Episode 117: The mind boggles and the heart goes all a flutter
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In episode 117, Mike and James delve into the first of a few podcasts on options for atrial fibrillation. In this first podcast they look at ways to assess risks and talk at length about a web-based tool that makes the process as easy as possible. The process is so easy that the hearts of both Mike and James start to flutter yet only one of them decides to take warfarin.
Comments
Just curious about people's
Just curious about people's thoughts about how the HAS-BLED criteria performs compared to the Outpatient Bleeding Risk Index (OBRI) rule (Am Fam Physician. 2010 Mar 15;81(6):780-782). Great podcast as usual!
The elderly healthy with AF travelling
Just as a matter of interest I have an increasing number of patients in their 70 and 80s who are travelling all over the place .. India, Mongolia , China etc. Some for long periods of time .... They may be susceptible to diarrhoea illhealth and travelling in areas where inr are difficult.
Looks to me that Aspirin 75/Clopidogrel may be a good temporary option for them !!!
Also in safety terms this ccounts for those with fairly good control of INR ... there are some who are notoriously difficult or sometimes unrelible .. again the Clopidogrel/ Aspirin mix looks an interesting second best
Single episode AF
Does all of this apply to people who have a single episode of AF with an identifiable trigger (eg thyrotoxic at time)? Should that group of patients be counselled along the same lines or do these guidelines apply to patients who are still in AF? Thanks for the podcasts
In Heart Failure
Have you heard of spacing the time of the ACEI and the beta blocker by 2 hours.
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