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409. Journal Club: The ARREST-AF Trial with Drs. Prashanthan Sanders and Mehak Dhande
Join CardioNerds EP Council Chair Dr. Naima Maqsood and Episode Lead Dr. Jeanne De Lavallaz as they discuss the results of the ARREST-AF Trial with expert faculty Dr. Prashanthan Sanders and Dr. Mehak Dhande. Audio editing by CardioNerds intern Bhavya Shah.
The ARREST-AF trial enrolled 122 patients with a BMI of 27 kg/m2 or greater and at least one cardiovascular risk factor with either paroxysmal or persistent AF and were scheduled to undergo de novo AF ablation. They were randomized to an intensive risk factor management (RFM) program versus usual care. The RFM program addressed obesity, sleep apnea, HTN, HLD, tobacco, and alcohol abuse, whereas the usual care arm had a discussion of risk factors but without an extensive risk factor modification or follow-up program. The study population had a mean age of 60 years, a mean BMI of 33 kg/m2, and 56-60% of patients with persistent AF. A third of the study population was female. The trial showed a significant improvement in the primary endpoint of the percentage of patients free from atrial fibrillation after ablation in those receiving the intensive lifestyle RFM program. At the end of the 12.3-month follow-up period, 66% percent of patients in the RFM group were free from AF compared to 42% in the usual care group (HR 0.53, p = 0.03). The RFM group also showed significant improvement in AF symptom severity, decline in body weight, systolic blood pressure, glycemic control, and exercise capacity. On average, patients in the RFM arm lost 9 kg of weight compared to 1 kg in the control group. Similarly, systolic blood pressure decreased by 13.1 mmHg in the RFM group but increased by four mmHg in the control group.
This episode was planned in collaboration with Heart Rhythm TV with mentorship from Dr. Daniel Alyesh and Dr. Mehak Dhande. (www.hrsonline.org/hrstv)
Enjoy this Circulation 2022 Paths to Discovery article to learn about the CardioNerds story, mission, and values. (www.ahajournals.org/doi/10.1161/CIRCULATIONAHA.122.061404)
US Cardiology Review is now the official journal of CardioNerds! Submit your manuscript here. (www.uscjournal.com/articles/case-primary-cardiac-b-cell-lymphoma-diagnosed-cardiac-mri)
CardioNerds Journal Club Page (www.cardionerds.com/cardsjc/)
CardioNerds Episode Page (www.cardionerds.com/episodes/)
CardioNerds Academy (www.cardionerds.com/academy/)
Cardionerds Healy Honor Roll (www.cardionerds.com/honor-roll-ambassadors/)
CardioNerds Journal Club
(www.cardionerds.com/cardsjc/) Subscribe to The Heartbeat Newsletter! (eepurl.com/hazGYL)
Check out CardioNerds SWAG! (teespring.com/cardionerds?pid=658&cid=102908)
Become a CardioNerds Patron! (www.patreon.com/cardionerds)
References - The SUMMIT Trial
Pathak, Rajeev K., et al. “Aggressive Risk Factor Reduction Study for Atrial Fibrillation and Implications for the Outcome of Ablation: The ARREST-AF Cohort Study.” Journal of the American College of Cardiology, vol. 64, no. 21, 2014, pp. 2222-2231. (www.jacc.org/doi/abs/10.1016/j.jacc.2014.09.028?.com) (www.jacc.org/doi/abs/10.1016/j.jacc.2014.09.028?.com)
Переглядів: 67

