dr. Gillian Lockitch is an independent Nu Skin Brand Affiliate. You can join her team as an affiliate (and build your own business), or as a member to buy products or devices at member prices. She may earn a commission from qualifying product purchases. Any products and devices mentioned in this podcast reflect her personal routine and are shared for educational purposes only. They are not intended to diagnose, treat, cure or prevent disease, and individual results may vary. Dr. Lockitch emphasizes that supplements and skincare devices should complement not replace appropriate lifestyle habits — nutrition, movement, sleep and others, nor healthcare professionals advice. Call to Action Your best healthy-longevity plan is the one designed with you for your lifestyle. Visit askdrgill.com or email askdrgill@gmail.com to begin a conversation about your personal Growing Older Living Younger Roadmap. Subscribe to the podcast, leave a review, and share this episode and the show link with someone ready to invest in extending their healthspan. Website: www.askdrgill.com Podcast: Growing Older Living Younger on Apple Podcasts, Spotify and other platforms Join the evolving Growing Older Living Younger Community Email: Askdrgill@gmail.com website: https://askdrgill.com To learn how to become an affiliate with the "World's Number 1 Home Beauty Device Brand" contact Dr. Lockitch at askdrgill@gmail.com or message her through The Growing Older Living Younger community.
This week we speak with Dr. Ted O'Leary, Co-Director of Adult Congenital Heart Disease Electrophysiology at Boston Children's Hospital about a recent publication he authored on the use of pulsed field ablation (PFA) for the transcatheter ablation management of complex atrial arrhythmias in ACHD patients. How does PFA work and what are some of the potential advantages and disadvantages of this novel ablation energy technology? What are the advantages of a variable loop catheter in this setting? Is PFA going to supplant radiofrequency current for standard "SVT" ablations one day? These are amongst the questions reviewed with Dr. O'Leary this week. DOI: 10.1161/CIRCEP.125.014619
Commentary by Dr. Timothy Ka-chun UN.
In this episode of the JACC: Clinical Electrophysiology podcast, Executive Editor Emile Daoud discusses the primary analysis of the HEAL‑LAA study. The paper by Oluseun Alli, et al, evaluates real‑world outcomes with a next‑generation, fluoropolymer‑coated left atrial appendage occlusion device. In 500 patients across 32 U.S. centers, the study demonstrated excellent early device sealing, no significant peri‑device leaks, and favorable safety outcomes through 12 months, offering timely insights into contemporary LAAC practice and post‑implant antithrombotic management.
In this episode, Jeremy Moore, MD, MS, Associate Editor of JACC: Clinical Electrophysiology, reviews a study showing that adults with Ebstein anomaly face a high lifetime risk of atrial arrhythmias, with more than half developing one by age 60. The most common arrhythmias were intra-atrial re-entrant and focal atrial tachycardias, which were more frequent than atrial fibrillation. Older age, prior cardiac surgery, significant tricuspid valve leakage, and severe right ventricular dysfunction were key risk factors, underscoring the need for lifelong specialized follow-up.
No Click Valvar de hoje temos grandes insights sobre o histórico de fibrilação atrial e o apêndice atrial esquerdo.
Recorded at EHRA 2026, this episode of The Lead features host Michael S. Lloyd, MD, FHRS, in conversation with Tina Baykaner, MD, MPH, and Prashanthan Sanders, MBBS, PhD, FHRS, about the journal article, Atrial Mechanical Contraction Predicts Cerebrovascular Risk in Patients With Transthyretin Amyloid Cardiomyopathy and Sinus Rhythm. Together, they discuss the study findings and explore the relationship between atrial mechanical contraction and cerebrovascular risk in patients with transthyretin amyloid cardiomyopathy who are in sinus rhythm. Learning Objectives: Review the key findings of the study examining atrial mechanical contraction and cerebrovascular risk in patients with transthyretin amyloid cardiomyopathy and sinus rhythm. Discuss the association between atrial mechanical contraction and cerebrovascular risk in this patient population. Explore the potential clinical implications of assessing atrial mechanical function in patients with transthyretin amyloid cardiomyopathy. Host: Michael S. Lloyd, MD, FHRS Guests: Tina Baykaner, MD, MPH Prashanthan Sanders, MBBS, PhD, FHRS Disclosures: M. Lloyd Honoraria/Speaking/Consulting Fee: Medtronic, Boston Scientific, Other T. Baykaner Honoraria/Speaking/Consulting Fee: Volta Medical, Medtronic, Pacemate, Johnson & Johnson, Abbott Medical, Boston Scientific Research: NIH, Boston Scientific P. Sanders Honoraria/Speaking/Consulting Fee: Boston Scientific, Abbott Medical Other Financial Relationships: Medtronic PLC, Pacemate, CathRx Research: Abbott, Becton Dickinson, Calyan Technologies, Ceryx Medical, Biosense Webster, CathRx, HelloAlfred, Medtronic, Inc., Abbott Medical
No Click Valvar de hoje temos grandes insights sobre a abordagem de fibrilação atrial em casos de regurgitação tricúspide.
