Podcasts about atrial flutter

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.

Identification of Atrial Fibrillation (A-Fib) & Atrial Flutter on the ECG and the treatment of unstable and stable SVT patients with A-Fib/Flutter.The ECG characteristics of A-Fib and A-Flutter.Recognition and treatment of unstable patients in A-Fib/Flutter with rapid ventricular response (RVR).Suggested energy settings for synchronized cardioversion of unstable patients with a narrow complex tachycardia.Team safety when cardioverting an unstable patient in A-FIB/Flutter.Adenosine's role for stable SVT patients with underlying atrial rhythms.Treatment of stable patients in A-Fib/Flutter with RVR.For other medical podcasts that cover narrow complex tachycardias, visit the pod resource page at passacls.com.Good luck with your ACLS class!Links: Buy Me a Coffee at https://buymeacoffee.com/paultaylor Free Prescription Discount Card - Get your free drug discount card to save money on prescription medications for you and your pets: https://nationaldrugcard.com/ndc3506/Pass ACLS Web Site - Other ACLS-related resources: https://passacls.com@Pass-ACLS-Podcast on LinkedIn

What happens when a health scare rewrites your entire life story? In this heartfelt episode, Carl shares how a commitment to better habits, less alcohol, more sleep, regular exercise, intersected with smart technology to spark a full-body transformation. From tracking sleep with the Oura ring to facing down a surprise heart diagnosis, he walks us through the highs, lows, and lessons. We explore the emotional power of running, journaling, and reconnecting with old friends, along with the modern tools that make us smarter, stronger patients. If you're navigating anxiety, aging, or health uncertainty, this one's for you.--------- EPISODE CHAPTERS ---------(0:00:02) - Health and Fitness Journey and Scare(0:14:43) - Diagnosis and Treatment of Atrial Flutter(0:28:57) - Embracing Positive Chemicals, Overcoming Stress(0:34:47) - Navigating Mental Health and Recovery(0:48:43) - Supplement Stack and Running Shoes(1:00:35) - Utilizing ChatGPT for Health Goals(1:04:25) - Genetics and Ablations for Atrial FlutterSend us a textFit, Healthy & Happy Podcast Welcome to the Fit, Healthy and Happy Podcast hosted by Josh and Kyle from Colossus...Listen on: Apple Podcasts Spotify

Identification of Atrial Fibrillation (A-Fib) & Atrial Flutter on the ECG and the treatment of unstable and stable SVT patients with A-Fib/Flutter.The ECG characteristics of A-Fib and A-Flutter.Recognition and treatment of unstable patients in A-Fib/Flutter with rapid ventricular response (RVR).Suggested energy settings for synchronized cardioversion of unstable patients with a narrow complex tachycardia.Team safety when cardioverting an unstable patient in A-FIB/Flutter.Adenosine's role for stable SVT patients with underlying atrial rhythms.Treatment of stable patients in A-Fib/Flutter with RVR.For other medical podcasts that cover narrow complex tachycardias, visit the pod resource page at passacls.com. **American Cancer Society (ACS) Fundraiser This is the seventh year that I'm participating in Men Wear Pink to increase breast cancer awareness and raise money for the American Cancer Society's life-saving mission.I hope you'll consider contributing.Every donation makes a difference in the fight against breast cancer! Paul Taylor's ACS Fundraiser Page: http://main.acsevents.org/goto/paultaylorTHANK YOU for your support! Good luck with your ACLS class!Links: Buy Me a Coffee at https://buymeacoffee.com/paultaylor Free Prescription Discount Card - Get your free drug discount card to save money on prescription medications for you and your pets: https://safemeds.vip/savePass ACLS Web Site - Other ACLS-related resources: https://passacls.com@Pass-ACLS-Podcast on LinkedIn

Dr. Emile Daoud, Deputy Editor of JACC Clinical Electrophysiology discusses Pulsed-Field Ablation of Atrial Flutter.

