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Management of Atrial Fibrillation: Pharmacological and Non-pharmacological Approaches

Management of Atrial Fibrillation: Pharmacological and Non-pharmacological Approaches

Format

Webcast

Time to Complete

3 hours (in 1-hour increments)

Released

September 24, 2010

Expires

September 24, 2011

Program Description

With the increasing prevalence and burden of atrial fibrillation (AFib), this series of three online programs focuses on the importance of anticoagulation in reducing the incidence of AFib-related stroke, current methods to optimize warfarin therapy, and the potential impact of emerging treatment options.

Target Audience:


Cardiologists, Internists, Primary Care Physicians, Nurse Practitioners, Physician Assistants and related healthcare providers.

Statement of Need:


Atrial fibrillation (AFib) affects approximately 2.2 million Americans and is likely to increase in prevalence due to the aging of the US population (AHA, 2010). During AFib, blood is ineffectively pumped out of the atria, often resulting in clotting. Stroke may occur if a clot then leaves the heart and is lodged in a cerebral artery. Individuals with AFib are at five times greater risk of stroke and approximately 15 percent of stroke incidences occur in AFib patients (Savelieva I et al., 2007). Moreover, AFib-related stroke is typically associated with greater morbidity and mortality (Savelieva I et al., 2007). Warfarin and aspirin are currently FDA approved to reduce the risk of stroke in AFib, and guidelines recommend people with AFib who are at moderate-to-high risk of stroke to be initiated on chronic warfarin therapy (Turpie AG, 2008)(Fuster V et al., 2006). However, despite guideline recommendations and studies demonstrating the benefits of anticoagulation in patients with AFib, 50 percent of ideal candidates go untreated due in part to warfarin complications (Savelieva I et al., 2007) (Fuster V et al., 2006)( Hart RG et al., 2007). Non-pharmacological interventions, such as catheter ablation, have also demonstrated the ability to restore sinus rhythm and reduce stroke risk in patients with AFib (Lévy S, 2006) (Crijns HJ, 2005). These treatment options are also of importance for clinical decision makers and present challenges due to the associated complexities of these procedures, including the need for sophisticated electrophysiology laboratories, expensive imaging techniques, and well-trained staff. Despite these interventions, data have indicated the need for long-term anticoagulation. (Echahidi N et al., 2008).

Educational Objectives

At the conclusion of this activity, participants should be better able to:

  • Review the etiology of atrial fibrillation (AFib) and its prevalence in the United States

  • Summarize the burden of AFib to society and individuals

  • Understand and recognize risk factors including patient characteristics for AFib and morbidities associated with AFib

  • Examine proper determinants and steps for diagnosis of AFib

  • Select management strategies for treating AFib in patients with comorbidities such as heart failure

  • Evaluate emerging treatment options for patients with AFib

  • Illustrate genetics involved in AFib and the role that personalized medicine may have in the future

  • Assess future monitoring and provider strategies to optimize outcomes in patients with AFib.

  • Compare the current treatment options for AFib

  • Review the evidence and recommendations of current AFib guidelines

  • Discuss important patient and health resource considerations in constructing AFib treatment plans

  • Using patient-specific factors; develop an AFib treatment regimen for a patient case

Disclosure

ACCREDITOR DISCLOSURE OF CONFLICTS OF INTEREST POLICY:
Policy on Faculty and Provider Disclosure: It is the policy of the National Association for Continuing Education to ensure fair balance, independence, objectivity and scientific rigor in all activities. All faculty participating in CME activities sponsored by the National Association for Continuing Education are required to present evidence-based data, identify and reference off-label product use and disclose all relevant financial relationships with those supporting the activity or others whose products or services are discussed. Faculty disclosure will be provided in the activity materials.

FACULTY INFO:
Moussa Mansour, MD

Cardiac Arrhythmia Service
Massachusetts General Hospital
Assistant Professor of Medicine
Harvard Medical School

Jeremy Neil Ruskin, MD
Director, Cardiac Arrhythmia Service
Massachusetts General Hospital
Associate Professor of Medicine
Harvard Medical School

Patrick T. Ellinor, MD, PHD
Director, Arrhythmia/Step Down Unit
Massachusetts General Hospital
Assistant Professor of Medicine
Harvard Medical School

ACCREDITOR DISCLOSURE OF CONFLICTS OF INTEREST POLICY:
It is the policy of Beth Israel Medical Center and St. Luke's and Roosevelt Hospitals that faculty and providers disclose real or apparent conflicts of interest relating to the topics of this educational activity, and also disclose discussions of unlabeled/unapproved uses of drugs or devices during their presentation(s). Beth Israel Medical Center and St. Luke's and Roosevelt Hospitals have established policies in place that will identify and resolve all conflicts of interest prior to this educational activity.

FACULTY DISCLOSURES:
The faculty has no disclosure to report.

DISCLOSURE OF UNLABELED USE:
This educational activity may contain discussion of published and/or investigational uses of agents that are not indicated by the FDA. Beth Israel Medical Center, St. Luke’s and Roosevelt Hospitals, AstraZeneca and Boehringer Ingelheim, and Haymarket Medical Education do not recommend the use of any agent outside of the labeled indications.

The opinions expressed in the educational activity are those of the faculty and do not necessarily represent the views of Beth Israel Medical Center, St. Luke’s and Roosevelt Hospitals, AstraZeneca and Boehringer Ingelheim, and Haymarket Medical Education. Please refer to the official prescribing information for each product for discussion of approved indications, contraindications, and warnings.

DISCLAIMER:
Participants have an implied responsibility to use the newly acquired information to enhance patient outcomes and their own professional development. The information presented in this activity is not meant to serve as a guideline for patient management. Any procedures, medications, or other courses of diagnosis or treatment discussed or suggested in this activity should not be used by clinicians without evaluation of their patient’s conditions and possible contraindications on dangers in use, review of any applicable manufacturer’s product information, and comparison with recommendations of other authorities.

This activity is jointly sponsored by Beth Israel Medical Center, St. Luke’s and Roosevelt Hospitals, Massachusetts General Hospital Academy and Reed Medical Education.

If you have any questions relating to the accreditation of this activity, please contact Timothy Lynch at tlynch@reedmeded.com

This program is supported by educational grants from AstraZeneca and Boehringer Ingelheim.

Credit

3.00

Type

AMA PRA Category 1 Credit(s)TM

Accreditation Statement

This activity has been planned and implemented in accordance with the Essential Areas and policies of the Accreditation Council for Continuing Medical Education through the joint sponsorship of Beth Israel Medical Center, St. Luke's and Roosevelt Hospitals, Massachusetts General Hospital Academy and Reed Medical Education. Beth Israel Medical Center and St. Luke's and Roosevelt Hospitals are accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians.

Designation Statement

Beth Israel Medical Center and St. Luke's and Roosevelt Hospitals designate this continuing medical education activity for a maximum of 3 AMA PRA Category 1 CreditsTM. Physicians should only claim credit commensurate with the extent of their participation in the activity.

Instructions

To obtain credit, a score of 70% or better is required. This CME is offered at no cost to participants. Please proceed with the activity until you have successfully completed this program, answered all test questions, completed the posttest survey, and have received your digital copy of your credit certificate.

SYSTEM REQUIREMENTS

Hardware and Software Requirements
  • A computer with an internet connection
  • Internet Browser: Internet Explorer 7.x or higher, Firefox 4.x or higher, Safari 2.x or higher, or any other W3C standards compliant browser
  • Additional Software: Adobe Flash Player and/or an HTML 5 capable browser maybe required for video or audio playback. PowerPoint or Adobe Acrobat Reader may occasionally be required
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