Durante anos, a prevenção de AVC na fibrilação atrial seguiu uma lógica relativamente simples: identificar o risco tromboembólico e prescrever anticoagulação.Mas a prática clínica mostrou que a equação é mais complexa.Sangramentos maiores, hemorragias intracranianas, baixa adesão, fragilidade, quedas recorrentes e limitações socioeconômicas frequentemente colocam médicos e pacientes diante de decisões difíceis.No Ep. 228 do DozeCast, os hosts Diandro Motta e Victor Bemfica, recebem a cardiologista Dra. Brunna Pileggi e a neurologista Dra. Gisele Sampaio para analisar em profundidade o Champion-AF, estudo que avalia o fechamento percutâneo do apêndice atrial esquerdo (LAAC) com dispositivo Watchman como alternativa à anticoagulação oral direta em pacientes com fibrilação atrial.A grande provocação do estudo é simples: devemos continuar reservando o fechamento do apêndice atrial apenas para situações extremas ou chegou o momento de antecipar essa decisão?O que você vai aprender:
Howie and Harlan discuss how AI is transforming medical research and publishing, the growing role of consumer health platforms and wearables, new advances in stroke treatment, and the debate over rising hospital costs. They also examine the FDA's approval of flavored vaping products and the nomination of a new surgeon general. Watch a video version of this episode on YouTube. Show notes: Social Media Health & Veritas on Instagram Howie's viral reel on Hantavirus Howie on X AI and Research Claude Code by Anthropic medRxiv Progress in Treating Strokes "Endovascular Treatment of Medium-Vessel-Occlusion Strokes" "Endovascular thrombectomy after large-vessel ischaemic stroke: a meta-analysis of individual patient data from five randomised trials" "In Memoriam: Eugene Braunwald, MD, MACC" The Costs of Healthcare The Keckley Report "The Hospital-Health Insurer War hurts Everyone" Hospitals: Higher Value, Higher Prices "This Is the Biggest Culprit for High Health Care Spending" "It's The Prices, Stupid: Why The United States Is So Different From Other Countries" Atrial fibrillation: symptoms and causes Atrial fibrillation ablation Health Care Affordability Lab Zack Cooper's lab at Yale. Wearables Venture into Healthcare "WHOOP Expands Health Platform with On-Demand Clinician Access and New AI Features" "Introducing ChatGPT Health" "Introducing the all-new Fitbit Air" "Dear Tim" Myoung Cha's blog post on Apple's impact on health. FDA Resignations Over Vape Policy Health & Veritas Episode 78: Elizabeth Arleo: Advice for Working Mothers from a Women's Health Specialist Howie discusses e-cigarettes and lung injuries. Health & Veritas Episode 118: Lucila Ohno-Machado: AI and the Art of Medicine Howie mentions mixed evidence for vaping as an alternative to smoking. "With Commissioner Under Pressure, F.D.A. Opens Door to Flavored Vapes" "FDA Commissioner Marty Makary Resigns—Trump Posts His Resignation Text" "Top Kennedy Spokesman Resigns in Protest of Move to Allow Flavored Vapes" The Financial Side of GLP-1s Hims & Hers Investor Presentation "Hims & Hers Health, Inc. Reports First Quarter 2026 Financial Results" Surgeon General Nominees "Trump Withdraws Nomination of Casey Means for Surgeon General" "Exclusive: Deleted tweets reveal new surgeon general pick criticized Trump and RFK Jr. health policies" "Trump's new surgeon general nominee has both praised and criticized his administration" "The Madness in RFK Jr.'s Autism Method" In the Yale School of Management's MBA for Executives program, you'll get a full MBA education in 22 months while applying new skills to your organization in real time. Yale's Executive Master of Public Health offers a rigorous public health education for working professionals, with the flexibility of evening online classes alongside three on-campus trainings. Email Howie and Harlan comments or questions.
In this episode, we review the high-yield topic of Atrial Septal Defect (ASD) from the Cardiovascular section at Medbullets.comFollow Medbullets on social media:Facebook: www.facebook.com/medbulletsInstagram: www.instagram.com/medbulletsofficialTwitter: www.twitter.com/medbulletsLinkedin: https://www.linkedin.com/company/medbullets
Join us as we review recent practice-changing articles on left atrial appendage closure vs AC for AFib, apixaban vs rivaroxaban for VTE, intensive LDL targeting, GLP1s and substance use disorders, and more! Fill your brain hole with a delicious stack of hotcakes! Featuring Paul Williams (@PaulNWilliamz), Shani Herzig (@ShaniHerzig) Rahul Ganatra (@rbganatra), and Matt Watto (@doctorwatto).Claim CME for this episode at curbsiders.vcuhealth.org!Patreon | Episodes | Subscribe | Spotify | YouTube | Newsletter | Contact | Swag! | CMECredits Written and Hosted by: Rahul Ganatra MD, MPH; Shani Herzig, MD, MPH; Paul Williams, MD, FACP, Matthew Watto MD, FACP Cover Art: Rahul Ganatra MD, MPH Reviewer: Emi Okamoto, MD Technical Production: Pod Paste Showrunners: Matthew Watto MD, FACP; Paul Williams MD, FACP Show Segments Intro, disclaimer Left atrial appendage closure vs anticoagulation in AF Apixaban vs rivaroxaban for VTE Intensive LDL targeting in ASCVD GLP1s and substance use disorders FDA approves Orforglipron E-cigarettes and cancer Early AM blood draws and sleep quality Outro Sponsor: FIGSGo to wearfigs.com to get 20% off during Nurses WeekSponsor: Panacea Financial If you're about to make the leap into residency and feeling the financial pressure of that transition, visit PanaceaFinancial.com/curbsiders todaySponsor: MasterClass Right now, as a listener of this show, you get at least 15% off any annual membership at MASTERCLASS.com/CURB.
Nesta terça-feira, analisamos avanços na medicina regenerativa e na imunoterapia, além de novos alertas cardiovasculares, começando pela incorporação do transplante de membrana amniótica no SUS para o tratamento de complicações do diabetes e lesões oculares. Detalhamos a nova aprovação da Anvisa para o nivolumabe, que passa a ser indicado para Linfoma de Hodgkin clássico avançado em adultos e adolescentes, reduzindo drasticamente o risco de progressão da doença. Por fim, abordamos no Radar um estudo que revela que a fibrilação atrial assintomática detectada em rastreios triplica o risco de insuficiência cardíaca, exigindo uma avaliação rigorosa da reserva ventricular.Afya News. Informação médica confiável e atualizada no seu tempo.Fontes do episódio aqui:https://portal.afya.com.br/podcasts/afya-news/21-04-2026
Commentary by Dr. Jian'an Wang.
Commentary by Dr. Jian'an Wang.
Left atrial appendage closure—promise meets proof, and proof meets pause. In The New England Journal of Medicine, two pivotal trials draw a nuanced arc: CHAMPION-AF shows noninferior stroke prevention with less bleeding vs direct oral anticoagulants, while CLOSURE-AF tempers enthusiasm—failing noninferiority in older, high-risk patients with meaningful procedural risk. The message is elegant and sobering: innovation must bow to evidence, and patient selection remains paramount. In atrial fibrillation, the art lies not in closing the appendage—but in opening judgment.