Check out the TIES Sales Showdown at www.tx.ag/TIESVisit The Sales Lab at https://thesaleslab.org and check out all our guests' recommended readings at https://thesaleslab.org/reading-listTo listen to The Sales Lab Podcast on your favorite apps, visit https://thesaleslab.simplecast.com/ and select your preferred method of listening.Connect with us on Facebook at https://www.facebook.com/saleslabpodcastConnect with us on Linkedin at https://www.linkedin.com/company/thesaleslabSubscribe to The Sales Lab channel on YouTube at  https://www.youtube.com/channel/UCp703YWbD3-KO73NXUTBI-Q 

Some Cochrane Reviews include network meta-analyses to bring together a range of comparisons to help identify the relative effects of different interventions and to rank them based on effectiveness. In June 2024, we published one of these, examining cardioversion for atrial arrhythmias. In this podcast, one of the authors Rui Providencia (left) interviews the first author, Kishore Kukendra‐Rajah (right) both from Barts Health NHS Trust in London in the UK.

Some Cochrane Reviews include network meta-analyses to bring together a range of comparisons to help identify the relative effects of different interventions and to rank them based on effectiveness. In June 2024, we published one of these, examining cardioversion for atrial arrhythmias. In this podcast, one of the authors Rui Providencia (left) interviews the first author, Kishore Kukendra‐Rajah (right) both from Barts Health NHS Trust in London in the UK.

Atrial Flutter by Albuquerque Fire Rescue

In deze aflevering bespreken we alles over hypokaliëmie. We behandelen de volgende onderwerpen:Waarom is kalium belangrijk?Wat is hypokaliëmie en wat zijn de symptomen?Is het gevaarlijk?Wanneer moeten we het behandelen, en hoe?Waarom moeten we altijd eerst magnesium geven?Welke richtwaarden moeten we aanhouden?Bronnen:Electrophysiology of Hypokalemia and Hyperkalemia - American Heart Association Deranged Physiology - Hypokalemia Het Acute Boekje - Hypokaliëmie EMCrit - HypokalemiaMechanism of Hypokalemia in Magnesium Deficiency : Journal of the American Society of Nephrology (lww.com)Association between potassium concentrations, variability and supplementation, and in-hospital mortality in ICU patients: a retrospective analysis | Annals of Intensive Care | Full Text (springeropen.com)Association of Intravenous Potassium and Magnesium Administration With Spontaneous Conversion of Atrial Fibrillation and Atrial Flutter in the Emergency Department | Cardiology | JAMA Network Open | JAMA NetworkExamining the "Repletion Reflex": The Association between Serum Potassium and Outcomes in Hospitalized Patients with Heart FailureAssociation of serum potassium concentration with mortality and ventricular arrhythmias in patients with acute myocardial infarction: A systematic review and meta-analysis - PubMed (nih.gov)Association between hyperkalemia at critical care initiation and mortality - PubMed (nih.gov)Bedankt voor het luisteren!Volg @intensiefdepodcast op InstagramVragen? intensiefdepodcast@gmail.com

Join the team from EMGuidewire from CMC Emergency Medicine Residency for another Intern Nuggets! In this episode, Drs. Crow and Lim discuss some tips on how they have approached the first half of their intern years as well as review management of Atrial Fibrillation and Atrial Flutter.

We look at the most common ECG rhythms and patterns seen in Medicine, including main identifying features of each. Consider subscribing on YouTube (if you found any of the info useful!): https://www.youtube.com/channel/UCRks8wB6vgz0E7buP0L_5RQ?sub_confirmation=1Patreon: https://www.patreon.com/rhesusmedicineBuy Us A Coffee!: https://www.buymeacoffee.com/rhesusmedicineRecommended sources for further reading:https://litfl.com/ecg-library/https://ecgwaves.com/Timestamps:0:00 Sinus Rhythm (Sinus Tachycardia & Sinus Bradycardia1:06 Atrial Fibrillation 2:35 – AF video link2:38 Atrial Flutter4:26 Premature Ventricular Contraction (PVCs) & Premature Atrial Contractions (PACs)5:40 Bundle Branch Block (LBBB & RBBB) 6:41 1st Degree AV Block7:03 2nd Degree AV Block - Mobitz 1 (Wenckebach) & Mobitz 2 (Hay)7:39 3rd Degree Heart Block (Complete Heart Block) 8:15 Heart Block Video Link8:19 Ventricular Tachycardia & Ventricular Fibrillation10:20 ST ElevationReferences:Nickson, C - Life in the Fast Lane (2023) Atrial Fibrillation. Available at https://litfl.com/atrial-fibrillation/Buttner, R. Burns, E - Life in the Fast Lane (2022) Atrial Flutter. Available at https://litfl.com/atrial-flutter-ecg-library/Larkin, J. Burns, E - Life in the Fast Lane (2021) AV Block: 1st Degree. Available at https://litfl.com/first-degree-heart-block-ecg-library/Burns, E. Buttner, R - Life in the Fast Lane (2021) AV Block: 2nd degree, Mobitz I (Wenckebach Phenomenon). Available at https://litfl.com/av-block-2nd-degree-mobitz-i-wenckebach-phenomenon/Burns, E. Buttner, R - Life in the Fast Lane (2022) AV Block: 2nd degree, Mobitz II (Hay block). Available at https://litfl.com/av-block-2nd-degree-mobitz-ii-hay-block/Larkin, J. Buttner, R. - Life in the Fast Lane (2023) AV Block: 3rd Degree. Available at https://litfl.com/av-block-3rd-degree-complete-heart-block/Buttner, R. Burns, E - Life in the Fast Lane (2023) Ventricular Tachycardia – Monomorphic VT. Available at https://litfl.com/ventricular-tachycardia-monomorphic-ecg-library/Burns, E. Buttner, R - Life in the Fast Lane (2022) The ST Segment. Available at https://litfl.com/st-segment-ecg-library/British Heart Foundation Atrial Flutter and Atrial Fibrillation. Available at https://www.bhf.org.uk/informationsupport/heart-matters-magazine/medical/ask-the-experts/atrial-flutterECG Waves The ECG Book. Available at https://ecgwaves.com/course/the-ecg-book/Please remember this podcast and all content from Rhesus Medicine is meant for educational purposes only and should not be used as a guide to diagnose or to treat. Please consult a healthcare professional for medical advice. 

