Podcasts about Atrial fibrillation

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In this episode of The Lead, host Christopher C. Cheung, MD, MPH, FHRS, is joined by Edward P. Gerstenfeld, MD, MS, FHRS, and Paul C. Zei, MD, PhD, FHRS, to discuss the journal article, A Prospective Randomized Multicenter Global Study Comparing Pulsed Field Ablation versus Anti-Arrhythmic Drug Therapy as a First Line Treatment for Persistent Atrial Fibrillation (AVANT GUARD). Together, they review the study design and findings, examining pulsed field ablation and anti-arrhythmic drug therapy as first-line treatment approaches for patients with persistent atrial fibrillation. Learning Objectives Review the design and key findings of the AVANT GUARD study comparing pulsed field ablation with anti-arrhythmic drug therapy as first-line treatment for persistent atrial fibrillation. Discuss the potential role of pulsed field ablation as an initial treatment strategy for patients with persistent atrial fibrillation. Examine the comparative considerations of ablation-based and pharmacologic approaches in the management of persistent atrial fibrillation.   Podcast Contributors: Host: Christopher C Cheung, MD, MPH, FHRS       Guests: Edward P. Gerstenfeld, MD, MS, FHRS and Paul C Zei, MD, PhD, FHRS   Disclosures: Christopher C Cheung, MD, MPH, FHRS Honoraria/Speaking/Consulting Fee: Medtronic, Inc., Biotronik, Biosense Webster, Inc., Abbott Edward P. Gerstenfeld, MD, MS, FHRS Honoraria/Speaking/Consulting Fee: Medtronic, Inc., Biosense Webster, Inc., Abbott, Boston Scientific, Varian Medical Systems Other Non-Financial Relationships: Adagio Medical, Boston Scientific, Abbott Medical Research: Abbott Medical Officer, Trustee, Director, Committee Chair, or Other Fiduciary Role: American College of Cardiology Paul C Zei, MD, PhD, FHRS Honoraria/Speaking/Consulting Fee/Speaker's Bureau: Varian Medical Systems, Biosense Webster, Inc., Abbott, Boston Scientific, APT Medical Research: Biosense Webster, Inc.

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In this episode of The Lead, host Sandeep A. Saha, MD, MS, FHRS, is joined by Babak Nazer, MD, and Rajesh Kabra, MD, FHRS, to discuss the journal article, Safety and Effectiveness of a Dual-Energy Focal Ablation Catheter to Treat Paroxysmal Atrial Fibrillation: 6-Month Results of the FlexPulse IDE Study. Together, they review the study's six-month findings and explore the safety and effectiveness of a dual-energy focal ablation catheter for the treatment of paroxysmal atrial fibrillation. Learning Objectives Review the six-month results of the FlexPulse IDE Study evaluating a dual-energy focal ablation catheter for the treatment of paroxysmal atrial fibrillation. Discuss the safety outcomes reported in the study and their implications for clinical practice. Examine the effectiveness findings of the dual-energy focal ablation approach in patients with paroxysmal atrial fibrillation. Podcast Contributors Sandeep A Saha, MD, MS, FHRS  Babak Nazer, MD Rajesh Kabra, MD, FHRS   Host and Contributor Disclosure(s): S. Saha• Honoraria/Speaking/Consulting Fee/Speaker's Bureau: Medtronic, Inc. B. Nazer •Honoraria/Speaking/Consulting Fee: Edwards Lifesciences, Biosense Webster, Inc., Siemens Healthineers •Research: Siemens Healthineers R. Kabra •Honoraria/Speaking/Consulting Fee: AtriCure, Inc., Biosense Webster, Inc., Milestone Pharmaceuticals, AltaThera Pharmaceuticals •Research: Abbott Medical, Medtronic, Inc.  

In this episode, Dr Imdad Ahmed discusses the strategy for same-day discharge after intravenous sotalol loading in patients with atrial fibrillation.

Commentary by Dr. Jian'an Wang.

Commentary by Dr. Jian'an Wang.

Commentary by Dr. Jian'an Wang.

This week, Bobbi Conner talks with Dr. Rachel Kaplan about managing atrial fibrillation.

In this episode of The Lead, host Melissa Middeldorp, MPH, PhD, FHRS is joined by Jenelle Dziano, PhD candidate, Clinical Exercise Physiologist and Adrian D. Elliott, PhD for a discussion of the recent journal article, Exercise Capacity and Quality-of-Life Improvements after Catheter Ablation in Patients with Clinically Asymptomatic Persistent Atrial Fibrillation. Together, they explore the study findings and discuss the impact of catheter ablation on exercise capacity and quality of life in patients with clinically asymptomatic persistent atrial fibrillation. Learning Objectives Review the key findings from the journal article examining exercise capacity and quality-of-life outcomes after catheter ablation in patients with clinically asymptomatic persistent atrial fibrillation. Discuss the potential clinical implications of catheter ablation for patients who may not report traditional atrial fibrillation symptoms. Explore the role of exercise capacity and quality-of-life measures in evaluating treatment outcomes for persistent atrial fibrillation. Podcast Contributors: Host: Melissa Middeldorp, MPH, PhD, FHRS Guests: Jenelle Dziano, PhD candidate, Clinical Exercise Physiologist and Adrian D. Elliott, PhD Host and Contributor Disclosure(s): M. Middeldorp: Nothing to disclose J. Dziano: Nothing to disclose A. Elliiott: Nothing to disclose