This Special Episode on Atrial Fibrillation covers: Cardiology this Week: A concise summary of recent studies Atrial fibrillation burden: clinical relevance of a new outcome Pulsed field ablation: game changer? Drug treatment following atrial fibrillation ablation Spotlight: Holiday Heart Syndrome Host: Rick Grobbee Guests: Rick Grobbee, Konstantinos Koskinas, Jason Andrade, Arian Sultan, Michiel Rienstra Want to watch that special episode? Go to: https://esc365.escardio.org/event/2549 Disclaimer: ESC TV Today is supported by Novartis through an independent funding. The programme has not been influenced in any way by its funding partner. This programme is intended for health care professionals only and is to be used for educational purposes. The European Society of Cardiology (ESC) does not aim to promote medicinal products nor devices. Any views or opinions expressed are the presenters' own and do not reflect the views of the ESC. All declarations of interest are listed at the end of the episode. The ESC is not liable for any translated content of this video. The English language always prevails. Declarations of interests: Stephan Achenbach, Jason Andrade, Yasmina Bououdina, Rick Grobbee and Nicolle Kraenkel have declared to have no potential conflicts of interest to report. Carlos Aguiar has declared to have potential conflicts of interest to report: personal fees for consultancy and/or speaker fees from Abbott, AbbVie, Alnylam, Amgen, AstraZeneca, Bayer, BiAL, Boehringer-Ingelheim, Daiichi-Sankyo, Ferrer, Gilead, GSK, Lilly, Novartis, Pfizer, Sanofi, Servier, Takeda, Tecnimede. John-Paul Carpenter has declared to have potential conflicts of interest to report: stockholder MyCardium AI. Davide Capodanno has declared to have potential conflicts of interest to report: Abbott Vascular, Bristol Myers Squibb, Daiichi Sankyo, Edwards Lifesciences, Novo Nordisk, Sanofi Aventis, Terumo. Konstantinos Koskinas has declared to have potential conflicts of interest to report: honoraria from MSD, Daiichi Sankyo, Sanofi. Felix Mahfoud has declared to have potential conflicts of interest to report: research grants from Deutsche Forschungsgemeinschaft (SFB TRR219), Deutsche Gesellschaft für Kardiologie (DGK), Deutsche Herzstiftung, Ablative Solutions, ReCor Medical. Consulting fees, payment honoraria lectures, presentations, speaker, support travel costs: Ablative Solutions, Astra-Zeneca, Novartis, Inari, Recor Medical, Medtronic, Philips, Merck. Steffen Petersen has declared to have potential conflicts of interest to report: consultancy for Circle Cardiovascular Imaging Inc. Calgary, Alberta, Canada. Michiel Rienstra has declared to have potential conflicts of interest to report: consultancy fees from Bayer (OCEANIC-AF national PI) , InCarda Therapeutics (RESTORE-SR national PI), Novartis to the institution. Speaker fee from Daiichi-Sankyo, Pfizer to the institution. Unrestricted research grant from the Dutch Heart Foundation and is conducted in collaboration with and supported by the Dutch CardioVascular Alliance, 01-002-2022-0118 EmbRACE. Unrestricted research grant from ZonMW and the Dutch Heart Foundation; DECISION project 848090001. Unrestricted research grants from the Netherlands Cardiovascular Research Initiative: an initiative with support of the Dutch Heart Foundation; RACE V (CVON 2014–9), RED-CVD (CVON2017-11). Unrestricted research grant from Top Sector Life Sciences & Health to the Dutch Heart Foundation (PPP Allowance; CVON-AI (2018B017). Unrestricted research grant from the European Union's Horizon 2020 research and innovation programme under grant agreement; EHRA-PATHS (945260). This research is funded by the Dutch Heart Foundation and is conducted in collaboration with and supported by the Dutch CardioVascular Alliance, 01 -002 -2022 -0118 EmbRACE. Emma Svennberg has declared to have potential conflicts
Join Digital Education Committee member and podcast host Melissa E. Middeldorp, MPH, PhD, along with this week's guest contributors, Joshua Silverstein MD, FHRS from Allegheny Health Network and Jonathan Ariyaratnam, BChir, MA, MB, CCDS, CEPS-A from the University of Adelaidefor this week's episode. This study by Vad and colleagues examined markers of atrial cardiomyopathy (AtCM) in 26,467 UK Biobank participants without prior atrial fibrillation (AF), heart failure (HF), or stroke, integrating cardiac MRI, ECG, clinical risk factors, and genetic data. AtCM was defined using four markers: left atrial dilation, reduced left atrial emptying fraction (120 ms), and abnormal P-wave terminal force and 15.7% of individuals had at least one marker, while 2.3% had two or more. Over a median follow-up of nearly five years, the presence of AtCM markers showed a dose–response relationship with incident AF, with a HR: 4.59 in those with ≥2 markers and was also strongly associated with HF and ischemic stroke. Adding AtCM markers to clinical and genetic risk models improved AF risk prediction, supporting the concept that atrial cardiomyopathy may represent a common substrate linking AF, HF, and stroke and may help refine future risk stratification strategies. Article for Discussion Learning Objectives Understand how imaging- and ECG-based markers of atrial cardiomyopathy are defined and how they relate to the risk of incident AF, heart failure, and stroke. Evaluate how integrating atrial cardiomyopathy markers with clinical and genetic risk scores may improve risk stratification for AF and related cardiovascular outcomes. Article Authors Oliver B Vad, Nick van Vreeswijk, Ahmed S Yassin, Yuri Blaauw, Christian Paludan-Müller, Jørgen K Kanters, Claus Graff, Ulrich Schotten, Emelia J Benjamin, Jesper H Svendsen, Michiel Rienstra Podcast Contributors Melissa E. Middeldorp, MPH, PhD Joshua R. Silverstein, MD, FHRS Jonathan Ariyaratnam, BChir, MA, MB, CCDS, CEPS-A Host and Contributor Disclosure(s): M. Middeldorp Nothing to disclose. J. Ariyaratnam Nothing to disclose. J. Silverstein Honoraria/Speaking/Consulting: Medical Device Business Services, Biosense Webster, Inc., Medtronic Stocks, Privately Held: Heart Rhythm Clinical Solutions/3PH Alliance Staff Disclosure(s) (note: HRS staff are NOT in control of educational content. Disclosures are provided solely for full transparency to the learner): S. Sailor: No relevant financial relationships with ineligible companies to disclose.