Відео

408. Journal Club: The SUMMIT Trial with Dr. Milton Packer
Переглядів 13014 днів тому
Join CardioNerds Heart Failure Section Chair Dr. Jenna Skowronski, episode lead Dr. Merna Hussein, and expert faculty Dr. Milton Packer as they discuss the SUMMIT trial (www.nejm.org/doi/full/10.1056/NEJMoa2410027) . The SUMMIT trial randomized 731 patients with HFpEF with LVEF ≥ 50% and obesity with BMI ≥ 30 kg/m2 to receive tirzepatide or placebo for at least 52 weeks. The two co-primary endp...
407. Journal Club: The Nex-Z Trial - A CRISPR-Cas9 Based Treatment for ATTR Cardiac Amyloidosis w...
Переглядів 5614 днів тому
Join CardioNerds Heart Failure Section Chair Dr. Jenna Skowronski, episode lead Dr. Apoorva Gangavelli, and expert faculty Dr. Ronald Witteles as they discuss the Nex-Z trial (www.nejm.org/doi/full/10.1056/NEJMoa2412309) . This was a phase 1, open-label trial investigating nex-z, a CRISPR-Cas9-based treatment, in 36 patients with transthyretin amyloidosis with cardiomyopathy (ATTR-CM). The prim...
406. Journal Club: The BPROAD Trial with Dr. Keith Ferdinand
Переглядів 8221 день тому
Join CardioNerds co-founder Dr. Daniel Ambinder, episode lead Dr. Nidhi Patel, and expert faculty Dr. Keith Ferdinand as they discuss the BP ROAD trial (www.nejm.org/doi/full/10.1056/NEJMoa2412006) . The BP ROAD trial randomized 12,821 patients 50 years of age or older with type 2 diabetes, elevated systolic blood pressure, and an increased risk of cardiovascular disease to receive intensive tr...
405. Case Report: Like Mother, Like Son? Peripartum Cardiomyopathy and Infantile Hypertrophic Car...
Переглядів 80Місяць тому
CardioNerds (Dr. Dan Ambinder and guest host, Dr. Pooja Prasad) join Dr. Donny Mattia from Phoenix Children’s pediatric cardiology fellowship, Dr. Sri Nayak from the Mayo Clinic - Arizona adult cardiology fellowship, and Dr. Harrison VanDolah from the University of Arizona College of Medicine - Phoenix Med/Peds program for a sunrise hike of Piestewa Peak, followed by some coffee at Berdena’s in...
404. Case Report: A Stressful Case of Cardiogenic Shock - Tufts Medical Center
Переглядів 2172 місяці тому
CardioNerds (Dr. Dan Ambinder ( Dr_DanMD) and Dr. Yoav Karpenshif ( YoavKarpenshif) - Chair of the CardioNerds Critical Care Cardiology Council) join Dr. Munim Khan, Dr. Shravani Gangidi, and Dr. Rachel Goodman ( goodmra1) from Tufts Medical Center’s general cardiology fellowship program for hot pot in China Town in Boston. They discuss a case involving a patien...
403. Cardio-Rheumatology: Treating Inflammation and Real-World Implementation of Therapies with D...
Переглядів 732 місяці тому
In this episode, CardioNerds Dr. Gurleen Kaur ( Gurleen_Kaur96) and Dr. Akiva Rosenzveig (x.com/AkivaRosenzveig) are joined by Cardio-Rheumatology experts, Dr. Brittany Weber ( Bweber04) and Dr. Michael Garshick ( garshick) to discuss treating inflammation, delving into the pathophysiology behind the inflammatory hypothesis of atherosclerotic cardiovascular dise...
402. Guidelines: 2022 AHA/ACC/HFSA Guideline for the Management of Heart Failure - Question #39 w...
Переглядів 892 місяці тому
The following question refers to Sections 7.3.3 and 7.3.6 of the 2022 ACC/AHA/HFSA Guideline for the Management of Heart Failure. The question is asked by Palisades Medical Center medicine resident & CardioNerds Academy Fellow Dr. Maryam Barkhordarian ( MaryamBMD) , answered first by UTSW AHFT Cardiologist & CardioNerds FIT Ambassador Dr. Natalie Tapaskar ( NatalieTapaskar...
401. Guidelines: 2022 AHA/ACC/HFSA Guideline for the Management of Heart Failure - Question #38 w...
Переглядів 752 місяці тому
The following question refers to Sections 7.4 and 7.5 of the 2022 AHA/ACC/HFSA Guideline for the Management of Heart Failure. The question is asked by the Director of the CardioNerds Internship Dr. Akiva Rosenzveig ( AkivaRosenzveig) , answered first by Vanderbilt AHFT cardiology fellow Dr. Jenna Skowronski ( JennaSkowronski) , and then by expert faculty Dr. Randall Starli...
400. Cardio-Rheumatology: Targeting Inflammation for Cardiovascular Risk Reduction with Dr. Paul ...
Переглядів 772 місяці тому
In this episode, Dr. Paul Ridker, a pioneer in the field of cardiovascular inflammation, joins the CardioNerds (x.com/cardionerds) (Dr. Gurleen Kaur (x.com/RichardAFerraro) , Dr. Richard Ferraro (x.com/RichardFerraroMD) , and Dr. Nidhi Patel (x.com/NidhihpatelMD) ) to discuss the evolving landscape of inflammation as a key factor in cardiovascular risk reduction. The discussion dives into the i...
399. Guidelines: 2022 AHA/ACC/HFSA Guideline for the Management of Heart Failure - Question #37 w...
Переглядів 953 місяці тому
The following question refers to Section 7.4 of the 2022 AHA/ACC/HFSA Guideline for the Management of Heart Failure.The question is asked by the Director of the CardioNerds Internship Dr. Akiva Rosenzveig, answered first by Vanderbilt AHFT cardiology fellow Dr. Jenna Skowronski, and then by expert faculty Dr. Clyde Yancy.Dr. Yancy is Professor of Medicine and Medical Social Sciences, Chief of C...
