Discover and read the best of Twitter Threads about #AFIB

Most recents (24)

1) Welcome to a 🆕#accredited #tweetorial from @cardiomet_CE! Earn 0.5hr 🆓 CE/#CME by following this 🧵. Our expert faculty is Sanjiv J Shah MD @HFpEF, Cardiologist & Director, Northwestern HFpEF Program (hfpef.org). Director of Research, @NMCardioVasc
#FOAMed Image
1b) .@HFpEF will be sharing the algorithm he uses to treat #HFpEF based on evidence we have thus far and his anecdotal experience treating patients over the past 16 years in the @NMCardioVasc HFpEF Clinic.
#CardioTwitter #MedEd @MedTweetorials #HeartFailure
2) CE/#CMEcredit for #physicians #physicianassociates #nurses #nursepractitioners #pharmacists 🇺🇸🇨🇦🇬🇧🇪🇺.
Statement of accreditation and faculty disclosures at cardiometabolic-ce.com/disclosures/.
FOLLOW US for accredited programs in #cardiometabolic space delivered wholly on Twitter!
Read 34 tweets
1/ 76 yo woman suffers an ischemic stroke in the left media territory, initial NIHSS 5. Treated with IVT. NIHSS at 24hs 3 points, new diagnosis of #AFib on the #Stroke unit monitor/ECG… 24h MRI shown belowê When would you start anticoagulation?
2/ When would you start DOAC therapy in this woman?
Let's dive into the NEWEST evidence to find the optimal timing! #StrokeCare #AFib @ELAN_Trial @FishingNeurons #ESOC2023
3/ Non-valvular atrial fibrillation accounts for about 25% of ischemic strokes. Early recurrent strokes are common, but starting oral anticoagulation too soon may increase the risk of harmful intracranial bleeding. We need a balance… or do we??? Image
Read 26 tweets
1/ Ever wondered how the 4th industrial revolution (#AI, robotics, and big data) is reshaping healthcare? 🏥 🚀
Let's dive into some fascinating facts and insights I found in the #book "Deep Medicine" by @EricTopol
2/ 💻👨‍⚕️ Electronic Medical Records (EMR) are mostly designed for billing, not for physicians' ease of use, contributing to doctor burnout 😩
How can we leverage #AI to improve the EMR and serve both purposes effectively? #HealthIT
3/⏱️ Did you know? If physicians make a #diagnosis within 5 minutes, they have a 95% chance of getting it right (System 1 thinking). This rate can drop to 25% afterward!
How can we harness #AI to assist in faster, more accurate diagnosis?
Read 10 tweets
1) Welcome to Part 1 of a new #accredited #tweetorial in our series of educational programs on #hypertrophic #cardiomyopathy #HCM. Previous programs, still available for 🆓CE/#CME, are at cardiometabolic-ce.com/category/hcm/.
Now you can earn another 1.5hr credit by following ALL of this 🧵!
2) Our expert author is Sergio Kaiser MD PhD FACC FESC 🇧🇷🇮🇱 @pabeda1, cardiologist 🫀, Professor 🎓 of #InternalMedicine, Rio de Janeiro State University. He brings the general cardiologist's perspective to our #HCM discussions. Read and learn!
#FOAMed #CardioTwitter
3) This program is supported by an unrestricted educational grant from Bristol Myers Squibb. Statement of accreditation and faculty disclosures at cardiometabolic-ce.com/disclosures/. Credit for #physicians #nursepractitioners #physicianassociates #nurses #pharmacists from @academiccme.
Read 68 tweets
Teaming up again with the great @VerwerftJan to share our experience with #echoCPET in #HFpEF. This hot-of-the-press paper @ESC_Journals demonstrates myriad of opportunities for diagnosis & treatment, far beyond #SGLT2i only. Tweetorial below!

@SarahStroobant2 @HerbotsLieven Image
We have recently described our set-up for a dedicated #dyspnoeaclinic in detail @JACCJournals



In #HFpEF, early & correct diagnosis are important, #phenotyping is everything. There are a lot of mechanisms for dyspnoea involved Image
Current @ESC_Journals paper goes one step further: "In patients with confirmed HFpEF or probability >90% according to well-validated HFpEF scores (both are complimentary in our view), why #echoCPET within a dedicated #dyspnoea clinic? What is the impact of findings?" Image
Read 9 tweets
1/ Had a great time writing this @EPLabDigest article with @DrCJBradley

tinyurl.com/mryk3cwe

2️⃣ different perspectives (IC And EP) using different devices (watchman/ amulet) for LAAC in the community center.