Atrial fibrillation is the most common sustained cardiac arrhythmia, affecting ~37.6 million people globally, with prevalence expected to double in the coming decades. A recent Lancet Seminar (2026) highlights several key principles shaping modern AF care: • Stroke prevention with oral anticoagulation remains the cornerstone • Early rhythm control strategies improve cardiovascular outcomes • Catheter ablation is increasingly used as first-line therapy • Lifestyle modification—weight loss, exercise, alcohol reduction—reduces AF burden • Integrated care models such as the ABC pathway and AF-CARE improve outcomes The future of AF management is holistic, preventive, and patient-centred. #Cardiology #AtrialFibrillation #StrokePrevention #Electrophysiology #PrecisionMedicine
A Diretriz Brasileira de Fibrilação Atrial 2025 muda o eixo da conversa.FA agora é formalmente tratada como doença progressiva e modificável — e isso muda quando anticoagular, quando buscar ritmo e quando indicar ablação.No DozeCast #213, Raquel Rios e Diandro Mota fazem um resumo prático e direto ao ponto do que realmente impacta o dia a dia.Você vai ouvir sobre:
This episode covers: Cardiology This Week: A concise summary of recent studies Atrial septal defects in adults Conservative and invasive management of chronic coronary syndromes Milestones: 4S trial Host: Rick Grobbee Guests: JP Carpenter, Annemien van den Bosch, Rasha Al-Lamee, Roxana Mehran Want to watch the episode? Go to: https://esc365.escardio.org/event/2552 Want to watch the extended interview on Atrial septal defects in adults, go to: https://esc365.escardio.org/event/2552?resource=interview Disclaimer: ESC TV Today is supported by Novartis through an independent funding. The programme has not been influenced in any way by its funding partner. This programme is intended for health care professionals only and is to be used for educational purposes. The European Society of Cardiology (ESC) does not aim to promote medicinal products nor devices. Any views or opinions expressed are the presenters' own and do not reflect the views of the ESC. All declarations of interest are listed at the end of the episode. The ESC is not liable for any translated content of this video. The English language always prevails. Declarations of interests: Stephan Achenbach, Yasmina Bououdina, Rick Grobbee, Nicolle Kraenkel and Annemien van den Bosch have declared to have no potential conflicts of interest to report. Carlos Aguiar has declared to have potential conflicts of interest to report: personal fees for consultancy and/or speaker fees from Abbott, AbbVie, Alnylam, Amgen, AstraZeneca, Bayer, BiAL, Boehringer-Ingelheim, Daiichi-Sankyo, Ferrer, Gilead, GSK, Lilly, Novartis, Pfizer, Sanofi, Servier, Takeda, Tecnimede. Rasha Al-Lamee has declared to have potential conflicts of interest to report:speaker's fees for Menarini pharmaceuticals, Abbott, Philips, Medtronic, Servier, Shockwave, Elixir. Advisory board: Janssen Pharmaceuticals, Abbott, Philips, Shockwave, CathWorks, Elixir, Astrazeneca. Consulting Fees: Menarini pharmaceuticals, Abbott, Philips, Shockwave, Elixir, IsomAB, VahatiCor, SpectraWave, AstraZeneca, Cathworks, Janssen Pharmaceuticals. John-Paul Carpenter has declared to have potential conflicts of interest to report: stockholder MyCardium AI. Davide Capodanno has declared to have potential conflicts of interest to report: Abbott Vascular, Bristol Myers Squibb, Daiichi Sankyo, Edwards Lifesciences, Novo Nordisk, Sanofi Aventis, Terumo. Konstantinos Koskinas has declared to have potential conflicts of interest to report: honoraria from MSD, Daiichi Sankyo, Sanofi. Felix Mahfoud has declared to have potential conflicts of interest to report: research grants from Deutsche Forschungsgemeinschaft (SFB TRR219), Deutsche Gesellschaft für Kardiologie (DGK), Deutsche Herzstiftung, Ablative Solutions, ReCor Medical. Consulting fees, payment honoraria lectures, presentations, speaker, support travel costs: Ablative Solutions, Astra-Zeneca, Novartis, Inari, Recor Medical, Medtronic, Philips, Merck. Roxana Mehran has declared to have potential conflicts of interest to report: institutional research payments from Abbott, Alleviant Medical, Chiesi, Concept Medical, Cordis, CPC Clinical Research, Daiichi Sankyo, Duke, Faraday Pharmaceuticals, Idorsia Pharmaceuticals, Janssen, MedAlliance, Medtronic, NewAmsterdam Pharma, Novartis, Novo Nordisk Inc., Population Health Research Institute (PHRI), Protembis GmbH, Radcliffe, RM Global Bioaccess Fund Management, Sanofi US Services, Inc. ; personal fees from: None ; Equity
Host: Rick Grobbee Guest: Annemien van den Bosch Want to watch that extended interview on Atrial septal defects in adults, go to: https://esc365.escardio.org/event/2552?resource=interview Want to watch the full episode? Go to: https://esc365.escardio.org/event/2552 Disclaimer: ESC TV Today is supported by Novartis through an independent funding. The programme has not been influenced in any way by its funding partner. This programme is intended for health care professionals only and is to be used for educational purposes. The European Society of Cardiology (ESC) does not aim to promote medicinal products nor devices. Any views or opinions expressed are the presenters' own and do not reflect the views of the ESC. All declarations of interest are listed at the end of the episode. The ESC is not liable for any translated content of this video. The English language always prevails. Declarations of interests: Stephan Achenbach, Yasmina Bououdina, Rick Grobbee, Nicolle Kraenkel and Annemien van den Bosch have declared to have no potential conflicts of interest to report. Carlos Aguiar has declared to have potential conflicts of interest to report: personal fees for consultancy and/or speaker fees from Abbott, AbbVie, Alnylam, Amgen, AstraZeneca, Bayer, BiAL, Boehringer-Ingelheim, Daiichi-Sankyo, Ferrer, Gilead, GSK, Lilly, Novartis, Pfizer, Sanofi, Servier, Takeda, Tecnimede. John-Paul Carpenter has declared to have potential conflicts of interest to report: stockholder MyCardium AI. Davide Capodanno has declared to have potential conflicts of interest to report: Abbott Vascular, Bristol Myers Squibb, Daiichi Sankyo, Edwards Lifesciences, Novo Nordisk, Sanofi Aventis, Terumo. Konstantinos Koskinas has declared to have potential conflicts of interest to report: honoraria from MSD, Daiichi Sankyo, Sanofi. Felix Mahfoud has declared to have potential conflicts of interest to report: research grants from Deutsche Forschungsgemeinschaft (SFB TRR219), Deutsche Gesellschaft für Kardiologie (DGK), Deutsche Herzstiftung, Ablative Solutions, ReCor Medical. Consulting fees, payment honoraria lectures, presentations, speaker, support travel costs: Ablative Solutions, Astra-Zeneca, Novartis, Inari, Recor Medical, Medtronic, Philips, Merck. Steffen Petersen has declared to have potential conflicts of interest to report: consultancy for Circle Cardiovascular Imaging Inc. Calgary, Alberta, Canada. Emma Svennberg has declared to have potential conflicts of interest to report: Abbott, Astra Zeneca, Bayer, Bristol-Myers, Squibb-Pfizer, Johnson & Johnson
Real Life Pharmacology - Pharmacology Education for Health Care Professionals