48. Critical Bicuspid Aortic Valve Stenosis Complicating Pregnancy - Vanderbilt University
Переглядів 1513 місяці тому
www.cardionerds.com/48-critical-bicuspid-aortic-valve-stenosis-complicating-pregnancy-vanderbilt-university/
51. Embolic Acute Coronary Syndrome from PFO & Pulmonary Hypertension - Lankenau Medical Center
Переглядів 1083 місяці тому
www.cardionerds.com/51-embolic-acute-coronary-syndrome-from-pfo-pulmonary-hypertension-lankenau-medical-center CardioNerds (Amit Goyal & Dan Ambinder) join Lankenau Medical Center cardiology fellows (Gwen McNeill and Shaung Ooi) for some Philly cheesesteaks! They discuss a fascinating case of Embolic Acute Coronary Syndrome from PFO and Pulmonary Hypertension. Dr. John Clark provides the E-CPR ...
50. Case Report: Hereditary Restrictive Cardiomyopathy - Duke University
Переглядів 3073 місяці тому
www.cardionerds.com/50-case-report-hereditary-restrictive-cardiomyopathy duke-university/ CardioNerds (Amit Goyal & Dan Ambinder) discuss a case of hereditary restrictive cardiomyopathy with Duke University cardiology fellows Navid Nafissi and Sipa Yankey, and Marat Fudim, an advanced heart failure attending at Duke University. E-CPR is provided by Dr. Richa Agarwal, fellowship program director...
Symptomatic Aortic Stenosis In Pregnancy
Переглядів 1413 місяці тому
www.cardionerds.com/48-critical-bicuspid-aortic-valve-stenosis-complicating-pregnancy vanderbilt-university/(opens in a new tab) CardioNerds (Amit & Dan) join Vanderbilt University cardiology fellows (Tara Holder, Majd El-Harasis, and Amar Parikh) for a Sunday morning brunch, Nashville style! They discuss an enthralling case of bicuspid aortic valve with critical aortic stenosis complicating pr...
Narratives in Cardiology: Career Flexibility in Cardiology with Dr. Minnow Walsh
Переглядів 543 місяці тому
Narratives in Cardiology: Career Flexibility in Cardiology with Dr. Minnow Walsh
397. Guidelines: 2022 AHA/ACC/HFSA Guideline for the Management of Heart Failure - Question #36 w...
Переглядів 433 місяці тому
397. Guidelines: 2022 AHA/ACC/HFSA Guideline for the Management of Heart Failure - Question #36 w...
396. Case Report: Unmasking Constrictive Pericarditis Using Multimodality Imaging - University of...
Переглядів 293 місяці тому
396. Case Report: Unmasking Constrictive Pericarditis Using Multimodality Imaging - University of...
395. Beyond the Boards: Channelopathies with Dr. Michael Ackerman
Переглядів 363 місяці тому
395. Beyond the Boards: Channelopathies with Dr. Michael Ackerman
394. 3rd Annual Sanjay V. Desai Lecture: Artificial Intelligence in Medical Education with Dr. Ka...
Переглядів 233 місяці тому
394. 3rd Annual Sanjay V. Desai Lecture: Artificial Intelligence in Medical Education with Dr. Ka...
393. SGLT Inhibitors: Clinical Implementation of SGLT Inhibitors with Dr. Alison Bailey
Переглядів 303 місяці тому
393. SGLT Inhibitors: Clinical Implementation of SGLT Inhibitors with Dr. Alison Bailey
392. Case Report: Heart Failure Out of the Blue, A Case of Cobalt Cardiomyopathy - Georgetown Uni...
Переглядів 103 місяці тому
392. Case Report: Heart Failure Out of the Blue, A Case of Cobalt Cardiomyopathy - Georgetown Uni...
391. Guidelines: 2022 AHA/ACC/HFSA Guideline for the Management of Heart Failure - Question #35 w...
Переглядів 193 місяці тому
391. Guidelines: 2022 AHA/ACC/HFSA Guideline for the Management of Heart Failure - Question #35 w...
390. Cardio-Rheumatology: Deciphering Cardiovascular Risk in Patients with Rheumatologic Conditio...
Переглядів 213 місяці тому
390. Cardio-Rheumatology: Deciphering Cardiovascular Risk in Patients with Rheumatologic Conditio...
389. Case Report: When “Normal” Cholesterol is Not Normal: Exposing an Unusual Presentation of Fa...
Переглядів 353 місяці тому
389. Case Report: When “Normal” Cholesterol is Not Normal: Exposing an Unusual Presentation of Fa...
388. Ironing out the Data: Iron Deficiency in Heart Failure with Dr. Robert Mentz
Переглядів 353 місяці тому
388. Ironing out the Data: Iron Deficiency in Heart Failure with Dr. Robert Mentz
387. Cardio-Rheumatology: The Role of Inflammation in Cardiovascular Disease with Dr. Antonio Abbate
Переглядів 43 місяці тому
387. Cardio-Rheumatology: The Role of Inflammation in Cardiovascular Disease with Dr. Antonio Abbate
386. Beyond the Boards: Cardiomyopathies with Dr. Steve Ommen
Переглядів 213 місяці тому
386. Beyond the Boards: Cardiomyopathies with Dr. Steve Ommen
385. Guidelines: 2022 AHA/ACC/HFSA Guideline for the Management of Heart Failure - Question #34 w...
Переглядів 133 місяці тому
385. Guidelines: 2022 AHA/ACC/HFSA Guideline for the Management of Heart Failure - Question #34 w...
384. Case Report: Little (a), Big Deal - National Lipid Association
Переглядів 103 місяці тому
384. Case Report: Little (a), Big Deal - National Lipid Association