Let’s take a dive into two different LAAC programs #Tweetorial
2/ #LAAC has come a long way over the past few years and now we have two main players in the space

🔸 @bostonsci #watchman
🔸 @AbbottNews #Amulet

Both are very effective and each has pros/cons

My center focuses on Watchman FLX while @DrCJBradley center focuses on Amulet… twitter.com/i/web/status/1…
3/ Historically #EPeeps has taken the driver seat in this space (rightfully so) due to experience with the LA/transeptal. HOWEVER the new gen #IC/structuralist have become a vital part of the team.

#LAAC programs require:
📌Implanter
🔎Imager
🧑🏼‍⚕️Anesthesiologist/Cath lab team… twitter.com/i/web/status/1…
Read 24 tweets
1/ Atrial Fibrillation: #GrayMatters Series

What do you do with that episode of #Afib when sick or post-op in the hospital?

What type of monitoring is best?

🎧: link.chtbl.com/Afib
🗒️: bit.ly/3QPiLFt
CME: bit.ly/CIMCME
Sponsor: go.amboss.com/CoreIM-E9
2/ When do you start AC for new Afib post-op?

We hope this infographic will be handy for the many times we may be in the gray zone!

From @accpchest guidelines

A few things to consider:
🤔 Patient specific risk
🤔 Blood thinner of choice
🤔 Bleeding risk of the surgery
3/ Credit to the team that worked tirelessly on this!

Hosts: Dr. Nick Villano, @Ali_Trainor, @FreedoBaggins
Off-air producer: @ShreyaTrivediMD
Experts: @jasonmatosmd, @PoojaJagadishMD, @gregorykatz
Graphic: Josie Levey

🎧:link.chtbl.com/Afib

coreimpodcast.com/2023/01/18/dia…
Read 5 tweets
1a) Welcome to a new #accredited #tweetorial, “MOA and Clinical Trial Data for Novel & Emerging Therapeutic Strategies for #HCM: Can We Target Our Therapy?"
1b) Our expert (and returning @cardiomet_ce) author is Giuseppe Galati MD, MMSc in Heart Failure, FHFA, @GiuseppeGalati_ , Consultant #Cardiologist #HeartFailure & #Cardiomyopathies
2) @GiuseppeGalati_ is in Milan 🇮🇹 This program is intended for #healthcare professionals & is accredited for 0.75h CE/#CME credit for #physicians #physicianassistants #nurses #nursepractitioners #pharmacists.
Read 46 tweets
1/ Out now on @ScienceAdvances!

#StemCells are a wonderful tool to create atrial cardiomyocytes that spontaneously and continuosly beat in a dish… but what happens if we transfect them with the highly potassium selective channelrhodopsin WiChR? #Thread

science.org/doi/full/10.11…
2/ WiChR is a channel that comes from the marine species Wobblia Lunata.

Differently from previosly described K+-conducting channels such as HcKcR1, this channel is characterized by small photocurrent inactivation and improved light sensitivity. #Thread #Physiology #Optogenetics
3/ During my secondment and thanks to the collaboration with @JoH_VieR and other labs, we successfully transfected my hiPSC-derived atrial cardiomyocytes with WiChR.
This beating cluster in the video is one of those that I indented to get sharp electrode recording! #StemCell
Read 7 tweets
September is #AFibAwarenessMonth!
A🧵on the basics of #AFib

#ACCEP #EPeeps #CardioTwitter
#AFib is the most common sustained heart rhythm problem in the world. 🌎
#AFib increases the risk of #stroke & #heartfailure. It causes symptoms like fatigue, dizziness & shortness of breath and can reduce patients’ quality of life.
Read 14 tweets
1/ 🧵 NEW Editorial.

In the latest issue of @JAMA_current, my mentor Michael Fine, Donna Washington and I were invited to discuss a new 📝 on disparities in SGLT2i and GLP1-RA use for diabetes and what it means for the field of #Pharmacoequity research.

jamanetwork.com/journals/jama/… ImageImage
2/ As has been discussed frequently over the last month with the insulin co-pay provisions in the #InflationReductionAct, >37 million people in the US have #diabetes.

Regrettably, underrepresented racial and ethnic groups folks have ⬆️ rates of diabetes.

jamanetwork.com/journals/jama/… Image
3/ Even with the ⬆️ rates of diabetes, Black, Hispanic, and Asian patients in the US have been shown to have lower rates of #diabetes treatment, especially with the newer drugs available such as SGLT2i & GLP1-RAs.

SGLT2: jamanetwork.com/journals/jaman…

GLP1: jamanetwork.com/journals/jama-… ImageImage
Read 8 tweets
‼️ NEW Paper ‼️

In @JAMANetworkOpen, we found that VA patients with #AFib who experience homelessness had a 21% ⬇️ odds of receiving stroke-preventing anticoagulation (blood thinners).