Atrial fibrillation is one of the most common cardiac arrhythmias nurses encounter, and understanding its management is essential for safe patient care. In this episode, we break down what atrial fibrillation is, why it increases stroke risk, and how treatment strategies focus on rate control, rhythm control, and anticoagulation. We'll review common medications, monitoring priorities, and key assessment findings you should never ignore. Your support helps me provide more free resources like this! Consider supporting and getting more amazing pharmacology content! Head on over to meded101.com/nurse
In this episode, we review the high-yield topic of Atrial Septal Defects from the Cardiovascular section.Follow Medbullets on social media:Facebook: www.facebook.com/medbulletsInstagram: www.instagram.com/medbulletsofficialTwitter: www.twitter.com/medbullets
This week we review a recent work on fetal atrial septal interventions in the patient with hypoplastic left ventricle or double outlet right ventricle with mitral valve atresia/dysplasia and a restrictive or intact atrial septum. How often was this procedure technically feasible and successful? What are the criteria to be considered for such an intervention? Why does use of a laser improve the crossing of the atrial septum in this procedure? Should prenatal intervention be used instead of postnatal intervention in this setting? Associate Professor of Pediatrics at Baylor College of Medicine, Dr. Betul Yilmaz shares her insights into this fascinating topic.https://doi.org/10.1161/CIRCINTERVENTIONS.125.015209
Join Digital Education Committee Chair and podcast host Michael S. Lloyd, MD, FHRS, and his guests Kelvin C. Chua, MBBS, MD, FHRS, CEPS-A, and Rahul N Doshi, MD, FHRS, for this week's Lead episode, which was recorded live at APHRS 2025 in Kyoto, Japan. This discussion will review recent evidence on the feasibility and safety of pulsed field ablation (PFA) for coronary sinus and left atrial appendage isolation, as well as mitral isthmus ablation, focusing on both acute and chronic outcomes. Panelists will examine procedural considerations, lesion durability, and safety signals highlighted in the study, and explore how these findings may inform evolving ablation strategies for complex atrial arrhythmias. Learning Objectives Summarize the acute and chronic feasibility and safety outcomes of pulsed field ablation (PFA) for coronary sinus isolation, left atrial appendage isolation, and mitral isthmus ablation as reported in the study. Evaluate procedural techniques and lesion durability considerations associated with using PFA in anatomically complex atrial structures. Assess the potential clinical implications of these findings for incorporating PFA into ablation strategies for complex atrial arrhythmias, including patient selection and risk mitigation. Podcast Contributors Michael S. Lloyd, MD, FHRS Kelvin C. Chua, MBBS, MD, FHRS, CEPS-A Rahul N Doshi, MD, FHRS Host and Contributor Disclosure(s): K.C. Chua•Nothing to disclose. R. N. Doshi•Speaking/Teaching/Consulting/Authoring: Boston Scientific, Kestra Inc., Abbott, Impulse Dynamics USA M. S. Lloyd •Honoraria/Speaking/Consulting: Medtronic, Agra MedTech, Circa Scientific •Membership on Advisory Committees: Boston Scientific Article for Discussion
Atualizações das Diretrizes de Fibrilação Atrial (SBC 2025) by Cardiopapers
Commentary by Dr. Jian'an Wang.
Commentary by Dr. Jian'an Wang.
Today we are exploring Left Atrial Appendage Occlusion or LAAO Therapy. We explore the clinical rationale, patient selection, referral pathways and key considerations for LAAO. and aim to understand the therapy as an option for patients who are unsuitable for long term anticoagulation therapy. This is a sponsored podcast.A/Prof Pankaj Jain is an academic interventional cardiologist with appointments at Royal Prince Alfred, Concord, and Macquarie University Hospitals. He is a Clinical Senior Lecturer at the University of Sydney, and Conjoint Senior Lecturer at the University of New South Wales. His interests include complex coronary and structural heart interventions, and mechanical support devices for heart failure.Dr Ata Doost is an Interventional Cardiologist. He completed his training at various hospitals throughout Australia and undertook his speciality fellowship training at Kings College Hospital in London He has appointments at Macquarie University Hospital and National Capital Private & Calvary Bruce Hospitals in Canberra and is a Senior Clinical lecturer at Macquarie University Medical School. Dr Doost has performed thousands of cardiac catheterisations and has extensive experience in structural heart procedures. He specialises in coronary interventions, advanced imaging, and valve therapies including TAVI and MitraClip.
Commentary by Dr. Sandeep Goyal.
Cardiomiopatia atrial – Critérios Diagnósticos by Cardiopapers
In this episode, the CardioNerds (Dr. Naima Maqsood, Dr. Akiva Rosenzveig, and Dr. Colin Blumenthal) are joined by renowned educator in electrophysiology, Dr. Joshua Cooper, to discuss everything atrial flutter; from anatomy and pathophysiology to diagnosis and management. Dr. Cooper's expert teaching comes through as Dr. Cooper vividly describes atrial anatomy to provide the foundational understanding to be able to understand why management of atrial flutter is unique from atrial fibrillation despite their every intertwined relationship. A foundational episode for learners to understand atrial flutter as well as numerous concepts in electrophysiology. Audio editing for this episode was performed by CardioNerds intern Dr. Bhavya Shah. CardioNerds Atrial Fibrillation PageCardioNerds Episode PageCardioNerds AcademyCardionerds Healy Honor Roll CardioNerds Journal ClubSubscribe to The Heartbeat Newsletter!Check out CardioNerds SWAG!Become a CardioNerds Patron! Pearls "The biggest mistake is failure to diagnose”. Atrial flutter, especially with 2:1 conduction, is commonly missed in both inpatient and outpatient settings so look carefully at that 12-lead EKG so you can mitigate the stroke and tachycardia induced cardiomyopathy risk Decremental conduction of the AV node makes it more challenging to rate control atrial flutter than atrial fibrillation Catheter Ablation is the first line treatment for atrial flutter and is highly successful, but cardioversion can be utilized as well prior to pursuing ablation in some cases. Class I AADs like propafenone and flecainide may stability the atrial flutter circuit by slowing conduction and thus may worsen the arrhythmia. Therefore, the preferred anti-arrhythmic medication in atrial flutter are class III agents. Atrial flutter can be triggered by firing from the left side of the heart, so in patients with both atrial fibrillation and flutter, ablating atrial fibrillation makes atrial flutter less likely to recur. BONUS PEARL: Dr. Cooper's youtube video on atrial flutter is a MUST SEE! Notes Notes: Notes drafted by Dr. Akiva Rosenzveig What are the distinguishing features of atrial fibrillation and flutter? Atrial flutter is an organized rhythm characterized by a wavefront that continuously travels around the same circuit leading to reproducible P-waves on surface EKG as well as a very mathematical and predictable relationship between atrial and ventricular activity Atrial fibrillation is an ever changing, chaotic rhythm that consists of small local circuits that interplay off each other. Consequently, no two beats are the same and the relationship between