Semaglutide is a glucagon-like peptide-1 (GLP-1) receptor agonist, an anti-obesity medication, that has shown promise in treating patients with heart failure. The STEP-HFpEF trial recently evaluated the effects of semaglutide on heart failure outcomes. 

The STEP-HFpEF trial aimed to investigate the effects of semaglutide on people with heart failure. Specifically, it looked at those who had heart failure with a preserved ejection fraction (HFpEF), meaning their heart’s ability to relax was not as effective as in normal hearts. Researchers wanted to see if semaglutide could positively impact participants’ health.

The trial involved a large number of people with heart failure. Half of the participants were given semaglutide, while others received a placebo. 

The population enrolled in the study had to meet the following criteria: 

1. Left ventricular ejection fraction (LVEF) > or equal to 45%
2. Body mass index (BMI) > or equal to 30kg/m2
3. Heart Failure symptoms
4. Functional limitations NYHA functional class II-IV and KCCQ-CSS <90 points

The study demonstrated that semaglutide is superior to a placebo in improving body weight and quality of life at 52 weeks. The validity of this study is bolstered by its randomized, double-blind design, which minimizes bias. The large sample size (529 patients) also adds to its credibility, as it included participants across various demographics and regions, enhancing the generalizability of the findings.

STEP-HFpEF Trial’s Clinical Implications for Management of Heart Failure

New Treatment Option: The trial demonstrated that semaglutide can reduce the symptoms in patients with heart failure and preserved ejection fraction. This introduces semaglutide as a potential new tool in the treatment toolkit for healthcare professionals.

Improved Quality of Life: Semaglutide was shown to improve the overall quality of life for participants. This means that patients not only had better physical health outcomes, but they felt better and experienced a better sense of well-being.

Combination Therapy: The trial evaluated semaglutide in addition to standard heart failure treatments. This suggests that semaglutide could complement existing therapies, possibly enhancing their effectiveness when used in combination.

Targeting Heart Failure Subtype: The study focused on patients with heart failure and preserved ejection fraction. This subgroup of heart failure patients has limited treatment options, so semaglutide’s effectiveness in this group opens new avenues for treatment.

Preventive Aspect: By reducing the risk of hospitalizations and cardiovascular death, semaglutide might not only help manage existing heart failure but also have a preventive effect, potentially slowing down the progression of the disease.

Tailored Approaches: As treatment plans are personalized, the inclusion of semaglutide could allow doctors to tailor treatments more precisely to individual patients, potentially improving outcomes based on each patient’s needs.

Shared Decision-Making: Patients and their healthcare providers now have another conversation point when discussing treatment options. The positive outcomes from the trial empower patients to be more involved in deciding their course of treatment.

Research Direction: The success of semaglutide in heart failure opens avenues for further research into GLP-1 receptor agonists and their effects on other aspects of cardiovascular health, potentially leading to more innovative treatments.

Guideline Updates: The findings could influence the development of updated medical guidelines for heart failure management, incorporating semaglutide as a recommended treatment option.

Healthcare Policies: Positive trial results could prompt discussions among policymakers and health authorities about the inclusion of semaglutide in insurance coverage or national healthcare programs.

It’s important to note that while the STEP-HF trial’s findings are promising, ongoing research and real-world experience will provide a more comprehensive understanding of semaglutide’s role in heart failure treatment. Healthcare professionals will need to balance the benefits and potential risks when considering semaglutide for individual patients.

Limitations of the STEP-HFpEF Trial

Duration of Follow-Up: The trial followed participants for a specific period, and while it showed positive outcomes, the long-term effects of semaglutide still need to be studied over a more extended timeframe to ensure its safety and sustained effectiveness.

Sample Characteristics: The trial participants were carefully selected, which mightnot fully represent all people with HFpEF in real life. The study included certain demographics and health conditions, so the results might not apply equally to everyone.

Placebo Effect: Sometimes, people who know they’re taking a new medicine can feel better just because they believe the medicine is working. This is called the placebo effect and can influence study outcomes.

Generalization: The trial took place in specific locations with specific conditions. Results could vary in other regions or populations with different healthcare settings or lifestyles.

Combination with Other Treatments: The trial looked at the effects of semaglutide on top of usual care. It’s possible that the improvements observed were due to a combination of both, rather than semaglutide alone.

Lack of Long-Term Safety Data: While the trial assessed short-term safety, potential rare or long-term side effects might not have been fully uncovered yet.

Cost and Accessibility: The trial doesn’t delve into the cost or practicality of long-term semaglutide use, which could impact its real-world application.

Conclusion

While the STEP-HFpEF trial provides valuable insights, ongoing studies and real-world observations will help fill in the gaps and provide a more comprehensive understanding of semaglutide’s role in treating HFpEF.