КОМЕНТАРІ

  • @Propofol1234
    @Propofol1234 Місяць тому

    @ 11:00, why would you not discontinue the beta blocker? Surely it can reduce cardiac output, when can lead to more congestion ( due to elevated LVEDV). Thank you.

  • @azmirofficial12
    @azmirofficial12 3 місяці тому

    hi do you need a professionals youtube thumbnail designer and video SEO experts

  • @tanujlamech1719
    @tanujlamech1719 3 місяці тому

    Excellent discussion, this is such an "everyday case" that we see, and I really enjoyed all the clinical pearls. If I could just ask a few quick questions: 1) When there's a patient with a systolic BP of 90 on double pressors, there's often hesitation in giving a large lasix dose (such as 80-100 mg) as a stress test. Is this fear warranted, and can the lasix dose by itself worsen hemodynamics? 2) Regarding late-start dialysis, a lot of the cardiac ICU patients whom I see tend to require dialysis initiation simply because of a large positive fluid balance (and not for uremia/hyperkalemia/acidosis), which results in an increased pre-load and worsening hemodynamics. In this situation, when the filling pressures are rising, the urine output is falling and the lasix isnt working, I find that starting earlier makes it easier to control fluid balance. I find this hard to reconcile with all the data showing a late start is better. Should I be waiting longer, and how long is it safe to wait, since "volume overload" is a bit of a subjective call? 3) Is there a lower limit of BP below which you dont start CRRT? Say the patient's on triple supports and the systolic BP is 60 - do you wait for the patient to stabilise, or go right ahead with CRRT? Thanks so much again for the really fantastic overview !