the atrial activity and ventricular activity is unpredictable leading to an irregularly irregular rhythm What are common atrial flutter circuits? Cavo-tricuspid isthmus (CTI)-dependent atrial flutter is the most common type of flutter. It is characterized by a circuit that circumnavigates the tricuspid valve. Typical atrial flutter is characterized by the circuit running in a counterclockwise pattern up the septum, from medial to lateral across the right atrial roof, down the lateral wall, and back towards the septum across the floor of the right atrium between the IVC and the inferior margin of the tricuspid valve i.e. the cavo-tricuspid isthmus. Surface EKG will show a gradual downslope in leads II, III, and AvF and a rapid rise at end of each flutter wave. Atypical CTI-dependent flutter follows the same route but in the opposite direction (clockwise). Therefore, we will see positive flutter waves in the inferior leads Mitral annular flutter is more commonly seen in atrial fibrillation patients who've been treated with ablation leading to scarring in the left atrium. Roof-dependent flutter is characterized by a circuit that travels around left atrium circumnavigating a lesion (often from prior ablation), traveling through the left atrial roof, down the posterior wall, and around the pulmonary veins Surgical/scar/incisional flutter is seen in people with a history of prior cardiac surgery and have iatrogenic scars in right atrium due to cannulation sites or incisions How does atrial flutter pharmacologic management differ from other atrial arrhythmias? The atrioventricular (AV) node is unique in that the faster it is stimulated, the longer the refractory period and the slower it conducts. This characteristic is called decremental conduction. In atrial fibrillation, the atrial rate is so fast that the AV node becomes overwhelmed and only lets some of those signals through to the ventricles creating an irregular tachycardia but at lower rates. In atrial flutter, the atrial rate is slower, therefore the AV node has more capability to conduct allowing for higher ventricular rates. Therefore, to achieve rate control one will need a higher dose of AV blocking medications. Atrial tachycardia may require even higher doses due to the increased ability of the AV node to conduct, as the atrial rates are slower than in atrial flutter. Sodium channel blockers (Class I) such as flecainide and propafenone slow wavefront propagation, making it easier for the AV node to handle the atrial rates. This will end up leading to increased ventricular rates which can be dangerously fast. That is why AV nodal blockers should be used in conjunction with flecainide and propafenone. What is the role of cardioversion in atrial flutter management? Due to high success rate with atrial flutter ablation, ablation is the first line treatment. However, sometimes cardioversion may be utilized in patients depending on how symptomatic they are and how long it will take to get an ablation. Cardioversion may also be utilized preferentially when the atrial flutter was triggered by infection or cardiac surgery to see if it will come back. If cardioversion is pursued, the patient will need to be anticoagulated due to the stroke risk after the procedure due to post-conversion stunning. How effective is atrial flutter ablation? The landmark Natale et al study in 2000 demonstrated 80% success rate after radiofrequency ablation as compared to 36% in patients on anti-arrhythmic therapy. The LADIP study in 2006 further corroborated these findings. Contemporary data shows above 90% success rate of atrial flutter ablation. In patients who have had both atrial fibrillation and atrial flutter, most electrophysiologists would ablate both. However, in patients with atrial fibrillation, the atrial flutter usually is initiated by trigger spots firing in the left atrium. Once the atrial fibrillation is ablated, the flutter will become less likely. Therefore, there are those who say there's no need to ablate the flutter circuit as well. Alternatively, if a patient has severe comorbidities and/or is high risk for ablation, one may consider performing the atrial flutter ablation only since atrial flutter is harder to manage medically compared with atrial fibrillation. How do you manage atrial flutter in the acute inpatient setting? In the inpatient setting, electrical cardioversion is often limited by blood pressure and the hypotensive effects of the sedatives required. If one is awake and too hypotensive, chemical cardioversion can be pursued. The most effective anti-arrhythmic for this is ibutilide. Amiodarone is not effective for acute cardioversion. Since ibutilide prolongs refractoriness in atrial and ventricular tissue, there's a risk of long QT induced torsades de pointes. Pretreating with magneisum reduces the risk to 1-2%. References Jolly WA, Ritchie WT. Auricular flutter and fibrillation. 1911. Ann Noninvasive Electrocardiol. 2003;8(1):92-96. doi:10.1046/j.1542-474x.2003.08114.x McMichael J. History of atrial fibrillation 1628-1819 Harvey - de Senac - Laënnec. Br Heart J. 1982;48(3):193-197. doi:10.1136/hrt.48.3.193 Lee KW, Yang Y, Scheinman MM; University of Califoirnia-San Francisco, San Francisco, CA, USA. Atrial flutter: a review of its history, mechanisms, clinical features, and current therapy. Curr Probl Cardiol. 2005;30(3):121-167. doi:10.1016/j.cpcardiol.200 2023 ACC/AHA/ACCP/HRS Guideline for the Diagnosis and Management of Atrial Fibrillation: A Report of the American College of Cardiology/American Heart Association Joint Committee on Clinical Practice Guidelines. Circulation. 2024;149(1):e167. doi:10.1161/ Cosío F. G. (2017). Atrial Flutter, Typical and Atypical: A Review. Arrhythmia & electrophysiology review, 6(2), 55–62. https://doi.org/10.15420/aer.2017.5.2 https://www.escardio.org/Journals/E-Journal-of-Cardiology-Practice/Volume-11/Atrial-flutter-common-and-main-atypical-forms Natale A, Newby KH, Pisanó E, et al. Prospective randomized comparison of antiarrhythmic therapy versus first-line radiofrequency ablation in patients with atrial flutter. J Am Coll Cardiol. 2000;35(7):1898-1904. doi:10.1016/s0735-1097(00)00635-5 Da Costa A, Thévenin J, Roche F, et al. Results from the Loire-Ardèche-Drôme-Isère-Puy-de-Dôme (LADIP) trial on atrial flutter, a multicentric prospective randomized study comparing amiodarone and radiofrequency ablation after the first episode of symptomatic atrial flutter. Circulation. 2006;114(16):1676-1681. doi:10.1161/CIRCULATIONAHA.106.638395 https://www.acc.org/Membership/Sections-and-Councils/Fellows-in-Training-Section/Section-Updates/2015/12/15/16/58/Atrial-Fibrillation#:~:text=The%20first%20'modern%20day'%20account,in%20open%20chest%20animal%20models.&text=In%201775%2C%20William%20Withering%20first,(purple%20foxglove)%20in%20AFib.
LISTENER DISCRETION IS ADVISED. Kim YG, Choi YY, Han KD, Min K, Choi HY, Shim J, Choi JI, Kim YH. Atrial fibrillation is associated with increased risk of lethal ventricular arrhythmias. Sci Rep. 2021 Sep 13;11(1):18111. doi: 10.1038/s41598-021-97335-y. PMID: 34518592 Ren J, Yang Y, Zhu J, Wu S, Wang J, Zhang H, Shao X. The use of intravenous amiodarone in patients with atrial fibrillation and Wolff-Parkinson-White syndrome. Pacing Clin Electrophysiol. 2021 Jan;44(1):35-43. doi: 10.1111/pace.14113. Epub 2020 Dec 9. PMID: 33118640.