In this episode, CardioNerds Dr. Colin Blumenthal, Dr. Kelly Arps, and Dr. Yong Hao Yeo are joined by electrophysiology expert Dr. Bradley Knight to discuss atrial fibrillation (AF) management in challenging clinical scenarios. We explore arrhythmias in patients with pre-excitation syndromes, particularly Wolff-Parkinson-White (WPW) syndrome, and strategies for rhythm control. We also discuss AF management in pregnancy, adult congenital heart disease, and patients with tachycardia-bradycardia (tach-brady) syndrome. This episode provides essential insights into nuanced decision-making for the care of patients with complex arrhythmia profiles. Audio editing by CardioNerds academy intern, Grace Qiu. Enjoy this Circulation 2022 Paths to Discovery article to learn about the CardioNerds story, mission, and values. 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 AF in WPW is a true emergency—AV nodal blocking agents can be deadly. In patients with WPW syndrome, AF can rapidly conduct through the accessory pathway, risking ventricular fibrillation and sudden death. Avoid AV nodal blockers like beta-blockers and calcium channel blockers. Catheter ablation is the first-line rhythm control strategy in WPW. Catheter ablation carries a Class I recommendation and offers >90% success. If antiarrhythmic drugs are needed, sodium channel blockers like flecainide or propafenone are preferred in patients without structural heart disease. In pregnancy, protecting the mother is protecting the fetus. An unstable mother means an unstable fetus. Rate control is the first step in AF with rapid ventricular responses and electrical cardioversion is safe when needed. Multidisciplinary care is essential. AF in congenital heart disease is often outside the pulmonary veins. Surgical scars and chamber remodeling in ACHD patients often lead to AF from non-pulmonary vein foci. Electrogram-based mapping and targeted ablation strategies are essential to increase success rate of durable rhythm control. Tachy-brady syndrome may require pacing to unlock therapy. AF may cause atrial myopathy and sinus node dysfunction. These patients often require permanent pacing to allow safe use of rate-controlling medications like beta-blockers and to prevent syncope or chronotropic incompetence. Notes: Notes drafted by Dr. Yong Hao Yeo Why is atrial tachycardia in patients with WPW syndrome dangerous? Patients with WPW commonly present with supraventricular tachycardia (SVT) due to atrioventricular reentrant circuits, either orthodromic or antidromic. This SVT can degenerate into AF. In the absence of AV nodal as the governor between the atrium and ventricles, the accessory pathway may conduct impulses rapidly and frequently. This can lead to dangerously high ventricular rates, predisposing patients to ventricular fibrillation and sudden cardiac arrest. What are some strategies for rhythm control in patients with WPW and atrial tachycardia? Catheter ablation is the first-line therapy (Class I recommendation), with a success rate of over 90%. Ablation reduces the risk of sudden cardiac arrest, though some patients may remain prone to AF. If ablation is not feasible/ contraindicated, sodium channel blockers such as flecainide and propafenone are good options in patients without ischemia or structural heart disease (Class IIa recommendation). Amiodarone should be avoided because it has a long half-life, can accumulate in the system, and may delay definitive treatment with catheter ablation. AV nodal blocking agents like beta blockers and calcium channel blockers should be avoided, as they are less effective at controlling ventricular rate in WPW and can increase conduction over the accessory pathway. These agents can also exacerbate the risk of rapid ventricular rates during AF and worsen left ventricular function. What are some special considerations in managing AF in pregnant patients? The primary goal in managing cardiovascular disease during pregnancy is to protect the mother, as fetal outcomes depend on maternal well-being. Therefore, while caution is necessary, we should avoid undertreating pregnant patients with AF. In cases of AF with rapid ventricular response (RVR), rate control is usually the first-line strategy, with beta blockers preferred over digoxin or non-dihydropyridine calcium channel blockers. It is then reasonable to initially observe for spontaneous conversion in stable patients. Antiarrhythmic drugs (AADs) are generally avoided during the first trimester, but clinical judgment on a case-by-case basis is essential. Evidence for the safety of AADs in pregnancy is limited, often derived from their use in other conditions such as fetal SVT. Flecainide and sotalol are reasonable options for rhythm control (Class IIa recommendation). Electrical cardioversion is considered safe in pregnancy and should be utilized when indicated (Do not forget!). There is no pregnancy-specific thromboembolic risk stratification tool. CHA₂DS₂-VASc scoring and the presence of risk factors like mitral stenosis can help guide anticoagulation decisions, though the magnitude of thromboembolic risk during pregnancy remains unclear. Rate control agents are typically continued during delivery due to the increased physiologic stress of labor and delivery. Multidisciplinary care is crucial and should involve obstetrics, maternal-fetal medicine, cardiology, and electrophysiology specialists. What are some key considerations for AF management in patients with adult congenital heart disease (ACHD)? Patients with repaired congenital heart disease are at increased risk for arrhythmias due to two main factors: surgical scars that create arrhythmogenic foci and mechanical remodeling of the atria or ventricles resulting from the underlying disease. In these patients with structural heart disease, sodium channel blockers may not be ideal antiarrhythmic options. When selecting an antiarrhythmic drug, clinicians must consider the nature of structural or surgical impairments, such as right bundle branch block or prolonged QT interval. It is also essential to assess renal and hepatic function (often impaired in patients with ACHD) to ensure appropriate metabolism and clearance of antiarrhythmic medications. Electrogram-based ablation strategies (those leveraging artificial intelligence are developing!) may help identify effective ablation targets, which are often outside the pulmonary veins in patients with ACHD. These individualized approaches can improve ablation success rates in this complex patient population. What makes tachycardia-bradycardia (tach-brady) syndrome a unique challenge in arrhythmia management? Patients who present with both AF and bradycardia, especially with syncope, require a thoughtful diagnostic approach to identify the underlying rhythm disturbance. Extended cardiac monitoring, including event monitors or implantable loop recorders, can help capture intermittent arrhythmias and correlate them with symptoms. AF may lead to atrial myopathy, and since the sinus node resides within the atrium, this can result in sinus node dysfunction—a hallmark of tachy-brady syndrome. Following spontaneous conversion from AF to sinus rhythm, sinus node dysfunction may persist, leading to prolonged pauses or chronotropic incompetence. Management becomes more complex when beta-blockers are needed for AF with RVR, as they can exacerbate bradycardia. Permanent pacemaker implantation is often the next step to consider. Permanent pacemaker implantation is often considered to facilitate safe rate control in these cases. In younger patients, aggressive AF burden reduction may prevent atrial remodeling and the development of true atrial myopathy, potentially avoiding pacemaker implantation. References Joglar JA, Chung MK, Armbruster AL, et al. 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. 2023;149(1). doi:https://doi.org/10.1161/CIR.0000000000001193 ‌ Van IC, Rienstra M, Bunting KV, et al. 2024 ESC Guidelines for the management of atrial fibrillation developed in collaboration with the European Association for Cardio-Thoracic Surgery (EACTS). European Heart Journal. 2024;45(36). doi:https://doi.org/10.1093/eurheartj/ehae176 ‌ Joglar JA, Kapa S, Saarel EV, et al. 2023 HRS expert consensus statement on the management of arrhythmias during pregnancy. Heart Rhythm. Published online May 1, 2023. doi:https://doi.org/10.1016/j.hrthm.2023.05.017 ‌ Stout KK, Daniels CJ, Aboulhosn JA, et al. 2018 AHA/ACC Guideline for the Management of Adults With Congenital Heart Disease: Executive Summary. Journal of the American College of Cardiology. 2019;73(12):1494-1563. doi:https://doi.org/10.1016/j.jacc.2018.08.1028 ‌