  • @AkbarKhan-uv9zc
    @AkbarKhan-uv9zc 3 місяці тому

    Wherever salt goes, [Dr Topf], water follows, [renal fellow]. Sweet episode. Enjoying listening to this so far.. The cardio-renal connection that we all needed!

  • @Mzw9rc
    @Mzw9rc 6 місяців тому

    Thank you, this helps a lot!

  • @deepakk7067
    @deepakk7067 7 місяців тому

    I was hoping that you would talk about a note on how to use the citation tools. Would appreciate if there is a another video even briefly talking about those thank you very very much for for all all you do.

  • @bharatrawlley6434
    @bharatrawlley6434 9 місяців тому

    Thanks so much for sharing this with the public!

  • @karlagusikowski
    @karlagusikowski Рік тому

    "Promo sm"

  • @ChromaticHarp
    @ChromaticHarp Рік тому

    I recently underwent emergency open heart surgery…I just happened on. this channel by coincidence…

  • @mohammadagha4830
    @mohammadagha4830 Рік тому

    Amazing explanation, thank you very much

  • @LuckystudioLUQMANKHAN
    @LuckystudioLUQMANKHAN Рік тому

  • @JaspalSingh-zr6co
    @JaspalSingh-zr6co Рік тому

    He is such an inspiration. Currently working my way to medical residency and his played a huge role in disciplining me!

  • @luisruiz5416
    @luisruiz5416 2 роки тому

    Great help for Infographic-building-beginning

  • @respectking4782
    @respectking4782 2 роки тому

    Plz

  • @respectking4782
    @respectking4782 2 роки тому

    Hello mam how to contact with u can u give me ur email I need ur help plz mam

  • @sahinmursel2245
    @sahinmursel2245 2 роки тому

    thank you so much

  • @julienmercier9281
    @julienmercier9281 3 роки тому

    Very useful. Thanks for this video!

  • @mercyonyoutube
    @mercyonyoutube 3 роки тому

    Thank you..it was helpful

  • @IrmãoCiro
    @IrmãoCiro 3 роки тому

    The best teacher! Doctor Rhanderson. :)

  • @tazrinomer9294
    @tazrinomer9294 3 роки тому

    I cannot thank you enough

  • @aymanausmani
    @aymanausmani 3 роки тому

    you're speaking so delicately... who are you and what have you done with ahmed ghoneem?

  • @dvshrai
    @dvshrai 3 роки тому

    Amazing work, great explanation. Love it

  • @emilianocantu9919
    @emilianocantu9919 3 роки тому

    Amazing video! 👏🏻👏🏻👏🏻👏🏻👏🏻👏🏻

  • @风城美籍华人
    @风城美籍华人 3 роки тому

    Great presentation. Thank you Dr Zheng!

  • @davidmbeckmann
    @davidmbeckmann 3 роки тому

    In the third patient, float a Swan and give fluid guided by the wedge?! Or give fluid in 250ml aliquots with serial evaluation of neck veins?!

  • @immadisarojini2775
    @immadisarojini2775 4 роки тому

    Nice

  • @immadisarojini2775
    @immadisarojini2775 4 роки тому

    Super sir

  • @aymansaeyeldin4990
    @aymansaeyeldin4990 4 роки тому

    Fantastic video Dr Isakadze thank you kindly

  • @drsaafanal-safi6100
    @drsaafanal-safi6100 4 роки тому

    ua-cam.com/video/V9uwXOZEt6o/v-deo.html

  • @ydesai1
    @ydesai1 4 роки тому

    what's the reason for the abnormally rapid filling in early diastole?