Short-Term Anticoagulation Versus Dual Antiplatelet Therapy for Preventing Device Thrombosis Following Left Atrial Appendage Closure
Cardiomiopatia Atrial - Disfunção elétrica + marcador estrutural? by Cardiopapers
☕ DECAF Trial insight! A new JAMA study shows that daily caffeinated coffee may lower recurrence of atrial fibrillation compared with abstinence. Patients drinking ~1 cup/day had 47% recurrence vs 64% with abstinence (HR 0.61, p=0.01)
Cardiomiopatia Atrial - Quando a IC começa pelos átrios by Cardiopapers
Dr. Naima Maqsood, Dr. Kelly Arps, and Dr. Jake Roberts discuss the acute management of atrial fibrillation with guest expert Dr. Jonathan Chrispin. Episode audio was edited by CardioNerds Intern Dr. Bhavya Shah. This episode reviews acute management strategies for atrial fibrillation. Atrial fibrillation is the most common chronic arrhythmia worldwide and is associated with increasingly prevalent comorbidities, including advanced age, obesity, and hypertension. Atrial fibrillation is a frequent indication for hospitalization and a complicating factor during hospital stays for other conditions. Here, we discuss considerations for the acute management of atrial fibrillation, including indications for rate versus rhythm control strategies, treatment targets for these approaches, considerations including pharmacologic versus electrical cardioversion, and management in the post-operative setting. CardioNerds Atrial Fibrillation PageCardioNerds Episode PageCardioNerds AcademyCardionerds Healy Honor Roll CardioNerds Journal ClubSubscribe to The Heartbeat Newsletter!Check out CardioNerds SWAG!Become a CardioNerds Patron! Pearls A key component to the management of acute atrial fibrillation involves addressing the underlying cause of the acute presentation. For example, if a patient presents with rapid atrial fibrillation and signs of infection, treatment of the underlying infection will help improve the elevated heart rate. Selecting a rate control versus rhythm control strategy in the acute setting involves considerations of comorbid conditions such as heart failure and competing risk factors such as critical illness that may favor one strategy over another. Recent data strongly supports the use of rhythm control in heart failure patients. Patients should be initiated on anticoagulation prior to pursuing a rhythm control strategy. There are several strategies for rate control medications with therapies including beta-blockers, non-dihydropyridine calcium channel blockers, and digoxin. The selection of which agent to use depends on additional comorbidities and the overall clinical assessment. For example, a patient with severely decompensated low-output heart failure may not tolerate a beta-blocker or calcium channel blocker in the acute phase due to hypotension risks but may benefit from the use of digoxin to provide rate control and some inotropic support. Thromboembolic prevention remains a cornerstone of atrial fibrillation management, and considerations must always be made in terms of the duration of atrial fibrillation, thromboembolic risk, and risks of anticoagulation. While postoperative atrial fibrillation is more common after cardiac surgeries, there is no major difference in management between patients who undergo cardiac versus non-cardiac procedures. Considerations involve whether the patient has a prior history of atrial fibrillation, surgery-specific bleeding risks related to anticoagulation, and monitoring in the post-operative period to assess for recurrence. Notes 1. Our first patient is a 65-year-old man with obesity, hypertension, obstructive sleep apnea, and pre-diabetes presenting for evaluation of worsening shortness of breath and palpitations. The patient has no known history of heart disease. Telemetry shows atrial fibrillation with ventricular rates elevated to 130-140 bpm. What would be the initial approach to addressing the acute management of atrial fibrillation in this patient? What are some of the primary considerations in the initial history and chart review? An important first step involves taking a careful history to understand the timing of symptom onset and potential underlying causes contributing to a patient's acute presentation with rapid atrial fibrillation. Understanding the episode trigger determines management by targeting reversible causes of the acute presentation and elucidating whether the episode is triggered by a cardiac or non-c...
In this episode, we review the high-yield topic Multifocal Atrial Tachycardiafrom the Cardiovascular section at Medbullets.comFollow Medbullets on social media:Facebook: www.facebook.com/medbulletsInstagram: www.instagram.com/medbulletsofficialTwitter: www.twitter.com/medbulletsLinkedin: https://www.linkedin.com/company/medbullets
Is your smartwatch just a fun gadget, or a serious medical device? In this episode, Jonathan Wolf is joined by Dr. Malcolm Findlay, a leading consultant cardiologist, to explore the powerful health data available on your wrist. They decode the most misunderstood metric, Heart Rate Variability (HRV), and reveal how your wearable can provide clinical-grade insights into your heart's health. Dr. Findlay explains the counter-intuitive science behind HRV — why more ‘wobble' in your heartbeat is a sign of good health — and breaks down the two opposing nervous systems that control it. He shares the latest on how these devices can accurately detect serious conditions like atrial fibrillation and why he, as a cardiologist, trusts the ECG function on a consumer smartwatch to make diagnoses. For listeners who track their own data, this episode is a practical guide to what your numbers actually mean. Dr. Findlay explains how to interpret your personal HRV trends, what constitutes a significant change, and when you should use the ECG feature. He also debunks common myths about heart rate zones, revealing the level of exercise intensity that truly benefits your long-term health. The episode concludes with an empowering look at how this technology is shifting control into our own hands. Can a simple alert from your watch really help prevent a catastrophic event like a stroke? Discover which metrics matter most and how to use them to guide your wellness journey.