This April 2026 Heart Rhythm Journal publication reports a sub-analysis of the CHAMPION-AF trial evaluating left atrial appendage closure (LAAC) versus oral anticoagulation in patients with atrial fibrillation who previously underwent catheter ablation. The analysis demonstrated that LAAC with the WATCHMAN FLX device provided comparable protection against stroke, systemic embolism, and cardiovascular death when compared with NOAC therapy, while also reducing long-term non-procedural bleeding events. These findings support consideration of LAAC as an alternative stroke prevention strategy in selected post-ablation AF patients through individualized, shared decision-making. Digital Education Committee Member Danesh Kella, MBBS, FHRS discusses this article from the Heart Rhythm Journal that preceded the Heart Rhythm 2026 Late-Breaking Clinical Trial. He is joined in the conversation by Jason T. Jacobson, MD, FHRS, Ammar M. Killu, MBBS, and Gregory M. Marcus, MD, FHRS.   Learning Objectives Describe the rationale for left atrial appendage closure as an alternative to chronic oral anticoagulation in patients with atrial fibrillation after catheter ablation. Review the efficacy and safety outcomes from the CHAMPION-AF sub-analysis comparing LAAC and NOAC therapy in post-ablation AF patients.  Discuss patient selection considerations and the role of shared decision-making when choosing stroke prevention strategies following AF ablation.    Podcast Contributors Danesh Kella, MBBS, FHRS Jason T. Jacobson, MD, FHRS Ammar M. Killu, MBBS Gregory M. Marcus, MD, FHRS    Host and Contributor Disclosure(s): J.T. Jacobson •Board/Advisory Committee Membership: Abbott Medical •Honoraria/Speaking/Teaching/Consulting: Zoll Medical Corporation, Vektor Medical, Inc. •Research: CardioFocus, Inc., Johnson and Johnson •Stocks, Privately Held: Atlas 5D D. Kella •Honoraria/Speaking/Teaching/Consulting: Zoll Medical Corporation, MBW Spectrum A. Killu •Board/Advisory Committee Membership: Boston Scientific •Honoraria/Speaking/Teaching/Consulting: AtriCure, Inc., Abbott, Biosense Webster, Inc., Siemans Healthineers •Research: Boston Scientific, Access Point Technologies G.M. Marcus •Honoraria/Speaking/Teaching/Consulting: InCarda Therapeutics •Research: NIH, PCORI, TRDRP •Stocks, Publicly Traded: InCarda Therapeutics  

This late-breaking sub-analysis from the CHAMPION-AF trial evaluated outcomes of left atrial appendage closure (LAAC) with the WATCHMAN FLX device versus oral anticoagulation in patients with atrial fibrillation who had previously undergone catheter ablation. Investigators found that LAAC provided similar protection against stroke, cardiovascular death, and systemic embolism compared with non-vitamin K oral anticoagulants (NOACs), while significantly reducing non-procedural bleeding events, regardless of prior ablation status. These findings suggest LAAC may be a viable alternative to long-term anticoagulation in select post-ablation AF patients through a shared decision-making approach. Join Digital Education Committee member Sandeep A. Saha, MD, MS, FHRS and his colleagues Scott C. Brancato, MD, FHRS and Rakesh Gopinathannair, MBA, MD, FHRS for this late-breaking coverage from Heart Rhythm 2026 in Chicago!   Learning Objectives Review the rationale for left atrial appendage closure as an alternative to long-term oral anticoagulation in patients with atrial fibrillation following catheter ablation. Analyze the CHAMPION-AF sub-analysis outcomes comparing LAAC and NOAC therapy with respect to stroke prevention, cardiovascular outcomes, and bleeding risk. Discuss how these findings may influence patient selection and shared decision-making for stroke prevention strategies in post-ablation atrial fibrillation care.    Podcast Contributors Sandeep A. Saha, MD, MS, FHRS Scott C. Brancato, MD, FHRS Rakesh Gopinathannair, MBA, MD, FHRS    Host and Contributor Disclosure(s): S. Brancato Nothing to disclose. R. Gopinathannair Board/Advisory Committee Membership: Heart Rhythm Society, AltaThera Pharmaceuticals Honoraria/Speaking/Teaching/Consulting: Abbott, Johnson and Johnson, Boston Scientific, Sanofi S. Saha Board/Advisory Committee Membership: Medtronic Honoraria/Speaking/Teaching/Consulting: Medtronic 

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This discussion reviews the late-breaking HRS 2026 study Total Fatal Adverse Events Following Atrial Fibrillation Ablation Reported in an FDA Mandatory Reporting System: A Matter of Concern? The TiFFANY Study, which examined fatal adverse event reports associated with atrial fibrillation ablation using data from the FDA MAUDE database. Faculty discuss the incidence and mechanisms of rare but serious complications across ablation technologies, including pulsed field ablation and thermal energy sources, and explore the implications for procedural safety, post-market surveillance, and clinical decision-making in AF ablation. Join host Melissa E. Middeldorp, MPH, PhD and her esteemed guests Christopher F. Liu, MD, FHRS and James Freeman, MD, MPH, Msci for this late-breaking coverage from Heart Rhythm 2026 in Chicago! Learning Objectives Describe the methodology and key findings of the TiFFANY study evaluating fatal adverse events following atrial fibrillation ablation. Compare reported safety signals and complication profiles among pulsed field ablation and traditional thermal ablation technologies. Assess the role and limitations of post-market adverse event databases in evaluating procedural safety and informing electrophysiology practice.  Podcast Contributors Melissa E. Middeldorp, MPH, PhD, FHRS Christopher F. Liu, MD, FHRS James Freeman, MD, MPH, Msci  Host and Contributor Disclosure(s): D.C. Raja Nothing to disclose. A. Deshmukh Honoraria/Speaking/Teaching/Consulting: GE Healthcare, Biotronik, Medtronic, Biosense Webster Research: AltaThera Pharmaceuticals P. Lim Nothing to disclose.  

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Research Examines the Connection Between Periodontitis and Atrial Fibrosis in Atrial FibrillationBy Today's RDH ResearchOriginal article published on Today's RDH: https://www.todaysrdh.com/research-examines-the-connection-between-periodontitis-and-atrial-fibrosis-in-atrial-fibrillation/Need CE? Start earning CE credits today at ⁠⁠⁠https://rdh.tv/ce⁠⁠⁠ Get daily dental hygiene articles at ⁠⁠⁠https://www.todaysrdh.com⁠⁠⁠ Follow Today's RDH on Facebook: ⁠⁠⁠https://www.facebook.com/TodaysRDH/⁠⁠⁠Follow Kara RDH on Facebook: ⁠⁠⁠https://www.facebook.com/DentalHygieneKaraRDH/⁠⁠⁠Follow Kara RDH on Instagram: ⁠⁠⁠https://www.instagram.com/kara_rdh/⁠

