The Curbsiders Internal Medicine Podcast9 Aug 2021

Reboot #159 Atrial Fibrillation

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!

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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

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