    • @ashutoshshrimali2001
      @ashutoshshrimali2001 13 днів тому

      late diastolic filling is not possible due to pericardial issue thus whatever filling has to occur must occur in Systolic phase of venous return & EARLY 1/3rd diastolic phase of Venous return, in short its compensatory increase.

  • @طنطلطيفة
    @طنطلطيفة 4 роки тому

    💞💞💞💞

  • @fatimahalf7590
    @fatimahalf7590 4 роки тому

    Amazing work 👏, very helpful Thank you Dr.Abdulhamied

  • @shoki3490
    @shoki3490 4 роки тому

    Best and easiest explaination of Constrictive pericarditi's features. Thanks

  • @drgadham
    @drgadham 4 роки тому

    Lovely presentation very good cae👏😊

  • @BohemianGroveify
    @BohemianGroveify 4 роки тому

    They aren't taking enough aboit covid myocarditis, it's more common than most realize in ex covid patients

    • @SedriqMiers
      @SedriqMiers 3 роки тому

      yet this condition is triggered by the 💉

    • @BohemianGroveify
      @BohemianGroveify 3 роки тому

      @@SedriqMiers yes it is also! Both the virus and the vaccine give this.

  • @Gnokhi
    @Gnokhi 4 роки тому

    Nice

  • @Reza-be6kn
    @Reza-be6kn 4 роки тому

    Truly epic job, Dr. Isakadze. Thank you so much for such timely teaching.

  • @sanaullah6911
    @sanaullah6911 4 роки тому

    Very useful overview. Precisely what criteria are used to decide the need for mechanical circulatory support?

    • @cardionerds1503
      @cardionerds1503 4 роки тому

      Great question. Lots of nuances there. We will be tackling this subject more in depth on a podcast in the future. Check out our heart failure series www.cardionerds.com/episodes/heart-failure-awareness-cardionerds-series/ for more information about advanced therapies in heart failure.

    • @balintlaczay6816
      @balintlaczay6816 4 роки тому

      Great question, thanks for asking. It's a very difficult decision as noted previously. You need to factor in the patient and their comorbidities, the state of their heart, and the severity of what process they are going through. Patients who require MCS are usually failing medical therapy (ie, persistently hypotensive, low output, not clearing lactate, end organs are underperfused). Then you have to assess what the goal or endpoint is, whether it's as a bridge to recovery (such as a patient with a transient process you think will reverse) or a bridge to a definitive treatment, which could include a transplant, LVAD, high risk PCI, VT ablation, just as a few examples. You then need to assess the patient and their comorbidities to consider how they would fare on MCS and whether they would be a candidate for the definitive therapies above. It's a complex that decision that needs coordinated input from the primary team, intensitivist, and interventionalists/heart failure specialists and of course the patient/family themselves.

    • @sanaullah6911
      @sanaullah6911 4 роки тому

      @@balintlaczay6816 Thanks for your reply. I am not sure about adult data, but certainly in pediatrics there's good evidence to show that early use of MCS has better outcomes than waiting for organs to start failing.

    • @balintlaczay6816
      @balintlaczay6816 4 роки тому

      @@sanaullah6911 Of course, thanks for clarifying. There are certainly differences in pediatrics and adults which I'm not the best one to clarify. And as for "waiting for organs to fail" what I meant to say is that end organ malperfusion is what often leads providers to pull the trigger on MCS. There are of course occasions where based on clinical trajectory or anticipated procedures MCS is pursued earlier in the clinical course.

  • @sangeetabirbale6341
    @sangeetabirbale6341 4 роки тому

    Well done!!

  • @zzz13339
    @zzz13339 4 роки тому

    Loved it. Always got your back

  • @dr.shrikantbirbale8072
    @dr.shrikantbirbale8072 4 роки тому

    👍

  • @entrophy3703
    @entrophy3703 4 роки тому

    Amazing confidence

  • @satishgavhane2632
    @satishgavhane2632 5 років тому

    Very interesting.