Welcome to the first episode in this week's triple-header of late-breaking clinical trial coverage from Heart Rhythm 2026 in Chicago. In this episode Melissa E. Middeldorp, MPH, PhD from the Digital Education Committee sits down with David H. Birnie, MD and T. Jared Bunch, MD, FHRS to talk through this exciting late breaker. This late-breaking substudy of the ALONE-AF trial presented at Heart Rhythm 2026 evaluated whether discontinuing oral anticoagulation (OAC) after successful atrial fibrillation ablation impacts cognitive function in patients without long-term recurrence. The findings suggest that stopping OAC approximately one year post-ablation does not adversely affect cognitive outcomes, with cognitive scores improving similarly in both discontinuation and continuation groups among patients who remained arrhythmia-free. These results support the potential safety of OAC discontinuation in selected patients, while addressing an important gap in post-ablation management. Learning Objectives Understand the clinical rationale and current uncertainty surrounding continuation versus discontinuation of oral anticoagulation after successful AF ablation. Evaluate the impact of anticoagulation discontinuation on cognitive function in patients without recurrent atrial fibrillation. Apply emerging evidence from ALONE-AF and related studies to inform individualized decision-making on long-term anticoagulation management post-ablation.   Podcast Contributors Melissa E. Middeldorp, MPH, PhD David H. Birnie, MD T. Jared Bunch, MD, FHRS   Contributor Information: M. Middeldorp Nothing to disclose. D. Birnie Nothing to disclose.  T.J. Bunch • Honoraria/Speaking/Teaching/Consulting: Heart Rhythm Society, Pfizer  

Lisa Salberg and Dr. Ethan Rowin break down new data on atrial fibrillation risk in patients taking myosin inhibitors for HCM. They explain what the latest research shows, how risk compares to traditional care, and what patients should watch for as treatment options continue to evolve.   This conversation was recorded April 28, 2026.

Commentary by Dr. Leandra Serio.

Commentary by Dr. Deep Chandh Raja.

New cardiovascular data suggest pulsed field ablation may challenge antiarrhythmic drugs as first-line therapy for persistent atrial fibrillation, while real-world evidence positions apixaban as the preferred DOAC for younger patients with nonvalvular AF due to superior safety and effectiveness. Additional findings from the SENIOR-RITA trial indicate that routine invasive management may not benefit frail older adults with NSTEMI and could worsen outcomes in the most frail patients. Together, these studies highlight a growing shift toward more individualized cardiovascular treatment strategies.

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This week on The Beat, CTSNet Editor-in-Chief Joel Dunning spoke with Dr. Zhi Lin, Chief Director of Cardiovascular Surgery Division 1 at Xiamen Cardiovascular Hospital of Xiamen University in Xiamen, China, and Dr. Oscar A. Flores Flores, a cardiothoracic surgeon at Hospital Civil de Guadalajara Fray Antonio Alcalde in Guadalajara, Mexico, about The Heart Sapling Visiting Scholar Program. Chapters 00:00 Intro 02:22 AATS, UAE Conference, King Faisal 05:28 JANS 1, LAA Closure vs Therapy AF 09:53 JANS 2, Thrombus-Free LAA Occlusion 11:49 JANS 3, Immunosuppression & Retransplantation 13:06 JANS 4, Biomarkers & Outcomes Isolated CABG 15:18 Video 1, Rheumatic MV Reconstruction 17:02 Video 2, Morgagni Hernia 18:07 Video 3, Robotic Excision Anterior Mediastinal 19:35 Lin Zhi & Oscar Flores, Chinese Fellowship & Surgery 34:25 Upcoming Events 35:13 Closing Dr. Flores discusses what the program entails, sharing his experience as a fellow and the opportunities he gained from it. Dr. Lin then outlines the program's goals and the various procedures that can be learned at Xiamen Cardiovascular Hospital of Xiamen University, which hosts the program. They also cover how to join the program and the application process. Furthermore, they discuss minimally invasive procedures in China and how this approach is growing in popularity. Joel also highlights recent JANS articles on left atrial appendage closure or medical therapy in atrial fibrillation, long-term thrombus-free left atrial appendage occlusion via magnetofluids, implications of immunosuppression and retransplantation for donor-derived cell-free DNA associated with increased risk of chronic lung allograft dysfunction and mortality, and immunosenescence biomarkers and outcomes in isolated coronary artery bypass grafting.  In addition, Joel explores rheumatic mitral valve reconstruction, tips for the surgical management of a Morgagni hernia, and right robotic excision of anterior mediastinal mass. Before closing, Joel highlights upcoming events in CT surgery.    JANS Items Mentioned  1. Left Atrial Appendage Closure or Medical Therapy in Atrial Fibrillation  2. Long-Term Thrombus-Free Left Atrial Appendage Occlusion Via Magnetofluids  3. Donor-Derived Cell-Free DNA Associated With Increased Risk of Chronic Lung Allograft Dysfunction and Mortality: Implications of Immunosuppression and Retransplantation  4. Immunosenescence Biomarkers and Outcomes in Isolated Coronary Artery Bypass Grafting  CTSNet Content Mentioned  1. Rheumatic Mitral Valve Reconstruction  2. Tips for the Surgical Management of a Morgagni Hernia  3. Right Robotic Excision of Anterior Mediastinal Mass  Other Items Mentioned  1. Endoscopic Cone Repair in an Adult Patient With Ebstein Anomaly    2. CTSNet Website Redesign: Important Updates and Transition Details   3. Career Center   4. CTSNet Events Calendar  Disclaimer The information and views presented on CTSNet.org represent the views of the authors and contributors of the material and not of CTSNet. Please review our full disclaimer page here.

Deputy Editor Kenneth Ellenbogen presents an in‑depth discussion of the study "Long PR Interval Leads to Atrial Remodeling, Fibrosis and Inducible Atrial Fibrillation in a Swine Model." In this episode, Dr. Ellenbogen walks listeners through how prolonged atrioventricular conduction can drive structural and electrical remodeling in the atria, leading to fibrosis and increased susceptibility to atrial fibrillation. He highlights the significance of these findings for understanding AF pathophysiology and considers how this preclinical model may inform future prevention and treatment strategies.

Join host Melissa Middeldorp and her guests Marco Perez and Kristie Coleman for this installment of The Lead! This multicenter randomized controlled trial evaluated whether smartwatch-based rhythm monitoring improves detection of previously undiagnosed atrial fibrillation (AF) in cardiology outpatients aged ≥65 years with elevated stroke risk. A total of 437 participants were randomized to either 6-month monitoring with an Apple Watch integrating photoplethysmography-based irregular rhythm detection and single-lead ECG confirmation, supported by a telemonitoring adjudication pathway, or to standard care. The primary endpoint of new AF occurred significantly more often in the intervention group than in controls (9.6% vs 2.3%; HR 4.40), with many cases asymptomatic and detected earlier through wearable monitoring. All diagnosed patients were initiated on anticoagulation, and major adverse cardiovascular events were similar between groups. Overall, the study demonstrates that prolonged smartwatch-based screening embedded within a clinical workflow substantially increases AF detection in a high-risk population, highlighting the feasibility of wearable-enabled case finding while underscoring ongoing questions regarding clinical outcomes and optimal implementation. Learning Objectives Describe the design and key findings of a randomized trial evaluating smartwatch-based screening for atrial fibrillation in older patients at elevated stroke risk. Discuss the clinical implications, limitations, and broader evidence context of wearable-enabled atrial fibrillation detection within contemporary screening strategies.   Article Authors Nicole J. van Steijn, Isabel S. Blommestijn, Sebastiaan Blok, Shari Pepplinkhuizen, Aernout Somsen, Reinoud E. Knops, Laura Breukel, Jan G.P. Tijssen, Igor I. Tulevski, Philip M. Croon, Michiel M. Winter Podcast Contributors Melissa E. Middeldorp, MPH, PhD Kristie Coleman, MPH, RN Marco Perez, MD Host and Contributor Disclosure(s): M. MiddeldorpNothing to disclose. K. Coleman •Honoraria/Speaking/Teaching/Consulting: Medtronic M. Perez •Honoraria/Teaching/Speaking/Consulting: Boston Scientific, Biontronik •Ownership/Partnership: QALY •Research: Apple, Inc.  

