What You Need to Know about Undiagnosed Atrial Fibrillation, an Under-Recognized Stroke Risk Factor

Format: Webcourse

Credit(s): >1.00 (>60 min)

Release Date: Nov 30, 2018

Expiration Date: Nov 30, 2019

Credit Type(s):

CME / AMA PRA Category 1 Credit™
MOC / ABIM MOC Part 2 Credit

PROGRAM OVERVIEW

While early diagnosis of atrial fibrillation (AFib) can prevent cardiovascular complications, detecting it can be very challenging. Because stroke risk-assessment scores are seldom calculated in real-world settings, clinicians are often unfamiliar with their use or have insufficient time to determine a patient’s score. Nearly 30% of patients with a CHADS₂ score of 3 or greater, but no diagnosed AFib, were later found to experience AFib episodes. Routine electrocardiogram (ECG) screening can help diagnose AFib, but such screening won’t detect sporadic and infrequent events that are often silent or asymptomatic. Various ECG self-monitoring apps have been shown to increase the yield of AFib detection.

This activity will improve the early detection of AFib through use of stroke risk-assessment scores and appropriate long-term monitoring via ECG apps. Participants will also explore the possibilities for oral anticoagulation in patients with diagnosed AFib or high-risk scores.

AGENDA

Welcome, Introduction, Pre‐Survey
The Challenge of Undiagnosed Atrial Fibrillation (AFib)
Approaches to Identify Those at Risk for New AFib
New Approaches for Early AFib Detection
Utility of Screening and Self‐monitoring Detection
Oral Anticoagulation in Newly Identified High‐risk AFib
Q&A Session and Concluding Remarks

TARGET AUDIENCE

This activity is intended for primary care clinicians and other healthcare professionals who treat patients with stroke-associated risk factors and those who may also have atrial fibrillation (AFib).

EDUCATIONAL OBJECTIVES

After completing this activity, the participant should be better able to:

Identify patients who have high stroke-associated risk using novel approaches for monitoring and diagnosis
Use the CHA₂DS₂-VASc risk assessment score as a tool to determine the appropriate course of action to manage diagnosed AFib
Consider appropriate oral anticoagulation for patients with newly diagnosed AFib and various degrees of disease burden/stroke risk

ACCREDITATION

This activity has been planned and implemented in accordance with the accreditation requirements and policies of the Accreditation Council for Continuing Medical Education (ACCME) through the joint providership of the Potomac Center for Medical Education (PCME) and Rockpointe. The Potomac Center for Medical Education is accredited by the ACCME to provide continuing medical education for physicians.

The Potomac Center for Medical Education designates this enduring material for a maximum of 1.25 AMA PRA Category 1 Credits™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

All other healthcare professionals will be issued a certificate of participation.

CREDIT DESIGNATION

All other healthcare professionals will be issued a certificate of participation.

AMERICAN ACADEMY OF FAMILY PHYSICIANS (AAFP)

This Enduring Material activity, What You Need to Know About Undiagnosed Atrial Fibrillation, An Under-Recognized Stroke Risk Factor, has been reviewed and is acceptable for up to 1.25 Prescribed credit(s) by the American Academy of Family Physicians. AAFP certification begins 11/30/2018. Term of approval is for one year from this date. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

FACULTY

Jeffrey L. Anderson, MD
Distinguished Clinical and Research Physician
Intermountain Medical Center Heart Institute
Professor of Medicine
University of Utah
Salt Lake City, UT

Jeffrey L. Anderson, MD, is a tenured Professor of Medicine and Cardiology at the University of Utah School of Medicine, where he is also past Chief of Cardiology. He is a Distinguished Clinical and Research Physician and immediate past Director of Cardiovascular Research at the Intermountain Medical Center Heart Institute and past Chief of Cardiology at LDS Hospital in Salt Lake City, UT. He is a Fellow of the American Heart Association (AHA), American College of Cardiology (ACC), and Heart Rhythm Society, and is a Master of the American College of Physicians.

He served as recent past Chair of the Task Force on Practice Guidelines for the AHA/ACC and is Past President of the Western States Affiliate of the AHA. He has served as a member and Chair of the FDA’s Cardiorenal Advisory Committee. He is board-certified in cardiovascular diseases and clinical electrophysiology and has a broad interest in cardiovascular diseases and prevention. With his colleagues, he has published more than 700 peer-reviewed and invited articles and book chapters and more than 600 abstracts presented at national and international meetings. His current research interests include cardiovascular genetics, pharmacogenetics, metabolomics and other cardiovascular risk factors, and clinical intervention trials to reduce and prevent cardiovascular diseases. He enjoys seeing and caring for patients, performing innovative clinical research, and teaching at all levels.

Christopher Cannon, MD
Cardiovascular Division
Brigham and Women's Hospital
Professor of Medicine
Harvard Medical School
Boston, MA

Christopher Cannon, MD is a Professor of Medicine at Harvard Medical School, and Senior Physician in the Cardiovascular Division at Brigham and Women’s Hospital. He earned his medical doctorate from Columbia University College of Physicians and Surgeons in New York and completed an internal medicine residency at Columbia Presbyterian Medical Center and a cardiovascular fellowship at Brigham and Women’s Hospital.