The implications of this study for treatment are significant. Semaglutide could be a valuable addition to the therapeutic options for heart failure patients. Its ability to improve quality of life suggests it could become an integral part of the treatment strategy alongside conventional heart failure therapies. 

However, as with any medical study, it’s important to consider potential limitations, such as the duration of follow-up and the need for further research to assess long-term safety and effectiveness. Overall, the use of semaglutide in heart failure patients represents a promising advancement in cardiac care.

In our fast-paced and ever-evolving cardiovascular care landscape, breakthroughs like the Watchman Implant are changing the game, offering new hope to those grappling with NVAFib—a heart condition notorious for increasing the risk of stroke.

In this video, Dr. Imran Baig delves into the intricacies of NVAFib and the innovative solution provided by the Watchman Implant. He sheds light on how the Watchman Implant is transforming the lives of those living with NVAFib, including many of our Connected Cardiovascular Care patients.

In our fast-paced and ever-evolving cardiovascular care landscape, breakthroughs like the Watchman Implant are changing the game, offering new hope to those grappling with NVAFib—a heart condition notorious for increasing the risk of stroke.

In this video, Dr. Imran Baig delves into the intricacies of NVAFib and the innovative solution provided by the Watchman Implant. He sheds light on how the Watchman Implant is transforming the lives of those living with NVAFib, including many of our Connected Cardiovascular Care patients.

Caffeine is known to increase the strength of heart muscle contractions and increase heart rate by a variety of mechanisms. Because of these effects, one of the more common concerns is whether caffeine increases the risk of arrhythmias (abnormal heart rhythms). The simple answer to this question is “no,” at least with a “normal” amount of caffeine intake. 

If you drink less than 400mg of caffeine per day, your risk of certain types of arrhythmias should not increase. Consuming 400mg of caffeine is equivalent to about 5 cups of coffee, depending on the strength of the brew, or approximately 8 cups of brewed tea. Energy drinks, of course, are an entirely different story!

The most recent medical trial involving caffeine and the heart was small (100 participants) but very interesting. The trial’s participants were fitted with a sleep tracker, continuous EKG monitoring, blood sugar monitors, and step counters. They were either allowed to drink caffeine or told to abstain completely. 

The trial found that the participants allowed to drink caffeine did not have an increase in a certain type of arrhythmia called atrial fibrillation (which increases the risk of stroke). It also found that those participants who consumed caffeine got less sleep but walked more during the day – which should not surprise anyone who can barely get out of bed before their first cup of coffee! However, the study did find an increase in premature ventricular contractions in caffeine drinkers. While these “early heartbeats” are usually benign, they can cause symptoms of palpitations or “heart fluttering” and, in rare cases, cause serious heart problems.

Caffeine is also commonly known to raise blood pressure, though this seems to be more of an issue in people who do not drink caffeine regularly. Therefore, drinking a moderate amount of caffeine each day is not likely to have a significant impact on your blood pressure.

If you’re like me, it would be very difficult to give up caffeine altogether. But if you’re concerned about your risk of heart disease, from caffeine or just in general, and want to lower that risk as much as possible, give us a call! We’re ready to partner with you to optimize your heart health!

Newly developed high-tech digital devices, including wearables and sensors, are capable of transmitting reams of individual physiologic data to sophisticated computer platforms armed with complex algorithms. Rich computational science capabilities, including artificial intelligence and prediction analysis technology, can place individual data in the context of data from thousands or even millions of patients.

This creation of a big data predictive model allows for the use of precision medicine and population health risk stratification. New approaches such as eHealth, which uses information and communications technology to support health and health-related fields, and mHealth, a subcategory of eHealth using mobile and wireless technology, are accelerating the shift to digital health for cardiovascular diseases.

Disease management appeared to be the primary focus of digital health companies from 2011 to 2018. More recently, the focus has shifted to earlier prediction of disease, including detection and prevention.

1. Why now? What’s the big deal?

Any large shift in a field begins with interest from various stakeholders long before adoption occurs at the cardiology practice or physician level. When innovators, investors, regulators and payers are all paying attention, physicians should sit up and take note.

Over the past decade, the explosion of interest in digital health has been widely felt across the spectrum of health care stakeholders.

Since the new expedited pathways for digital device approval was rolled out by the U.S. Food and Drug Administration (FDA), venture capital funds have invested billions of dollars, launching thousands of new digital health startups focused on every aspect of the patient and provider health journey.

The Centers for Medicare and Medicaid Services (CMS) started paying for remote physiologic monitoring (RPM) in 2019 and expanded that decision in 2020, building the economic justification of digital health ventures, which will no doubt be of much interest in 2021 and beyond.