Join an expert-led discussion exploring the safety and clinical outcomes of Class 1c antiarrhythmic therapy following percutaneous coronary intervention (PCI) in patients with new-onset atrial fibrillation, based on insights from a nationwide cohort study. Deep Chandh Raja, MBBS, MD, PhD (Australian National University and Kauvery Hospital) hosts a dynamic conversation with Sandeep Gautam, MD, MPH, FHRS (University of Missouri Health) and Deepak Padmanabhan, MD, FHRS (Narayana Institute of Cardiac Sciences, Bengaluru). Together, they examine real-world data on the use of Class 1c agents in a traditionally high-risk population, addressing long-standing concerns about proarrhythmia and ischemic heart disease. The discussion will highlight patient selection, evolving clinical practice patterns, and implications for guideline-directed management, offering clinicians practical insights into optimizing rhythm control strategies in complex post-PCI patients. Learning Objectives Evaluate the safety profile and clinical outcomes associated with Class 1c antiarrhythmic therapy in patients with new-onset atrial fibrillation following PCI.  Identify appropriate patient selection criteria and clinical considerations when prescribing Class 1c agents in the context of ischemic heart disease. Apply evidence from nationwide cohort data to inform decision-making and optimize rhythm management strategies in post-PCI atrial fibrillation patients. Link to the Article for Discussion Article AuthorsTing-Chun Huang MD, Po-Hsueh Su MD, Hui-Wen Lin MS, Po-Tseng Lee MD, Yu Liao MD, Chao-Yu Chen MD, Li-Hao Yap MD, Sheng-Hsiang Lin PhD, Yi-Heng Li MD, PhD Podcast ContributorsDeep Chandh Raja, MBBS, MD, PhD Sandeep Gautam, MD, MPH, FHRS Deepak Padmanabhan, MD, FHRS   Host and Contributor Disclosure(s): D.C. RajaNothing to disclose. S. Gautam Honoraria/Teaching/Speaking/Consulting: Biosense Webster Fellowship Support: Medtronic Inc., Abbott D. Padmanabhan Nothing to disclose.

Good morning from Pharma Daily: the podcast that brings you the most important developments in the pharmaceutical and biotech world. Today, we're diving into a series of transformative developments that underscore the continual evolution of this dynamic industry.First, let's explore the latest strategic move from Takeda Pharmaceuticals, which has embarked on a $1.3 billion restructuring plan in the United States. This has resulted in layoffs affecting 634 employees, a decision aimed at streamlining operations and cutting annual costs by over $1.26 billion. Such significant restructuring efforts are likely to alter market dynamics, as Takeda reallocates resources to focus on its core competencies and innovation-driven growth. The industry may witness shifts as Takeda aims to bolster its competitive edge amid a rapidly evolving market landscape.In a significant regulatory development, Biogen has successfully secured FDA approval for a high-dose version of Spinraza, designed to treat spinal muscular atrophy (SMA). This approval, following the resolution of prior manufacturing concerns, is a strategic effort to enhance therapeutic efficacy and maintain Biogen's competitive positioning against newer market players. The high-dose formulation of Spinraza promises improved patient outcomes, reinforcing Biogen's dedication to addressing unmet medical needs in SMA and offering hope to patients and families affected by this debilitating condition.Meanwhile, Samsung Biologics faces internal challenges as its labor union votes in favor of striking over unresolved governance issues and rigid labor policies. This potential strike highlights growing tensions within the company and raises concerns about operational continuity, which could affect production timelines and contractual obligations with partners. It's a reminder of the delicate balance between corporate governance and employee relations within major organizations.On the innovation front, Idorsia's investigational drug Quviviq has shown promise in treating pediatric insomnia following successful Phase 2 trials. If approved, Quviviq could be a pioneering treatment for children with insomnia, setting a new standard of care for this underserved patient population. This development highlights the importance of addressing specific medical needs across different demographics within the broader field of sleep disorders.Financial investments in research and development continue to shape the industry, with Eli Lilly embracing insilico medicine's AI technology through a $2.75 billion collaboration. This partnership aims to leverage AI-driven insights for drug discovery, reflecting an industry-wide trend toward integrating digital technologies into R&D processes. By adopting AI, companies like Eli Lilly are poised to accelerate drug discovery timelines and enhance precision in identifying potential therapeutic candidates. Additionally, Eli Lilly is spearheading research efforts into GLP-1 receptor agonists for treating substance use disorders, based on emerging scientific evidence suggesting these compounds could play a role in managing addiction by modulating reward pathways linked to addictive behaviors.In cardiovascular health advancements, Boston Scientific's Watchman heart implant has demonstrated substantial clinical benefits by reducing bleeding risks compared to traditional anticoagulants while maintaining non-inferiority in stroke prevention and mortality outcomes among atrial fibrillation patients. This advancement is likely to influence future clinical practice guidelines by offering safer long-term management options for atrial fibrillation.Moreover, Advocate Health's ambitious hospital drone delivery program, in partnership with Zipline, seeks to revolutionize logistics within healthcare delivery systems across major U.S. cities. By enhancing supply chain efficiencies and ensuring timely access to critical Support the show

Registered dietitian nutritionist Leyla Muedin discusses a New England Journal of Medicine paper (July 2024, cited via Holistic Primary Care) warning about drug-induced magnesium depletion, especially from diuretics, proton pump inhibitors (e.g., Nexium, Prilosec), and certain antibiotics. She notes magnesium is often not routinely measured despite links between deficiency and cardiovascular, metabolic, and neurological problems, including arrhythmias (AFib, long QT, torsades), endothelial dysfunction, and longer ICU stays. Prevalence estimates range from 7–11% (up to 20%) in hospitalized patients and 2–4% among outpatients, with higher rates among long-term PPI and diuretic users. She reviews symptoms and causes, explains limits of serum magnesium testing, highlights associations with diabetes, alcohol use, low potassium and calcium, and outlines evaluation options and oral repletion approaches, favoring better-absorbed forms like magnesium glycinate over oxide due to diarrhea risk.

