Dec 08 2023 This Week in Cardiology

Dec 8, 2023

This podcast discusses the recent AFib guideline documents, a potential new treatment for POTS, and challenges in treating certain patient populations. It highlights the findings and limitations of trials on ablation and left atrial appendage occlusion. The speaker raises concerns about a preventive procedure and introduces a small study on transcutaneous vagus nerve stimulation for POTS with promising results.

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Introduction

00:00 • 2min

Updates and Recommendations for AFib and Heart Failure

02:13 • 5min

Findings of the STAR AF2 Trial and Limitations of the Castle AF Trial

07:27 • 8min

Analysis of Left Atrial Appendage Occlusion Guidelines and Efficacy

15:15 • 8min

Concerns about a preventive procedure and a study on transcutaneous vagus nerve stimulation for POTS

23:30 • 5min

Three aspects of the recent AF guideline documents and a possible new treatment of POTS are the topics John Mandrola, MD, discusses in this week's podcast.

This podcast is intended for healthcare professionals only.

To read a partial transcript or to comment, visit:

https://www.medscape.com/twic

I AF Guidelines

ACC/AHA Issue Updated Atrial Fibrillation Guideline

https://www.medscape.com/viewarticle/998956

- Guideline doc: https://www.ahajournals.org/doi/10.1161/CIR.0000000000001193

- CASTLE AF https://www.nejm.org/doi/full/10.1056/nejmoa1707855

- Analysis of US Inpatient Sample https://bmccardiovascdisord.biomedcentral.com/articles/10.1186/1471-2261-14-73

- RAFT AF https://www.ahajournals.org/doi/10.1161/CIRCULATIONAHA.121.057095

- Beta Blockers in AF https://pubmed.ncbi.nlm.nih.gov/25193873/

Section 2 AF Guidelines – EARLY Rhythm Control Gets Emphasis

- STOP AF https://www.nejm.org/doi/full/10.1056/NEJMoa2029554

- EARLY AF https://www.nejm.org/doi/full/10.1056/nejmoa2029980

- EAST https://www.nejm.org/doi/full/10.1056/NEJMoa2019422

- Natural History of AF https://www.jacc.org/doi/abs/10.1016/j.jacc.2019.09.050

Section 3 AF Guidelines – Dubious Upgrade of percutaneous LAAC

- PROTECT and PREVAIL Meta-analysis 5-year https://doi.org/10.1016/j.jacc.2017.10.021

- PINNACLE FLX https://www.ahajournals.org/doi/full/10.1161/CIRCULATIONAHA.120.050117

II. Postural Orthostatic tachycardia Syndrome

Vagus Nerve Stimulation Promising In POTS

https://www.medscape.com/viewarticle/998913

- Stavrakis et al. Noninvasive VNS for POTS https://doi.org/10.1016/j.jacep.2023.10.015

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