Here's more on our journey to this #Pharmacoequity paper.

Link: ja.ma/3ODXdss

1/
Previously, if you looked up "homeless & atrial fibrillation" in PubMed, only 5 results came up.

This included a 2003 @JAMAInternalMed study that saw that Ohio Medicaid enrollees had ⬇️ use of warfarin if they had homelessness or inadequate housing.

ja.ma/3PFwj52

2/
We started digging into this in 2019, when 1st author, David Wilson, a PittMed student & Veteran, met with me for a summer research project.

We decided to use our national #AFib cohort to see if there was a relation b/w homelessness & AF treatment.

ja.ma/3ODXdss

3/
Read 12 tweets
2/ what is the left atrial appendage?

The LAA is derived from the left wall of the primary atrium (embryo). Its diff from the true LA and its suited to function as a decompression chamber during left ventricular systole and during other periods when left atrial pressure is high
3/ the appendage is like your fingerprint. No two are the same.

Common shapes are:

🥦Cauliflower/Broccoli (hardest)
💨Windsock (easiest)
🐓Chicken wing
🌵Cactus

#LAAO #Watchman #Structural #Cardiotwitter #EPeeps @EPeeps_Bot @TAVRBot @RadialFirstBot @EchofirstB
Read 25 tweets
Check out Top 10🔑points from the 🆕ACC/@American_Heart/@HFSA Guideline for the Management of #HeartFailure #CardioTwitter #ClinicalGuidelines #ACC22

🧵Key Points👇
1⃣ Guideline-directed medical therapy for #HeartFailure w/ reduced ejection fraction #HFrEF now incorporates four medication classes that include #SGLT2i. #ClinicalGuidelines
2⃣ #SGLT2i have a Class of Recommendation 2a in #HFmrEF. Weaker recommendations (COR 2b) are made for ARNi, ACEi, ARB, MRA & beta blockers in this population. #ClinicalGuidelines
Read 11 tweets
Thread of anecdotal experiences March/April 2022
'West Coast has 10 players this week unavailable because of Covid positive or close contact🤦‍♂️ #AFL'
posted by
@SaintEd61
ImageImage
Read 95 tweets
Is sex a critical factor for treating #AtrialFibrillation?❤️‍🩹

New #CardiovascularResearch study examines #SexDifferences in calcium handling & therapies in patients with #AFib
academic.oup.com/cardiovascres/…

Our tweetorial explains the findings⬇️👩‍🏫

@ESC_Journals @escardio #EPeeps (1/9)
#Atrial #myocytes were isolated from patients with & without #AtrialFibrillation

Sex differences in #risk factors & therapies were considered in the analysis (2/9)
To explore #SexDifferences in the mechanisms of #Afib, calcium handling was examined & calcium handling proteins investigated (3/9)
Read 9 tweets
1) Welcome to a new #accredited #tweetorial on managing #VTE at the extremes of weight & renal function. Free CE/#CME credit for following along with expert author @AryaRoopen from King’s Thrombosis Centre at King's College Hospital in London! Only the best for our learners! Image
2) When we think about "special populations" in #VTE, we think weight, age, and #cancer status. @aakonc already addressed the last of those (earn credit still at cardiometabolic-ce.com/antithrombotic…). Learn the rest here! Hello to @ProfMakris @bhwords @MiddeldorpS @fniainle @AliTaherMD
3) This educational program is intended for health care providers & is supported by a grant from Bristol Myers Squibb & its Alliance partner Pfizer, Inc. Faculty disclosures at cardiometabolic-ce.com/disclosures/. Credit for #physicians #physicianassociates #nurses #NPs #pharmacists
Read 51 tweets
In our @JAMA_current editorial, we tackle a timely question in #CardioTwitter: should we recommend #apixaban or #rivaroxaban as first-line anticoagulant for #Afib?The two #DOACs are not interchangeable for bleeding or stroke. Let's review all RCTs & RWE🧵
jamanetwork.com/journals/jama/… Image
Why should you care? Why now? 1) >70% of #Medicare pts on anticoagulation are taking #DOACs, practically replacing warfarin 2) Generic DOACs will enter the market in 2022, massively ⬆️ patient access & use 3) Insurance companies may not cover all DOACs in their formularies 💵💊 Image
RCTs first: in ROCKET-AF (n=14K pts), riva was NON-INFERIOR to warfarin for stroke (per-protocol)🧠, w/ similar rates of major/non-major bleed🩸. In ARISTOTLE (n=18K pts), apixa was SUPERIOR to warfarin for stroke (ITT)🧠 AND w significantly⬇️ major bleed🩸, AND even⬇️mortality. Image
Read 17 tweets
Don’t miss a new accredited #tweetorial launching TOMORROW here on @cardiomet_CE. #Interventional #cardiologist, #researcher, & #SoMe education leader @DLBHATTMD will be talking all about #aspirin, its role in #cardiovascular wellness & prevention, and new approaches to . . .
1) Welcome to an #accredited #tweetorial on the foundational role of #aspirin in #cardiovascular care. There are new approaches to #aspirin formulation & dosing. This program is accredited for 0.50h CE/#CME. I am @DLBHATTMD. #FOAMed #cardiotwitter #medtwitter Image
Read 49 tweets
Do You keep slamming Your face because You missed the 1st #HFA @escardio Clinical Practice Update Course on #HeartFailure, orchestrated masterfully by MC Mullens?

