Thanks to Dr. Wentzein for joining us!

• Paroxysmal Atrial Fibrillation is defined as intermittent episodes lasting less than 7 days. Persistent Atrial fibrillation lasts > 7 days
• Indications for cardioversion in Atrial Fibrillation: Hemodynamically unstable, refractory to medical interventions, severe CHF symtpoms, unstable angina
• The ARISTOTLE trial: In patients with nonvalvular atrial fibrillation and at ≥1 risk factor, apixaban is associated with a greater reduction in rates of stroke or systemic embolism while having a lower rate of lower bleeding than warfarin.
• CHADS VASC: 
  • CHF, HTN, Age 65-75, DM2, Prior stroke
  • Vascular disease, Age >75, Female
• In general, don’t combine beta-blockers with calcium channel blockers due to the risk of complete heart block.
• The AFFIRM trial: In patients with nonvalvular AF, there is no survival benefit between rate and rhythm control.
• Causes of High Output Heart Failure: Systemic AV Fistulas, hyperthyroidism, anemia, beriberi, psoriasis, sepsis, kidney/liver disease
• Side-effects of Amiodarone include thyroid disorders, lung toxicity, hepatotoxicity, and corneal deposits
• For Atrial Fibrillation > 48 hours, start antiocoagulation three weeks before and continue four weeks after DCCV
• For atrial fibrillation < 48 hours, continue anticoagulation for four weeks
• The ACUTE trial showed that with TEE guided cardioversion (to evaluate for a thrombus), anticoagulation is still needed