In this episode, we review the high-yield topic of ⁠⁠⁠⁠Atrial Flutter ⁠⁠⁠from the Cardiovascular section. Follow ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠Medbullets⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠ on social media: Facebook: www.facebook.com/medbullets Instagram: www.instagram.com/medbulletsofficial Twitter: www.twitter.com/medbullets

AF conversion in the ED, HRT, a shining example of evidence-based medicine and less-is-more, multimorbidity, and what's coming at AHA are the topics John Mandrola, MD, covers in this week's podcast. This podcast is intended for healthcare professionals only. To read a partial transcript or to comment, visit: https://www.medscape.com/twic I. AF Conversion - IV Potassium and Magnesium an Acute Treatment for AF? https://www.medscape.com/viewarticle/983137 - Association of Intravenous Potassium and Magnesium Administration With Spontaneous Conversion of Atrial Fibrillation and Atrial Flutter in the Emergency Department https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2797474 II. HRT - USPSTF Doesn't Change Postmenopausal Hormone Recommendations https://www.medscape.com/viewarticle/983349 - Hormone Therapy To Prevent Disease and Prolong Life in Postmenopausal Women https://doi.org/10.7326/0003-4819-117-12-1016 - Risks and Benefits of Estrogen Plus Progestin in Healthy Postmenopausal WomenPrincipal Results From the Women's Health Initiative Randomized Controlled Trial https://jamanetwork.com/journals/jama/fullarticle/195120 - Hormone Therapy for the Primary Prevention of Chronic Conditions in Postmenopausal PersonsUS Preventive Services Task Force Recommendation Statement https://jamanetwork.com/journals/jama/fullarticle/2797867 - Menopausal Hormone Therapy for Prevention of Chronic Conditions https://jamanetwork.com/journals/jama/fullarticle/2797897 III. BP Targets After Stroke Intervention - Intensive BP Lowering Harmful in Acute Ischemic Stroke: ENCHANTED2/MT https://www.medscape.com/viewarticle/983176 - Intensive blood pressure control after endovascular thrombectomy for acute ischaemic stroke (ENCHANTED2/MT): a multicentre, open-label, blinded-endpoint, randomised controlled trial https://doi.org/10.1016/S0140-6736(22)01882-7 IV. Multimorbidity - ACC Issues Guidance on Integrating ASCVD and Multimorbidity Care https://www.medscape.com/viewarticle/983123 - 2022 ACC Expert Consensus Decision Pathway for Integrating Atherosclerotic Cardiovascular Disease and Multimorbidity Treatment: A Framework for Pragmatic, Patient-Centered Care: A Report of the American College of Cardiology Solution Set Oversight Committee https://www.jacc.org/doi/10.1016/j.jacc.2022.08.754 V. AHA Preview - AHA 2022 to Recapture In-Person Vibe but Preserve Global Reach https://www.medscape.com/viewarticle/983315 - Mandrola's Top 5 Picks From AHA 2022 Previewed https://www.medscape.com/viewarticle/983237 You may also like: Medscape editor-in-chief Eric Topol, MD, and master storyteller and clinician Abraham Verghese, MD, on Medicine and the Machine https://www.medscape.com/features/public/machine The Bob Harrington Show with Stanford University Chair of Medicine, Robert A. Harrington, MD. https://www.medscape.com/author/bob-harrington Questions or feedback, please contact news@medscape.net

