Hey folks Scott Wingard here and this is an MCrit we today. We're going to discuss the first of two

episodes on new onset atrial fibrillation. In this episode basically the too long

didn't listen will be you got to start doing echoes either before or after,

rate control in new onset AFIB, especially if the patient's younger, but probably all the time and we'll explain some reasons why and what you might be missing if you don't

and how it may change your treatment of this patient.

In the second episode which will come in a few weeks I'm going to discuss how to fast track a patient with new onset a fib to get cardioverted and the heck out of your

department without an admission to the hospital regardless of the onset of the atrial fibrillation because we'll go through all of it

whether you should cardiovert versus medication how to avoid needing the trans-isophageal

echo in order to get these patients out without an admission.

All of that will be covered.

But in this episode, I'm joined by two brilliant folks

from the cardiac ICU to discuss why we may be blowing off

some of these new onset AFIB patients without an adequate examination

and what might be missed. So let's roll right into that. So I'm super pleased to have you to here.

Why don't you briefly tell us who you are and what you do and then we'll roll right into the episode

Sure, my name is Chris Riegel. I'm a acute care MP in the You have touched medical center in Boston. Fantastic.

And now, you came to me with a case that was representative of something that you folks have seen

a bunch, like more than most people would expect in your practice, which is young people with

agile fibrillation treated in the standard fashion who go on to have severe cardiac dysfunction

and many of them require mechanical circulatory support.

And you think there's some key points that should be brought to people's attention on these cases.

Maybe as a representative case to start us off with, Chris,

...