Join Digital Education Committee member and podcast host Melissa E. Middeldorp, MPH, PhD, along with this week's guest contributors,Sheldon Litwin, MD from the Medical University of South Carolina and Abhishek Deshmuckh, MBBS from the Mayo Clinic for this week's episode. This real-world retrospective cohort study evaluated whether glucagon-like peptide-1 receptor agonist (GLP-1RA) therapy is associated with improved outcomes after atrial fibrillation (AF) ablation in obese patients using a large multicenter electronic health record database (TriNetX). After propensity matching 6,700 patients (3,350 GLP-1RA users and 3,350 non-users), GLP-1RA therapy was associated with significantly lower AF recurrence, progression to permanent AF, cardiovascular and heart failure hospitalizations, and all-cause mortality over a median ~2-year follow-up, although repeat ablation rates were unchanged. The authors propose that benefits may be mediated through weight-loss, reduction in systemic inflammation and epicardial fat, improved metabolic control, and potential direct atrial effects, but emphasize that causal inference is limited due to observational design and lack of weight-loss trajectory or adherence data. Overall, the study suggests GLP-1RAs could become an adjunct rhythm-control strategy in obese AF patients undergoing ablation, warranting prospective randomized trials.   Learning Objectives Understand the association between GLP-1 RA therapy and reduced AF recurrence and cardiovascular outcomes after catheter ablation in obese patients. Evaluate the potential mechanisms and clinical implications of GLP-1 RAs as an adjunctive metabolic therapy in rhythm control strategies for AF. Article for Discussion Article Authors Sandrine Venier, Pascal Defaye, Lisa Lochon, Rémi Benali, Arnaud Bisson, Adrien Carabelli, Youssou Diouf, Peggy Jacon, Laurent Fauchier Podcast Contributors Melissa E. Middeldorp, MPH, PhD Abhishek Deshmuckh, MBBS Sheldon Litwin, MD Host and Contributor Disclosure(s): M. Middeldorp Nothing to disclose. A. Deshmukh •Honoraria/Teaching/Speaking/Consulting: GE Healthcare   S. Litwin Honoraria/Teaching/Speaking/Consulting: Axon Therapies, Novo Nordisk, Alleviant, Corvia Medical 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.

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

In this episode of the Heart podcast, Digital Media Editor, Professor James Rudd, is joined by Dr Robin Bouleau from Stockholm, Sweden. They discuss his study that aimed to test whether having PVCs but a normal heart was a risk for future AF and stroke. If you enjoy the show, please leave us a positive review wherever you get your podcasts. It helps us to reach more people - thanks! Link to published paper: https://heart.bmj.com/content/112/1/21.long

Treatment for atrial fibrillation (A-fib) is becoming safer and more efficient with the addition of pulsed field ablation (PFA). Cardiac electrophysiologist William Maddox, M.D., explains how PFA targets cardiac tissue while sparing nearby structures and how it can be combined with radiofrequency ablation when needed.

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

Join Digital Education Committee member and podcast host Melissa E. Middeldorp, MPH, PhD, along with this week's guest contributors, Nino Isakadze, MD, MHS, and Geraldine A. Lee, PhD, FESC for this week's episode. The POP-AF trial was a prospective, randomized controlled study evaluating whether a nurse-led, integrated lifestyle intervention before AF ablation improves outcomes. A total of 145 patients with symptomatic paroxysmal or persistent AF and at least one modifiable risk factor were randomized to either standard pre-ablation care or a structured, multidisciplinary lifestyle program targeting weight loss, physical activity, alcohol reduction, smoking cessation, blood pressure, lipid and glycemic control, and obstructive sleep apnea treatment. After pulsed-field pulmonary vein isolation, patients were followed for 12 months. The primary endpoint, a composite of repeat ablations and cardioversions was reduced by 51% in the intervention group (IRR 0.49, 95% CI 0.30–0.78). Successful index ablation without antiarrhythmic drugs was also significantly higher (76% vs 53%). Notably, these benefits were achieved with an average weight loss (~5.5%), suggesting that comprehensive, personalized risk-factor management meaningfully enhances rhythm control outcomes when implemented before ablation.  Read the Article   Learning Objectives Understand how a structured, nurse-led integrated lifestyle intervention before AF ablation significantly reduces repeat procedures and cardioversions compared with standard care. Evaluate the role of comprehensive risk-factor modification which includes weight, blood pressure, alcohol use, and OSA management improves rhythm control outcomes in patients undergoing PVI.    Article Authors Jasper Vermeer, Tineke Vinck-de Greef, Maarten van den Broek, Bianca de Louw, Gijs van Steenbergen, Dennis van Veghel, Lukas Dekker Podcast Contributors Melissa E. Middeldorp, MPH, PhD Nino Isakadze, MD, MHS Geraldine A. Lee, PhD, FESC   All relevant financial relationships have been mitigated. Host and Contributor Disclosure(s): M. Middeldorp Nothing to disclose.   N. Isakadze Research: Apple, Inc., Itamar Medical Board Membership: Boston Scientific   G. Lee Research: H2020 (EHRA-PATHS)   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.

Commentary by Dr. Takeshi Aiba

Commentary by Dr.  Jian'an Wang

To have Dr. Morse answer a question, visit: https://drmorses.tv/ask/ All of Dr. Morse's and his son's websites under one roof: https://handcrafted.health/ Facebook Page: https://www.facebook.com/handcrafted.health 00:00:00 - Intro 00:01:33 - Paroxysmal Atrial Fibrillation (PAF) 00:23:31- Torn Meniscus - Cartilage Loss 00:38:57 - Endometriosis - Unwanted Hair Growth - Excessive Hair Loss - Acne - Cystic Gut 01:03:41 - Benign Tumor 01:13:50 - Growths 00:01:33 - Paroxysmal Atrial Fibrillation (PAF) AFib has been running my life for the past year with multiple weekly episodes. 00:23:31- Torn Meniscus - Cartilage Loss I am now in constant pain and have great difficulty walking. 00:38:57 - Endometriosis - Unwanted Hair Growth - Excessive Hair Loss - Acne - Cystic Gut My main health issue is, very severe and painful menstrual periods with heavy bleeding. 01:03:41 - Benign Tumor My 5-year-old daughter has a benign tumor, I'm trying to find a solution for her.  01:13:50 - Growths The latest one I have is hard and sometimes pulses a little bit.