Dr. Cannon has published more than 1,000 original articles, reviews, or electronic publications in the field of acute coronary syndromes and prevention and has authored or edited 18 books. He has received numerous awards, including leadership awards from the American College of Cardiology and the American Heart Association.

He has been Principal Investigator of more than 20 multicenter clinical trials, including TACTICS-TIMI 18, PROVE IT, IMPROVE IT, and RE-DUAL PCI trials. Dr. Cannon serves as Executive Director of Cardiometabolic Trials at the Baim Institute for Clinical Research. He is involved in many other trials and registry projects in the fields of acute coronary syndromes, atrial fibrillation, diabetes, lipids, and prevention.

Christopher B. Granger, MD, FAHA, FACC
Professor of Medicine
Director, Cardiac Intensive Care Unit
Duke University Medical Center
Durham, NC

Christopher B. Granger, MD, FAHA, FACC is a Professor of Medicine in the Division of Cardiology at Duke University and Director of the Cardiac Care Unit for the Duke University Medical Center. Dr. Granger is a Fellow of the American College of Cardiology (ACC), American Heart Association (AHA), and European Society of Cardiology. He is Associate Editor of the American Heart Journal and serves on the editorial board of the Journal of the American College of Cardiology. He is a cardiology section author for Current Medical Diagnosis and Treatment, serves on the publication oversight committee of the AHA, and is chairman of the Advisory Working Group of the AHA’s Mission: Lifeline program. He is a member of the 2011 ACC/AHA STEMI Guidelines Committee. He has served on FDA advisory committees on an ad hoc basis. He is on the Board of External Experts of the National Heart, Lung and Blood Institute (NHLBI).

Dr. Granger’s primary research interest is in the conduct and methodology of large randomized clinical trials in heart disease; he has co-authored more than 500 peer-reviewed manuscripts. He currently serves on a number of clinical-trial steering committees and data safety monitoring committees. He has coordinated the Duke Clinical Research Institutes’ activities in many clinical trials evaluating acute MI reperfusion and antithrombotic strategies in acute coronary syndromes and atrial fibrillation.

Dr. Granger is Co-chairman of the Steering Committee of the ARISTOTLE trial assessing an oral factor Xa inhibitor for stroke prevention in atrial fibrillation. In addition, he is Co-director of the Reperfusion of Acute MI in Carolina Emergency Departments (RACE) projects, North Carolina state-wide programs to improve reperfusion care for acute myocardial infarction and cardiac arrest.

FACULTY AND PLANNING COMMITTEE DISCLOSURES

Jeffrey L. Anderson, MD: Nothing to disclose

Christopher Cannon, MD: Consultant/Independent Contractor: Alnylam, Amarin, Amgen, Arisaph, AstraZeneca, Boehringer Ingelheim, Bristol-Myers Squibb, Eisai, GlaxoSmithKline, Kowa, Lipimedix, Merck, Pfizer, Regeneron, Sanofi, Takeda; Research/Grant Support: Amgen, Arisaph, Boehringer Ingelheim, Bristol-Myers Squibb, Daiichi-Sankyo, Janssen, Merck, Takeda

Christopher B. Granger, MD, FAHA, FACC: Consultant/Independent Contractor: AbbVie, Armetheon, AstraZeneca, Bayer, Boehringer Ingelheim, Boston Scientific, Bristol-Myers Squibb, Daiichi-Sankyo, Gilead Sciences, GlaxoSmithKline, Janssen, Medtronic, Merck, Novartis, Pfizer, Rho Pharmaceuticals, Sirtex, Verseon; Research/Grant Support: Armetheon, AstraZeneca, Bayer, Boehringer Ingelheim, Bristol-Myers Squibb, Daiichi-Sankyo, GlaxoSmithKline, Janssen, Medtronic Foundation, Novartis, Pfizer

Planning and Reviewer Committee: Barry Watkins, PhD, Chad Williamson, MS, MBA, CHCP, Blair St. Amand, Lindsay Scott, PT, DPT, ATC, and Ashley Marostica, RN, MSN, CCM, have no relevant financial relationships to disclose.

Brian W. Jack, AAFP Reviewer: Consultant/Independent Contractor: TeleHealth

FDA DISCLOSURE

The contents of some CME/CE activities may contain discussions of non-approved or off-label uses of some agents mentioned. Please consult the prescribing information for full disclosure of approved uses.

SYSTEM REQUIREMENTS

In order to view this presentation, your computer must have audio capabilities (working speakers or headphones) and must have an internet browser capable of playing an HTML5 video.

METHOD OF PARTICIPATION

To receive credit for this activity, the participant must read the CME information (including learning objectives and disclosures) and review the entire activity. Upon finishing the activity, participant must complete the session post-test, evaluation, and all required personal information. To receive CME certificate, participant will need to pass the post-test with 75% accuracy or better. If participant receives less than 75%, participant should review the activity and take the test again.

POST-TEST AND EVALUATION

After completing the CME activity, participant must check the box attesting to their participation in the activity. After successful completion of the post-test, participant will be asked to fill out a program evaluation form and prompted to print and/or save the CME certificate. Participant should PLEASE be ready to print and/or save certificate at this time.