Enjoy this rapid clinical overview of afib (atrial fibrillation) based on Curbsiders episode #159 with Cardiologist Dr. James Furgerson; Plus, updates on ablation and left atrial appendage occlusion!
This episode is not available for CME, but episode #159 on Atrial Fibrillation is available for CME credit through the ACP!
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Featuring Dr. James Furgerson, production and infographic by Cyrus Askin
The primary care doctor is relevant to preventing and controlling atrial fibrillation as there are many modifiable risk factors, including obesity, hypertension, OSA, and alcohol use.
The benefit of weight loss/exercise to reduce burden of afib (Chung et al, 2020)
Dr. Furgerson mentioned that patients with afib should be encouraged to avoid even moderate alcohol intake, BUT that caffeine intake is probably safe (Kim, 2021)!
LAAO (left atrial appendage occlusion) closure in patients with afib undergoing cardiac surgery for another indication led to a decrease in stroke or systemic embolism in an RCT with 3.8 years follow up. Editorialist notes this will likely become a standard of care. (Whitlock, NEJM 2021)
CABANA was a large, negative trial of ablation for all-comers with afib. However, a new prespecified follow up study of afib ablation for patients with heart failure (most had HFpEF) was published, suggesting lower mortality and improved quality of life (Packer, Circulation 2021)
Rhythm control is not dead! The EAST-AFNET4 trial of rhythm control (antiarrhythmics or with ablation) vs rate control for patients with recently diagnosed afib (<1 year) found a decrease in the primary composite CV outcome (cardiovascular-related death, stroke, hospitalization for heart failure [HF], or acute coronary syndrome). Stay tuned! —Fleischmann, JWatch 2021.
Listeners will the key concepts and clinical pearls from past Curbsiders episodes on afib
After listening to this episode listeners will…
Dr Furgerson reports no relevant financial disclosures. The Curbsiders report no relevant financial disclosures.
Watto MF, Williams PN, Garbitelli B. “#289 Afib Triple Distilled”. The Curbsiders Internal Medicine Podcast. http://thecurbsiders.com/episode-list Final publishing date August 11, 2021.
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