Broadcast from KSQD, Santa Cruz on 2-26-2026: Dr. Dawn opens with an urgent measles advisory, noting the virus has an R-value of 15 compared to COVID's peak of 5, with South Carolina reporting over 1,000 cases. She recommends those who received only one MMR shot—particularly people now in their 60s—get an immune titer blood test, as protection declines after 40-50 years. Measles can cause "immune amnesia" destroying immunity to other pathogens, and rarely leads to fatal subacute sclerosing panencephalitis years later. Dr. Dawn criticizes Quest Labs' cholesterol reporting, which flags average levels as "moderate risk" with alarming red H markers even when values fall within their own stated normal ranges. She explains this creates unnecessary panic and pushes patients toward statins based on outdated 2008-2012 guidelines, when cardiology has since recognized that cholesterol can be too low. An emailer asks how an EKG can detect a past heart attack from "jagged lines." Dr. Dawn explains that each spike represents electrical signals moving toward or away from electrode pads, and a 12-lead EKG views the heart from multiple angles—smaller-than-expected spikes in specific leads indicate dead or damaged heart muscle. She urges everyone to learn CPR and AED use, which more than doubles survival chances. An emailer reports that food tastes strong on the first bite but becomes tasteless thereafter. Dr. Dawn identifies numerous medications causing taste changes including calcium channel blockers, beta blockers, statins, diuretics, and even acetaminophen. She also highlights zinc—both deficiency and toxicity above 40mg daily can impair taste, noting a zinc nasal spray was pulled from market after causing smell loss. An emailer asks about Prenuvo full-body MRI scans costing $499-1,000. Dr. Dawn cautions that while Prenuvo found 22 cancers in 1,000 people scanned, 1 in 20 scans requires follow-up biopsy and more than half are false positives—leading to stress, expense, and potential complications from unnecessary procedures. An emailer asks about seed oils after reading a Johns Hopkins article defending them. Dr. Dawn distinguishes fruit oils (olive, avocado) from industrially-extracted seed oils requiring hexane solvent, a neurotoxin that may leave residues despite claims of evaporation. She cites a BMJ study showing coconut oil raised HDL (good cholesterol) while matching olive oil's LDL impact, and recommends cold-pressed oils while avoiding hexane-extracted products, especially for infants.

In this episode, Dr. Austin Rupp and I try to answer the following questions:Should patients with provoked VTE be offered long term anticoagulation if they have persistent risk factors, like obesity? Does coffee make atrial fibrillation worse (or better??)? Is age-adjusted d-dimer safe to use in DVT? Should we prescribe beta blockers after acute MI if the EF is normal?Does fish oil improve cardiovascular outcomes in patients on dialysis?What's the best approach for dialysis in patients with acute kidney injury?The articles:Extended Apixaban for Provoked VTE (HI-PRO)Coffee and Atrial Fibrillation (DECAF)Age-Adjusted D-dimer for DVT (ADJUST-DVT)Beta-blockers after MI with normal EFFish Oil in Dialysis Patients (PISCES)Conservative Dialysis in AKI (LIBERATE-D)Music from Uppbeat (free for Creators!): https://uppbeat.io/t/soundroll/dope License code: NP8HLP5WKGKXFW2R

Darshan H. Brahmbhatt, Podcast Editor of JACC: Advances, discusses a recently published original research paper on Atrial Fibrillation/Flutter in Transthyretin Cardiac Amyloidosis: Prevalence, Incidence, Clinical Predictors, and Effect of Tafamidis.

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Dr. Rod Passman, Director, Center for Arrhythmia Research, Northwestern Medicine, joins John Williams to talk about how many people in the U.S. are living with atrial fibrillation, the most common symptoms of AFib, how AFib is sometimes asymptomatic, who is at most risk of Afib, the role wearables have in detecting AFib, what you can […]

Dr. Rod Passman, Director, Center for Arrhythmia Research, Northwestern Medicine, joins John Williams to talk about how many people in the U.S. are living with atrial fibrillation, the most common symptoms of AFib, how AFib is sometimes asymptomatic, who is at most risk of Afib, the role wearables have in detecting AFib, what you can […]

Dr. Rod Passman, Director, Center for Arrhythmia Research, Northwestern Medicine, joins John Williams to talk about how many people in the U.S. are living with atrial fibrillation, the most common symptoms of AFib, how AFib is sometimes asymptomatic, who is at most risk of Afib, the role wearables have in detecting AFib, what you can […]

In this standout episode of Next Steps 4 Seniors: Conversations on Aging, we’re bringing back an audience favorite: our eye-opening interview with Nurse Practitioner Liz Jackson from Henry Ford Hospital. Liz breaks down the B.E.F.A.S.T. method for spotting stroke symptoms early, dives into the different types of strokes, and explains why timing is everything when it comes to treatment. We also tackle the red flags of heart attacks, the sneaky signs of vascular disease (yes, even leg cramping!), and how managing conditions like high blood pressure and diabetes can be game-changers. Early detection = lives saved. This episode is packed with info that could protect you or someone you love. Every week brings two ways to grow: Tuesdays dive into the physical next steps with real-life guidance for seniors and families, and Fridays uplift the heart with spiritual and emotional next steps—encouragement, faith, and hope for the journey ahead. To learn more about Next Steps 4 Seniors, contact us at 248-651-5010 or visit us online at www.nextsteps4seniors.com Find us on YouTube at https://www.youtube.com/@nextsteps4seniorsLearn more : https://omny.fm/shows/next-steps-4-seniors-with-wendy-jonesSee omnystudio.com/listener for privacy information.

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

CardioNerds (Dr. Ramy Doss, Dr. Kelly Arps, and Dr. Naima Maqsood) dive into the nuances of atrial fibrillation (AF) ablation with Dr. Jon Piccini. They provide a high-yield overview of AF ablation, guiding listeners from patient selection through post-procedural management. We review appropriate candidacy for catheter ablation across AF phenotypes, key elements of pre-procedural evaluation including imaging and anticoagulation strategy, and the fundamental procedural steps with pulmonary vein isolation as the cornerstone. The discussion compares lesion set strategies in de novo ablation and reviews currently used energy sources—including radiofrequency, cryoablation, and pulsed-field ablation—highlighting differences in safety and efficacy. They also examine surgical and hybrid approaches for selected patients and outline essential components of post-ablation care, including rhythm monitoring, anticoagulation decisions, and management of complications. This episode integrates contemporary evidence with practical insights to support clinicians delivering comprehensive AF ablation care. Audio editing for this episode was performed by CardioNerds intern Dr. Bhavya Shah. NOTE: This episode was recorded in March 2025. Since then, the OCEAN trial showed that among patients who had had successful catheter ablation for atrial fibrillation at least 1 year earlier and had risk factors for stroke, treatment with rivaroxaban did not result in a significantly lower incidence of a composite of stroke, systemic embolism, or new covert embolic stroke than treatment with aspirin.  Enjoy this Circulation 2022 Paths to Discovery article to learn about the CardioNerds story, mission, and values. 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!