In atrial fibrillation (A-Fib) and atrial flutter (A-Flutter) the electrical impulse for cardiac contraction is in the atria but isn't the normal pacemaker of the heart, the SA node. The ECG characteristics of A-Fib and A-Flutter. Recognition and treatment of unstable patients in A-Fib/Flutter with rapid ventricular response (RVR). Team safety when cardioverting a patient in A-FIB with RVR. Treatment of stable patients in A-Fib/Flutter with RVR. Connect with me: Website:  https://passacls.com (https://passacls.com) https://twitter.com/PassACLS (@PassACLS) on Twitter https://www.linkedin.com/company/pass-acls-podcast/ (@Pass-ACLS-Podcast) on LinkedIn Good luck with your ACLS class!

Trade: Inderal Class: Beta Blocker MOA: Nonselective Beta antagonist that binds with both the beta1 and beta 2 receptors. Inhibits the strength of the hearts contractions, as well as decreases heart rate resulting in decreased cardiac O2 consumptionIndication: Angina, reentry SVT, Atrial Fibrillation, Atrial Flutter. Contraindication: Cardiogenic shock, Heart failure, AV block, bradycardia, pulmonary edema, sick sinus syndrome.Side effects:  Bradycardia, AV block, Bronchospasm, hypotension. Dosing:Adult: 1-3mg IV/IO Slow IVPPediatric: 0.01 to 0.1mg/kg slow IVP

Atrial fibrillation (A-Fib) and atrial flutter (A-Flutter) are conditions where the stimulus for atrial contraction is above the ventricles but isn't the SA node. Identifying ECG characteristics of A-Fib and A-Flutter. A-Fib & A-Flutter may result in a rapid ventricular response (RVR) resulting in a heart rate greater than 150, putting us in the tachycardia algorithm. Treatment of unstable A-Fib or Flutter patients is delivery of a synchronized shock. Treatment of stable patients with narrow complex tachycardia including: Adenosine, calcium channel blockers, and beta blocker medications. Connect with me: Website:  https://passacls.com (https://passacls.com) https://twitter.com/PassACLS (@PassACLS) on Twitter https://www.linkedin.com/company/pass-acls-podcast/ (@Pass-ACLS-Podcast) on LinkedIn Good luck with your ACLS class!

Coronary artery calcification and exercise, translating clinical trials, the question of metabolically healthy obesity, and Watchman complications are the topics John Mandrola, MD, discusses in this week's podcast. To read a partial transcript or to comment, visit: https://www.medscape.com/twic I - CAC and Physical Activity - Physical Activity Paradoxically Tied to Higher Coronary Calcium https://www.medscape.com/viewarticle/959366 - Physical activity and the progression of coronary artery calcification http://dx.doi.org/10.1136/heartjnl-2021-319346 II - Translating Clinical Trials - SYNTAX Score II 2020 Wobbles in Real-World Validation https://www.medscape.com/viewarticle/958834 - Redevelopment and validation of the SYNTAX score II to individualise decision making between percutaneous and surgical revascularisation in patients with complex coronary artery disease: secondary analysis of the multicentre randomised controlled SYNTAXES trial with external cohort validation https://doi.org/10.1016/S0140-6736(20)32114-0 - External Validation of the SYNTAX Score II 2020 https://www.jacc.org/doi/full/10.1016/j.jacc.2021.07.027 III - Healthy and Obesity - ‘Metabolically Healthy Obesity' Has Heart Risks. Is it a Misnomer? https://www.medscape.com/viewarticle/959994 - Metabolically healthy obesity and cardiovascular events: A nationwide cohort study https://doi.org/10.1111/dom.14492 - Relation of Obesity to New-Onset Atrial Fibrillation and Atrial Flutter in Adults https://pubmed.ncbi.nlm.nih.gov/29501206/ - Paediatric obesity appears to lower the risk of diabetes if selection bias is ignored https://pubmed.ncbi.nlm.nih.gov/29374028 IV - Watchman Complications - FDA Investigating Potential Sex Differences in LAAO Adverse Outcomes https://www.medscape.com/viewarticle/959806 You may also like: Medscape editor-in-chief Eric Topol, MD, and master storyteller and clinician Abraham Verghese, MD, on Medicine and the Machine https://www.medscape.com/features/public/machine The Bob Harrington Show with Stanford University Chair of Medicine, Robert A. Harrington, MD. https://www.medscape.com/author/bob-harrington Questions or feedback, please contact news@medscape.net