COVID-19 changed everything about health care delivery in 2020. Innovative care solutions were sparked by the desire of patients to avoid unnecessary exposure to the novel coronavirus, along with interest in reducing the cost of travel and avoiding long waiting times while increasing communication with clinicians.

Most importantly, the need for fewer face-to-face doctor-patient interactions has accelerated the adoption of remote services and telemedicine. Conservative estimates for telemedicine adoption from 2019 to 2020 suggest an increase of 50- to 175-fold compared with January 2019 levels.

The increase has been significantly enhanced by CMS waivers for certain telehealth regulations.

This newly accepted form of doctor-patient communication creates the immediate need to improve and facilitate vital signs and other physiologic measurements that are difficult to obtain in remote interactions.

Enter the need for wearable technology and platform solutions for distance medical care.

2. What devices should I consider?

The number of wearable devices has exploded in the past five years. Generally, cardiology-related wearables include fitness trackers to digital blood pressure cuffs, weight scales to arrhythmia monitoring systems. Some are connected to a proprietary mobile application, and others are part of a digital solution with a platform that facilitates communication between patients and providers.

Many devices are available directly to consumers and are not FDA-approved. Since many are not considered medical grade (but are vastly popular), the focus here is on reliable devices with accurate data confirmed through rigorous FDA approval.

From a clinician’s standpoint, there are several basic parameters that should be present when considering adoption of physiologic monitoring devices. Is the monitoring device part of a platform? Does it include disease-based physiologic measurements for disease monitoring like blood pressure cuffs, weight scales or oxygen sensors for congestive heart failure?

Does the digital device measure a single parameter that requires a proprietary application (app) without integration into a wider electronic health record (EHR) system or other device?

Current wearable devices and systems include:

• EKG monitoring and arrhythmia detection patches, such as ZioPatch from iRhythm Technologies; CAM patch from Bardy Diagnostics; Bioflux monitor from Biotricity, etc.
• Arrhythmia detection, including atrial fibrillation (AFib, with wristwatch devices, such as Apple Watch, Livmor Halo+ System and Garmin FitBit, and smartphone apps, such as Pulse-Smart, Kardia Mobile, ECG Check, etc.
• Physiologic monitoring via a variety of sensors available to measure heart rate, respiratory rate, SpO2, accelerometers (walk speed), heart rate variability, skin temperature, stress and sleep disorder assessment.
• Remote monitoring systems for cardiovascular-focused conditions like those from intelliH, Biofourmis, CareMindr, Current Health, Hello Heart, Livongo, Medical Innovations, Myia, Orma Health, among others, provide actionable data to stratify patient information and inform clinicians in real time.
• Digital stethoscopes like Coala and EKO can assist clinicians in performing a remote physical examination, enhancing the quality of a telemedicine visit. Additionally, for patients with vascular disease, Siren Care has developed smart socks to check temperature changes and alert clinicians of impending lower extremity ulcerations before they become clinically apparent.

All these devices and their platforms or apps must be customized for your patients and practice workflow.

The challenge for today’s practicing clinician is which device for which patient? A tailored approach to disease state monitoring is recommended, such as congestive HF monitoring using a blood pressure cuff, weight scale and O2 sensor on platforms from IntelliH or Vivify Health.

AFib detection should use a highly sensitive and specific FDA-approved solution platform to reduce false alarms, which can create confusion for patients.

Available systems like the Livmor Halo system, which provides continuous monitoring for asymptomatic patients, or a short-term monitor patch like iRhythm or spot-check monitors such as AliveCor all detect arrhythmias but require an individualized approach determined by clinicians as best for each patient condition.

3. What am I supposed to do with all the data?

As the population ages, the prevalence of chronic disease continues to rise. Simultaneously, tech-savvy generations continue to look to mobile and remote devices to interact with the health care system, just as they have for other business sectors like banking and commerce.

In addition, improved wireless connections and the introduction of 5G technology for cellular connections enable patients and providers to share large amounts of data almost instantaneously.

This real-time exchange of information reduces episodic care costs by proactively identifying at-risk patients through more frequent physiologic monitoring devices, including wearables and other devices.

With appropriate escalation alerts for data, including high/low parameters for blood pressure, weight, oxygen, heart rate, etc., a portal with clearly identified red, green or yellow color-coded alerts (like many systems have adopted) are the best way to create a workflow escalation from medical assistants to nurse practitioners to physicians.

With this set up, the experience at my center has proven a large amount of data to be very manageable for large panels of patients followed by RPM.

4. Does digital health reduce cost and improve outcomes?

Many different methods have been used to determine the impact of digital health on reducing the cost of treatment in cardiology, including direct and indirect methods. One accepted model is the decision analytic-based health technology approach.

