Is Routine Transesophageal Echocardiogram (TEE) Needed Before Atrial Fibrillation Ablation in Patients Treated with Uninterrupted Direct Oral Anticoagulation for At Least 3 Weeks?

What do the guidelines say? The 2017 AF guidelines give a Class IIa recommendation for performing a transesophageal echocardiogram (TEE) for patients with AF undergoing ablation who are in AF on presentation, even if they have been receiving therapeutic anticoagulation for 3 weeks or longer1. However, the more recent 2020 European College of Cardiology AF … Read more

Management of Stroke Patients: A One Man Show or A Tag-Team?

Atrial fibrillation (AF) increases risk of stroke up to 5 folds, resulting in considerable physical, cognitive impairment and high mortality1. Thus, AF related strokes are very expensive to treat compared to non-AF strokes2. Oral anticoagulation is a well-established therapy in the majority of stroke cases3. Warfarin reduces the risk of stroke by 64% and mortality … Read more

The Future of Wearable Technology & Detecting Atrial Fibrillation at AHA18

Like many of us, I have several family members who experience atrial fibrillation (AFib) regularly, as between 2-6 million people in the United States have this disorder. My father-in-law in particular has experienced difficultly with AFib recently and because he knows I study the heart, he often asks me about different treatment options and advice … Read more

WATCHMAN: An Alternative to Warfarin for the High Risk Patient

“Wisdom consists of the anticipation of consequences” Norman Cousins I recently saw Mr. John Doe for atrial fibrillation (AF). Well into his eighties, he enjoys a good quality of life. This elderly gentleman is mostly unaware of his paroxysms of AF. However, he had also suffered a stroke in the past, and as such was … Read more

Deciphering the CABANA trial and what if anything do the results mean to the management of atrial fibrillation?

“The truth is rarely pure and never simple.” Oscar Wilde “Facts do not cease to exist because they are ignored.” Aldous Huxley As is apparent from my previous blogs, I am very passionate about atrial fibrillation (AF). Undoubtedly, the most common arrhythmia nationally, and likely worldwide, can cause disabling symptoms, lead to a stroke and … Read more