mayoclinic.org

This episode covers atrial flutter!

Commentary by Dr. Andrea Russo

Should we be giving procainamide to patients with atrial fibrillation/ flutter? We discuss two clinical trials that may give us some answers. References:Stiell IG, Clement CM, Symington C, et al. Emergency department use of intravenous procainamide for patients with acute atrial fibrillation or flutter. Acad Emerg Med. 2007; 14: 1158-1164Stiell IG, Sivilotti MLA, Taljaard M, et al. Electrical versus pharmacological cardioversion for emergency department patients with acute atrial fibrillation (RAFF2): a partial factorial randomized trial. Lancet. 2020; 395 (10221): 339-349

This episode covers atrial flutter!

Commentary by Dr. Valentin Fuster

Neste poscast, o Dr. Jonathan Souza explica sobre Fibrilação Atrial e o tema mais explorado dentro deste assunto na prova do TEC - Anticoagulação.

In rowing and in business reputation counts for a lot. Coming back from a bad experience is even more challenging. The JL Racing business has had a torrid year and is fighting back to the forefront of the rowing apparel market as founder Joline Esparza explains, it has not all been plain sailing. Timestamps to the show: 1:00 Introduction and background in rowing 3:00 The JL Rowing business- finding technical fabrics that FIT the athletes' body 7:00 The Turtleshell jacket. It allows us to row without distraction 10:30 Making clothes with different torso and shorts sizes means garments are sized for rowers 12:50 Campaigning at the Crew Classic 2017 against the US Rowing sponsor who excluded all other clothing companies from their regattas. 17:00 I had to take the issue to my friends. "Be Outraged. Ask me why." 21:45 The resolution included people taking US Rowing to task on other issues as well. The Board was shaken up and long term changes came about as a result. 28:15 A new Partnership - Kellen Brink and Jonathan Maloney of Wild Oar also had a family business. The opportunity to grow the potential in El Salvador with a 2000 person manufacturing facility. 33:00 The business aligns with out social and family values and pays the best local wages with benefits like a clinic and English classes 35:00 Then problems arose. We started with 72 different unisuit designs and we had to digitise ever pattern and size variation. 40:00 The online ordering system had to change as well. 44:00 Water use in garment dying is huge. Sublimation saves so much water and we need to convince people it's better 46:00 This year we switched to biodegradable and recyclable plastic bags 48:00 Cancer is why Joline hasn't been out at regattas this year... but she will be at HOCR 51:00 Atrial Fibrillation and Atrial Flutter in rowers is a new focus of research 55:30 Resolutions and Solutions. We have more quality control and order processing capacity. The design team is 15 people, colour matching is a challenge and analytics now feed good information to management. 94% of orders now ship in under 4 weeks. 1:01 What next? Joline's role has changed and her focus is on community aspect of rowing and supporting each other. 1:02 Share, learn and be healthy via the Pocock Foundation with disadvantaged youth. ErgEd for kids and Scholarships. 1:08 Plug for the US Rowing convention. The speakers are amazing including Steven O'Connor from Fulham Reach Rowing Club in London UK 1:10 Bryan Todd from GLRF has created the Rowers Pledge https://www.glrf.info/glrfcentral/pledgemovement.html You need everyone to sign. Teaching your daughters why you are not safe. Let's make it obvious that rowing clubs are safe spaces. Find out more at https://jlracing.com/ And please share this podcast with your friends in rowing and subscribe in your favourite podcast app or on our website https://rowing.chat

