Reboot #159 Atrial Fibrillation

The Curbsiders Internal Medicine Podcast

Health & Fitness, Medicine, Science, Higher Education, Education

4.8 • 3.1K Ratings

🗓️ 9 August 2021

⏱️ 83 minutes

🔗️ Recording | iTunes | RSS

🧾️ Download transcript

Summary

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

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

Credits

Writer and Producer: Cyrus Askin MD
Infographic: Cyrus Askin MD
Cover Art: Cyrus Askin MD
Hosts: Matthew Watto MD, Paul Williams MD, Cyrus Askin MD
Editors: Matthew Watto MD
Guest: James Furgerson MD

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

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

Sponsor: Panacea Financial panaceafinancial.com

Visit panaceafinancial.com today to open your account and join a bank built with you in mind.

Time Stamps*
*Note: Time stamps refer to ad-free version

00:00 Intro, disclaimer and guest bio
03:45 Guest one liner, a bit on physician well-being and some other randomness
08:15 A case of palpitations; risk factors for atrial fibrillation
12:17 Subclinical atrial fibrillation, overdiagnosis of atrial fibrillation; How much afib burden matters?
15:08 Case summary and next steps in initial work up
18:48 Counseling patient about atrial fibrillation and its consequences
21:40 Ischemic heart disease and atrial fibrillation
24:17 Recap of diagnosis, initial work up and risk stratification in atrial fibrillation
25:25 Rate versus rhythm control; AFFIRM trial
30:50 Strict versus lenient rate control; RACE trial
33:30 Deciding on rate versus rhythm control; Downside of antiarrhythmic therapies; When to switch from rate to rhythm control strategy
36:52 Ablation for atrial fibrillation; CASTLE-AF, CABANA trials
40:40 When to refer to cardiology and electrophysiology
42:42 Choice of agent for anticoagulation and latest guidelines for atrial fibrillation; New definition for valvular atrial fibrillation
45:22 DOACs in CKD and some other nuances in choice of agent
52:27 Bleeding and anticoagulation
58:38 Cardioversion for atrial fibrillation (initial versus delayed)
63:32 Anticoagulation before and after cardioversion
67:48 Lifestyles measures for atrial fibrillation
70:45 Atrial fibrillation during critical illness, after CABG and in hyperthyroidism
74:12 Aspirin monotherapy is not appropriate for atrial fibrillation
76:42 Take home points
78:50 Outro

Transcript

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0:00.0	Our sponsor for this episode is Panacea Financial, a nationwide digital bank built four doctors
0:07.4	by doctors.
0:09.0	Panacea offers loans just for physicians and medical students with low rates, free checking
0:13.6	with no ATM fees nationwide, a personal banker for every customer and 24-7 live customer
0:19.7	service.
0:20.7	Visit panaceafinancial.com today to open your account and join a bank built with you
0:26.2	in mind.
0:27.2	Panacea Financial is a division of premise member FDIC.
0:35.0	This episode of the curbsiders is sponsored by the American College of Physicians, all
0:39.0	new CME 100 video package which is now available.
0:43.2	You can get 75 hours of virtual scientific lectures from the Internal Medicine Meeting
0:48.2	2021, plus an exclusive 25 bonus CME sessions.
0:52.9	They're available for nearly three years of access, order now at acponline.org, forward
0:59.2	slash 100 curb and use the code 100 curb.
1:29.2	Hey Paul, how's it going?
1:42.8	I'm trying the...
1:43.8	I like this naturalistic approach we're doing now, this is good.
1:48.2	It's like where we forget that we're just like sitting here with microphones and we
1:52.8	just recorded for two hours and got some great content on A-Fib.
1:57.9	Paul, why don't you tell the audience what the show is about?
2:01.6	Sure, I mean, it may feel like they just walked into a conversation between friends, but
2:05.1	really, this is an internal medicine, maybe the internal medicine podcast.
	...

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