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Barriers in Anticoagulation: Challenges in Stroke Prevention

Activity Type:

  • Course

Release Date: 12/16/2015

Expiration Date: 12/31/2018

  • Participation - no CE credit: 2.5


Barriers in Anticoagulation:  Challenges in Stroke Prevention for AFib

This learning pathway discusses the clinically relevant day-to-day challenges in anticoagulation management that may not be addressed in the guidelines, but are common in clinical practice.  This activity is complimentary.

The presentations are:

Patient Selection: Can the Risk of Bleeding EVER Exceed the Benefit of Anticoagulants? – duration <22 minutes
Not all patients benefit from anticoagulation.  This presentation will review the tools we have to risk stratify patients when deciding to provide anticoagulation therapy.  The viewer will review cases that will highlight these pertinent concerns.

Defining Use of NOACs in Patients with Valvular Heart Disease - Should We Redefine "Valvular AF”? – duration <23 minutes
Are all valvular AF patients the same?  This presentation will give the viewer a thorough overview of the literature on valvular and non-valvular AF from an anticoagulation point of view.  The presentation also reviews the current clinical data on NOACs and their application in valvular AF.  

Stroke Prevention in AF:  Important Sub-groups – duration <15 minutes
Not all AF patients were created equally.  The viewer will gain an understanding of dosing of NOACs based on renal function.  Also, the utilization and safety of NOACs in the renal failure population will be discussed.  The presentation concludes with a discussion about the role age plays in determining NOAC use and what available clinical data tells us in this regard.

Peri-operative Anticoagulation Management – duration <22 minutes
This presentation reviews the current understanding of individual NOACs regarding peri-operative management.  The viewer will appreciate the differences and similarities among the anticoagulation agents when caring for these patients.   

Oral Anticoagulants and Anti-platelet Therapy in AF Patients with Acute Coronary Syndromes or PCI – duration <18 minutes
The “triple threat’ is real and the risks are significant when it comes to NOACs, warfarin, and antiplatelet agents.  The viewer will be provided with the data available to drive our clinical decision making about the safety of the “triple threat”.  This presentation will examine the utilization of bleeding scores when managing patients with acute coronary syndrome and anticoagulation.

Reversal of NOACs:  The Future is Now – duration 30 minutes
One of the main concerns among practitioners regarding NOACs is the lack of a universal antidote in an aging AF population in case of bleeding.  This presentation will review the available antidotes and their utilization in clinical practice.  The viewer will also gain an appreciation for the protocols available to manage a patient with major bleeding on a NOAC. 

Treatment and Risk factors Associated With Left-Atrial Thrombus Formation After Placement of the Watchman Occlusion Device – duration 17 minutes
Risk factor associated with development of thrombus on Watchman left atrial appendage occluder device and management.  

CIED Implantation in a Patient on Anticoagulation – duration 19 minutes
This presentation reviews patient selection, patient management, and implanting pearls and pitfall for CIEDs on patients with anticoagulation.

Does Catheter Ablation of Atrial Fibrillation Reduce Stroke Risk? – duration 16 minutes
This presentation mechanistic relationships between stroke and atrial fibrillation and whether ablation modifies stroke risk


*CME/CE is NOT available for this activity



Ralph Verdino, MD
Director, Cardiology Electrophysiology Fellowship Program
Associate Professor of Medicine at the Hospital of the University of Pennsylvania and
the Presbyterian Medical Center of Philadelphia and the Veteran's Administration Medical Center

Cynthia Tracy, MD
Associate Director, Division of Cardiology
George Washington University Medical Center

Stuart J. Connolly, MD, FRCPC
Director, Division of Cardiology
McMaster University
Population Health Research Institute
Hamilton Health Sciences

David A. Vorchheimer, MD, FACP, FACC
Montefiore Hospital

Charles Pollack, MA, MD, FACEP, FAAEM, FESC, FAHA
Professor of Emergency Medicine and Associate Provost
Thomas Jefferson University
Philadelphia, PA

Saifuldeen Al-Qaisi, MD
Arizona Heart Rhythm Center
Phoenix, AZ

Dan L. Musat, MD
Valley Health System
New York and New Jersey

T. Jared Bunch, MD
Medical Director of Heart Rhythm Services for
Intermountain Healthcare
Salt Lake City, UT


Supported in part by Boehringer Ingelheim Pharmaceuticals, Inc.

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