Today’s episode of Ask the Doctor was hosted by Dr. Michael Lange and Dr. Susan Summerton. Ask the Doctor is the longest-running live, syndicated medical talk show in the United States, broadcasting coast-to-coast for over 33 years. We opened the show discussing the massive global whey protein shortage. Whey protein is extremely difficult to obtain worldwide due to increased demand from patients using GLP-1 receptor drugs, who are being advised to consume higher protein intake to prevent muscle loss. In addition, major corporations such as Starbucks and Dunkin’ have purchased large quantities of whey protein for functional and sports drinks. Because of this shortage, Fortifeye Fit Pro is currently on backorder, though other Fortifeye whey protein products remain available, and we are actively working to secure supply. We then discussed black currant seed oil and GLA (gamma-linolenic acid) and why GLA may be a missing fatty acid in the modern diet. Fortifeye now offers Black Currant Seed Oil + GLA in a 90-count bottle. GLA helps support dry eye by stimulating Series-1 prostaglandins, which play an important role in controlling inflammation. Dr. Lange reviewed his clinical experience using Fortifeye Advanced Dry Eye Therapy, which combines: • Fortifeye Super Omega (RTG-form omega-3) • Fortifeye Focus • Fortifeye Black Currant Seed Oil + GLA This three-supplement combination has been very effective in helping reduce dry eye symptoms and improve overall ocular comfort. We also discussed the end of the BOGO on Fortifeye Vegan Super Protein. While the BOGO promotion has ended, this remains one of the top vegan proteins on the market, offering an amino acid profile comparable to whey protein, outstanding taste, and three delicious flavors. In addition, we covered exciting new research on carotenoids including lutein, zeaxanthin, and astaxanthin. These nutrients may help lower triglycerides and cholesterol, support brain health and mood, and may even help with depression. These carotenoids are beneficial for children and adults, supporting not only eye health but systemic and cognitive health as well. All three carotenoids are found together in Fortifeye Focus. We explained what photobiomodulation therapy (PBM) is and how it works. PBM uses specific wavelengths of low-level red and near-infrared light to stimulate mitochondrial function, increase cellular energy (ATP), improve circulation, and reduce inflammation. As more companies bring this technology to market, increased competition is expected to drive costs down, making this promising therapy more accessible to patients. Dr. Lange and Dr. Summerton shared their enthusiasm for photobiomodulation therapy as a supportive treatment option for macular degeneration, diabetic retinopathy, and dry eye disease. Dr. Kane has noted that when diet and supplementation are optimized, this technology may work even more effectively, reinforcing the importance of combining advanced technology with proper nutrition. Dr. Summerton also weighed in on chelation therapy, explaining how reducing toxic metal burden and oxidative stress may further support cellular health, circulation, and inflammation control. When used appropriately and combined with nutrition and lifestyle optimization, chelation therapy may enhance overall systemic and ocular health. An important discussion followed on the often-overlooked connection between dry eye disease and atrial fibrillation (AFib). Dr. Lange explained that many patients with both conditions commonly share deficiencies in: • Magnesium • Potassium • Sodium chloride • Omega-3 fatty acids • Hydration These deficiencies may contribute to inflammation, nerve dysfunction, poor tear quality, impaired circulation, and cardiac rhythm instability.

CardioNerds (Dr. Colin Blumenthal, Dr. Kelly Arps, and Dr. Natalie Marrero) discuss anti-arrhythmic drugs in the management of atrial fibrillation and atrial flutter with electrophysiologist Dr. Andrew Epstein. We discuss two major classes of anti-arrhythmic drugs, class IC and class III, as well as digoxin. Dr. Epstein explains their mechanisms of action, indications and specific patient populations in which they would be particularly helpful, efficacy, adverse side effects, contraindications, and key drug-drug interactions. We also elaborate on defining clinical trials and their clinical implications. Given the large burden of atrial fibrillation and atrial flutter in our patient population and the high prevalence of anti-arrhythmic drug use, this episode is sure to be applicable to many practicing physicians and trainees. Audio editing by CardioNerds academy intern, Grace Qiu.  Enjoy this Circulation 2022 Paths to Discovery article to learn about the CardioNerds story, mission, and values. 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 Anti-arrhythmic drugs should not be thought of as an alternative to ablation but, instead, should be considered an adjunct to catheter ablation.   Class IC anti-arrhythmic drugs, flecainide and propafenone, are highly efficacious for acute cardioversion and a great option for patients with infrequent episodes of AF who do not have a history of ischemic heart disease.    Class III anti-arrhythmic drugs like ibutilide, sotalol, and dofetilide, are highly effective for acute conversion; however, they require hospitalization for close monitoring during initiation and dose titration given the risk of prolonged QT.   Amiodarone should not be used as a first line agent given its toxicities, prolonged half-life, large volume of distribution, and drug-drug interactions.   Dr. Epstein notes that, “All drugs are poisons with a few beneficial side effects,” when highlighting the many adverse side effects of anti-arrhythmic drugs, particularly amiodarone, and the importance of balancing their benefit in rhythm control with their side effect profile.   Notes Notes: Notes drafted by Dr. Natalie Marrero. What are the Class IC anti-arrhythmic drugs and what indications exist for their use?   Class IC anti-arrhythmic drugs are anti-arrhythmic drugs that work by blocking sodium channels and, thereby, prolonging depolarizing.   Class IC anti-arrhythmic drugs include flecainide and propafenone.   Class IC anti-arrhythmic drugs are good agents to use in patients that have infrequent episodes of AF and do not want daily dosing as these agents can be used by patients when they feel palpitations and desire acute conversion back to sinus rhythm (“pill in the pocket” approach).    What are the adverse consequences and/or contraindications to using a class IC agent?  Class IC anti-arrhythmic agents are contraindicated in patients with a history of ischemic heart disease based on increased mortality associated with their use in these patients in the CAST trial.   Given the results of the CAST trial, providers should screen annually for ischemia via a functional stress test in patients on these drugs at risk for coronary disease.   These drugs can increase 1:1 conduction of atrial flutter and, therefore, require concomitant use of a beta blocker.   These agents are generally well-tolerated without any organ toxicities; however, they can precipitate heart failure in patients with cardiomyopathies, cause sinus node depression, and unmask genetic arrythmias such as a Brugada pattern.   What are the class III agents and what are indications for their use?   Class III agents are drugs that block the potassium channel, prolonging the QT, and include Ibutilide, Sotalol, and Dofetilide.    Class III agents can be considered in patients with or without a history of ischemic heart disease that desire effective acute chemical cardioversion and are willing to go to the hospital for close monitoring during dose initiation and titration.   Other specific circumstances in which one can use these agents, specifically Ibutilide, are in patients with recurrent atrial fibrillation and Wolf Parkinson White (due to slowed conduction via the accessory pathway).  What are the adverse consequences and/or contraindications to using a class III agent?  Ibutilide, Sotalol, and Dofetilide prolong the QT and increase the risk of torsade de pointes, which is why they require ECG monitoring in-patient during drug initiation and dose titration.    These agents are generally well-tolerated.   Sotalol should be avoided or used cautiously in patients with left ventricular dysfunction, while dofetilide can be used and has dose-response beneficial effects in patients with left ventricular dysfunction.   Both sotalol and dofetilide are renally cleared with specific creatinine clearance cutoffs (CrCl < 20 for dofetilide and CrCl