1. EachPod

Reboot #159 Atrial Fibrillation

Author
The Curbsiders Internal Medicine Podcast
Published
Mon 09 Aug 2021
Episode Link
https://audioboom.com/posts/7920359

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








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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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