Are You particularly disappointed to have missed the clinical pearls of #HFA giants @kevin_damman & @FinnGustafsson?
Catch up for 2 months on the platform on demand: escardio.org/Education/Cour…

I'll release just a teaser under the form of a clinical case below. You might call on my partners in crime @Ph_Bertrand & @petranijst to do the same...

Have fun & see you live without #COVID next year!
@Ph_Bertrand @petranijst 61 y/o woman
PMH: Chronic HCV, hypertension, poorly controlled diabetes (HbA1c 9.6%), obesity (BMI 32 kg/m²)
Currently no meds

Found in apartment with motoric aphasia & right hemiplegia due to ischemic stroke (middle cerebral artery)
R/No thrombolysis (subacute), thrombectomy!
Read 27 tweets
#EPFellows of #IFPdigital ⏰its time to share great literature recommendations from our fellows council for the Digital IFP on Basic #Afib📚Enjoy & feel free to add to the list #EPeeps @Caerrhyn @Dominik_Linz @Rodrigo41353865 @iwanari65284818 @LaredoMikael @dr_pmueller @vhchong1
1/ The Beginning
Spontaneous initiation of atrial fibrillation by ectopic beats originating in the pulmonary veins -
Michel Haïssaguerre
pubmed.ncbi.nlm.nih.gov/9725923/
2/ The Beginning
2020 Guidelines for Management of Atrial Fibrillation
- ESC Clinical Practice Guidelines
escardio.org/Guidelines/Cli…
Read 18 tweets
World class ⁦@ClevelandClinic⁩ Hospital Medicine Grand Rounds - Update in #HospitalMedicine by Dr. Jessica Donato! A rising star! ⁦@BIDMC_IM⁩ ⁦@HarvardHospMed⁩ ⁦@CWRUSOM⁩ ⁦@SocietyHospMed
Is postop #afib associated w increased risk for CVA/TIA?
Is one #DOAC better than other for #afib?
Read 21 tweets
(1/12) #AFibAwareness #Tweetorial: Today the #ACCEP will be sharing information about #AFib risk factors, risk reduction techniques & more! Follow along as we discuss how mental health, exercise & OSA factor into AFib symptoms & treatment options. ⬇
@DrJCheungEP @Dr_Mike_Fradley (2/12) #AFibAwareness #Tweetorial: Normally, the human ❤ pumps >100k heartbeats each day. If you have #AFib, the ❤ doesn’t always beat the way it should.

People w/ AF are 5x more likely to have a #stroke, & it can lead to HF. Treating AF early can help: bit.ly/3eShyZl
(3/12) #AFibAwareness #Tweetorial: Some people with #AFib don’t have any symptoms. Those who do may report:
💗 Heart palpitations
😴 Feeling unusually tired
🌬️ Unexplained shortness of breath
😵 Dizziness
💥 Chest pain
bit.ly/3AAS0eV
Read 12 tweets
#ESCCongress #HOTLINE #LOOP study #CVprev
Screening for #Afib with loop recorder to prevent stroke
🫀 Incl:age >/=70& 1+ RF; Excl:known Afib
🫀 ILR (Linq) vs Control: afib: tx with OAC
🫀1o: Time to stroke or systemic embolism: 64m F/U
🫀42%💃
💥 AF 32% ILR vs 12% Control w/ OAC ImageImageImageImage
#ESCCongress #HOTLINE #LOOP study #CVprev
Screening for #Afib with loop recorder to prevent stroke
🫀1o outcome:NS
🫀2o outcome NS
🫀 death from any cause NS
🩸 NS dif in Bleed
[Baseline SBP>157: benefit from ILR but hope they tx BP!]
💥Afib diagnosed but NS diff in any outcomes ImageImageImageImage
Read 5 tweets

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