Passover Sale Wednesday 17th to 24th 2019, CODE at Checkout RISEN to Save 7%, Please send eMail and Call for Starter Free Protocols, Health Issues, Epstein Barr Virus, Shingles of Eyes, Atrial Flutter, Atrial Fibrillation, KetoPower, SAFE Ketogenic Diets, Childhood Vomiting with Some Foods, Dysbiosis, Detox Heavy Metals, Need for Pro-Antiinflammatory Fatty Acids, Omega Supreme Pro, Peripheral Neuropathy, Ultra Thiamine B1, NeuroGEN, Hip Bursitis, ArthritX, InflamX, Joint Performance, Tendon Mender, Cell Defense Plus, NutruSilver, AllicinMED, Nutriodine, Antipathogenics, Anti-Cancer, Ellagic Acid, MalignaBlock, Power C Plus, Oncomycin MyCO D2,Dr Bill Deagle MD AAEM ACAM A4M, NutriMedical Report Show, www.NutriMedical.com, www.ClayandIRON.com, www.Deagle-Network.com,NutriMedical Report Show, For information regarding your data privacy, visit Acast.com/privacy See acast.com/privacy for privacy and opt-out information.

In this episode I cover arrhythmias.If you want to follow along with written notes on arrhythmias go to zerotofinals.com/arrhythmias or find the cardiology section in the Zero to Finals medicine book.This episode covers the pathophysiology, presentation, differentials, ECG findings and principles of management of various types of arrhythmias.

In this EM Cases main Episode 112 Tachydysrhythmias with Amal Mattu and Paul Dorion we discuss a potpurri of clinical goodies for the recognition and management of both wide and narrow complex tachydysrhythmias and answer questions such as: Which patients with stable Ventricular Tachycardia (VT) require immediate electrical cardioversion, chemical cardioversion or no cardioversion at all? Are there any algorithms that can reliably distinguish VT from SVT with aberrancy? What is the "verapamil death test"?  While procainamide may be the first line medication for stable VT based on the PROCAMIO study, what are the indications for IV amiodarone for VT? How should we best manage patients with VT who have an ICD? How can the Bix Rule help distinguish Atrial Flutter from SVT? What is the preferred medication for conversion of SVT to sinus rhythm, Adenosine or Calcium Channel Blockers (CCBs)? Why is amiodarone contraindicated in patients with WPW associated with atrial fibrillation? What are the important differences in the approach and treatment of atrial fibrillation vs. atrial flutter? How can we safely curb the high bounce-back rate of patients with atrial fibrillation who present to the ED? and many more... The post Ep 112 Tachydysrhythmias with Amal Mattu and Paul Dorion appeared first on Emergency Medicine Cases.

This week we delve into the argument for cardioversion in recent-onset AF as well as the logistics of getting it done. https://media.blubrry.com/coreem/content.blubrry.com/coreem/Podcast_Episode_98_0_Final_Cut.m4a Download Leave a Comment Tags: Atrial Fibrillation, Atrial Flutter, Cardiology, Cardioversion Show Notes Read More Core EM: Podcast 64.0 – Rate Control in AF Core EM: Recent Onset Atrial Fibrillation Core EM: 30-Day Outcomes After Aggressive AF Management in the ED The SGEM: SGEM#88: Shock Through the Heart (Ottawa Aggressive Atrial Fibrillation Protocol References Nuito I et al. Time to cardioversion for acute atrial fibrillation and thromboembolic complications. JAMA 2014; 312(6): 647-9. PMID: 25117135 Stiell IG et al. Association of the Ottawa aggressive protocol with rapid discharge of emergency department patients with recent-onset atrial fibrillation and flutter.

This week we delve into the argument for cardioversion in recent-onset AF as well as the logistics of getting it done. https://media.blubrry.com/coreem/content.blubrry.com/coreem/Podcast_Episode_98_0_Final_Cut.m4a Download Leave a Comment Tags: Atrial Fibrillation, Atrial Flutter, Cardiology, Cardioversion Show Notes Read More Core EM: Podcast 64.0 – Rate Control in AF Core EM: Recent Onset Atrial Fibrillation Core EM: 30-Day Outcomes After Aggressive AF Management in the ED The SGEM: SGEM#88: Shock Through the Heart (Ottawa Aggressive Atrial Fibrillation Protocol References Nuito I et al. Time to cardioversion for acute atrial fibrillation and thromboembolic complications. JAMA 2014; 312(6): 647-9. PMID: 25117135 Stiell IG et al. Association of the Ottawa aggressive protocol with rapid discharge of emergency department patients with recent-onset atrial fibrillation and flutter. Can J Emerg Med 2010; 12(3): 181-91. PMID: 20522282