This week we replay an episode from 2 years ago on postoperative ectopic atrial tachycardia (EAT) following congenital heart surgery in children. Are there risk factors for this arrhythmia and are any modifiable? What is the 'go to' therapy used by the electrophysiologists at Children's LA for the acute and chronic treatment of this arrhythmia in the postoperative period? Is the presence of EAT in a postoperative congenital heart patient a marker for a worse outcome? These are amongst the questions posed to Children's of Los Angeles pediatric electrophysiologist, Dr. Jonathan Uniat. · DOI: 10.1007/s00246-022-03068-8
Atrial fibrillation, or AFib, is the most common heart rhythm disorder though many people don't even know they have it. In this episode of Baptist HealthTalk, Dr. Brian Wilner, electrophysiologist at Baptist Health Miami Cardiac & Vascular Institute, explains how AFib is detected, who's most at risk and why untreated AFib raises your chances of having a stroke.You'll also hear what AFib feels like, the latest treatment options - from medications and ablation to the WATCHMAN device - and how lifestyle choices like exercise, sleep and alcohol can impact your heart health. Think you might have AFib? Talk to your cardiologist or an electrophysiologist about testing and treatment. Host:Willard ShepardAward-Winning JournalistGuest:Bryan Wilner, M.D.Cardiac ElectrophysiologistBaptist Health Miami Cardiac & Vascular Institute
Dr. Kelly Arps, Dr. Naima Maqsood, and Dr. Sahi Allam discuss modifiable risk factors and lifestyle management of atrial fibrillation with Dr. Prash Sanders. Atrial fibrillation is becoming more prevalent across the world as people are living longer with cardiovascular disease. While much of our current focus lies on the pharmacological and procedural management of atrial fibrillation, several studies have shown that targeted reduction of risk factors, such as obesity, sleep apnea, hypertension, and alcohol use, can also significantly reduce atrial fibrillation burden and symptoms. Today, we discuss the data behind lifestyle management and why it is considered the “4th pillar” of atrial fibrillation treatment. We also explore ways to incorporate prevention strategies into our general cardiology and electrophysiology clinics to better serve the growing atrial fibrillation population. Audio editing for this episode was performed by CardioNerds Intern, Julia Marques Fernandes. CardioNerds Atrial Fibrillation PageCardioNerds Episode PageCardioNerds AcademyCardionerds Healy Honor Roll CardioNerds Journal ClubSubscribe to The Heartbeat Newsletter!Check out CardioNerds SWAG!Become a CardioNerds Patron! Pearls More people have atrial fibrillation because it is being detected earlier using wearable technology, and patients are living longer with subclinical or clinical cardiovascular disease There are 3 components of atrial fibrillation: an electrical “trigger” + a susceptible substrate (due to age, sex, genetics) + “perpetuators” that cause the trigger to continue stimulating the substrate (lifestyle risk factors such as obesity, smoking, diabetes, etc.) Obesity is the highest attributable risk factor for atrial fibrillation. Treating obesity often helps to treat other risk factors, such as hypertension and sleep apnea. Counseling is patient-dependent. Most patients are unable to make major behavioral changes cold-turkey and will need to make small, incremental changes. Dr. Sanders' tip: He tells his own patients that “atrial fibrillation is the body's response to stress.” The key to treating atrial fibrillation is to control your underlying stressors - procedures and medications are simply band-aids that do not fix the root of the problem. Notes Notes drafted by Dr. Allam. 1. How common is atrial fibrillation? Atrial fibrillation is the most common sustained arrhythmia. Currently, an estimated 50-60 million individuals worldwide are estimated to have atrial fibrillation, or roughly 1 in 4 individuals over the age of 45.1 The rising global prevalence of atrial fibrillation can be attributed to the aging of the population, increased rates of obesity, and greater accumulation of cardiovascular risk factors and survival with clinical cardiovascular disease.2 Atrial fibrillation is also being detected earlier through digital and wearable devices.2 Annually, we spend approximately $5,312 per adult on the management of atrial fibrillation in the United States.3 2. What is the underlying pathophysiology of atrial fibrillation? How do risk factors like sleep apnea or obesity “trigger” atrial fibrillation? For atrial fibrillation to occur, there is an electrical “trigger”, a susceptible substrate (due to age, sex, genetics), and “perpetuators” that allow the trigger to continue stimulating the substrate.2 90% of electrical “triggers” come from the pulmonary veins “Perpetuators” influence how the autonomic nervous system interacts with the triggers and substrate to perpetuate atrial fibrillation. Sleep apnea, obesity, and other risk factors are the “perpetuators” Over time, as atrial fibrillation recurs, the substrate remodels to result in persistent atrial fibrillation. 3. What are some of the risk factors for atrial fibrillation and what are the possible benefits of controlling them?
This is a story of faith, community, healing, and self-advocacy. Twenty years ago Amy Faith Folger discovered the keto diet. After reading Jason Fung's book on intermittent fasting she lost 85 pounds in 3 MONTHS! Thanks to her community, her faith, and her relentless pursuit of weight-loss strategies that work, she has been able, so far, to drop 160 pounds. In this episode, Dr. Brian, Dr. Tro, Amy, and Adele talk about… (00:00) Intro (08:47) Losing weight on carnivore with lipodemiao (15:08) What NOT to do if you are a doctor trying to help a patient with lipodemiao and obesity (24:30) CGMs and stress (26:47) Taking care of yourself for the sake of the people in your life (35:05) Atrial fibrillation, obesity, and electrolyte deficiency (42:53) Insufficient education of patients on nutrition and the addiction component of (45:00) Covid mRNA vaccine injury and death (51:39) The power of community and taking care of your gut biome (56:54) Why we need to teach people HOW to cook keto/carnivore meals (58:34) GLP-1s pros and cons (01:07:00) Outro For more information, please see the links below. Thank you for listening! Links: Please consider supporting us on Patreon: https://www.lowcarbmd.com/ Resources Mentioned in this Episode: Paul Thacker on the LCMD Podcast: https://lowcarbmd.com/podcast/episode-280-paul-thacker-and-kris-newby/ Jason Fung's fasting book: https://www.amazon.com/Complete-Guide-Fasting-Intermittent-Alternate-Day/dp/1628600012 Dr. Brian Lenzkes: Website: https://arizonametabolichealth.com/ Twitter: https://twitter.com/BrianLenzkes?ref_src=twsrc^google|twcamp^serp|twgr^author Dr. Tro Kalayjian: Website: https://www.doctortro.com/ Twitter: https://twitter.com/DoctorTro Instagram: https://www.instagram.com/doctortro/ Toward Health App Join a growing community of individuals who are improving their metabolic health; together. Get started at your own pace with a self-guided curriculum developed by Dr. Tro and his care team, community chat, weekly meetings, courses, challenges, message boards and more. Apple: https://apps.apple.com/us/app/doctor-tro/id1588693888 Google: https://play.google.com/store/apps/details?id=uk.co.disciplemedia.doctortro&hl=en_US&gl=US Learn more: https://doctortro.com/community/
Story at-a-glance Atrial fibrillation (AFib) is typically linked to cardiovascular risk factors like hypertension and aging, but evidence suggests chronic oral infections also play a direct role in its development New research links Porphyromonas gingivalis, the key bacterium in gum disease, to heart scarring and arrhythmias. Findings show it travels to the heart and interferes with electrical signaling In animal models, P. gingivalis exposure increased AFib risk, while human heart tissue confirmed higher bacterial load and damage in patients with severe gum disease A 14-year study of 1.25 million people found chronic gum disease increased AFib risk by 4%, while recovery lowered risk to nearly the same level as gum-healthy individuals To improve your gum health, make sure to brush and floss daily, try oil pulling, eat a whole-food diet, manage your stress levels, and get regular cleanings from a biological dentist trained in systemic oral care