Cost-effectiveness and incremental cost per additional quality-adjusted life year (QALY) are frequently cited to derive the impact of an intervention. Fields such as HF and stroke are commonly studied in this space.

Telehealth and telemedicine services have been the most frequently delivered digital intervention, which includes message services, telephone support, mobile apps, video conferencing, wearable medical devices and remote physiologic monitoring.

The TEMA-HF 1 (TElemonitoring in the MAnagement of Heart Failure) study in patients with severe HF provides some data on the effect on mortality and rehospitalization rates of a telemonitoring-facilitated collaboration between general practitioners and a HF clinic.

In the telemonitoring group vs. the usual care group, all-cause mortality was significantly lower (5% vs. 17.5%; p=0.01); follow-up days lost to hospitalization, dialysis or death were significantly lower (13 vs. 30 days; p=0.02); and the number of HF hospitalizations was lower (0.24 vs. 0.42 hospitalizations/patient, p=0.06).

In recent years, more outcomes trials continue to add support to the value of remote monitoring for chronic disease as a means to provide better care and reduce health care costs.

5. Who will pay for all these wearable devices?

Used with permission from Manatt, and available here. Click the image above for a larger view.

The inevitable question is, of course, who is going to pay for it. Medicare and commercial payers have committed to RPM payments through CPT codes established since January 2019.

In 2020, CMS doubled down, saying the agency will pay for several new CPT codes that not only reimburse providers for various types of care they may already be providing, but would open new potential revenue streams to help ease the transition into value-based care.

Code 99453 covers the set-up of devices in an episode of care and patient education, while code 99454 covers the cost of device(s) with daily recording(s) or programmed alert(s) and can be billed every 30 days. These CPT codes offer reimbursement for providing the patient with a device as defined by the FDA.

While CMS may further define the device definition in 2021, it currently remains very broad. Code 99457 covers the first 20 minutes each calendar month of RPM treatment management services of clinical staff/physician/other qualified health care professional time requiring interactive communication with the patient/caregiver during the month.

CMS began paying for CPT code 99458 on Jan. 1, 2020. The new code covers each additional 20 minutes (each calendar month) spent on treatment management services. Also beginning Jan. 1, 2020, CPT codes 99457 and 99458 were designated as care management services by CMS, which means they can be furnished under general rather than direct supervision of the billing provider.

The net effect is that the physician or other qualified health care professional supervising the delivery of RPM services doesn’t have to be located at the same site as the clinical staff delivering them.

Conclusion

Now, more than ever, the barriers to adoption of remote monitoring and digital health have been mostly overcome for cardiologists. There are now solutions for the concerns about increased amounts of data leading to increased workload and lack of workflow integration crippling cardiology practice efficiencies.

Establishment of viable payment options through CMS and other payers for RPM, mitigation of patient concerns over health information privacy using secure portals, greater patient and physician understanding of supporting research proving quality of care through data and science all support increased use of remote monitoring devices.

The future of cardiology and cardiovascular care will no doubt integrate wearable devices, remote monitoring, machine learning, artificial intelligence and algorithms to risk stratify patients as the health care system moves from fee-for-service to a more value-based approach. And 2021 is only the beginning of the digital revolution for cardiology.

Sound scary? Many patients experience significant anxiety associated with their diagnosis and recommendation for TAVR. Here are a few suggestions for managing your anxiety prior to a TAVR procedure:

Keep the Goal in Mind

It’s important to remember that the purpose of TAVR is to live a longer and more fulfilling life. Common symptoms of a diseased aortic valve can themselves cause patients to experience anxiety. These symptoms include chest pain or palpitations, shortness of breath, and lightheadedness- all of which can limit a patient’s activity level and should subside immediately following TAVR.

Just Relax

Practicing relaxation techniques in the form of mindfulness, meditation, or breathing exercises can help patients alleviate anxiety leading up to TAVR. Different techniques work for different people and many free resources are available online and can be sued on a smartphone. It’s important that patients take time to discover what techniques work for them and dedicate time each day to intentionally address their anxiety.

Take Charge

Patients often experience anxiety related to TAVR due to feeling out of control. Yet everyone has the power to control one thing: their lifestyle. Maintaining an adequate sleep schedule and making heart-healthy choices can help to reduce patients’ anxiety and improve recovery from TAVR. A heart-healthy diet should be rich in fruits and vegetable, whole grains, and lean protein while limiting saturated fats and cholesterol. 

Recovery Worries

Although less invasive than open heart surgery, patients worry about recovery time following TAVR. We recommend patients develop a plan for members of their family or support system to offer assistance during their hospital stay and upon their return home. Knowing who will water the plants, take out the trash, and prepare meals can provide peace of mind and reduce stress prior to TAVR.

Pain and physical limitations following TAVR can be another source of anxiety for patients. It is common for patients to experience mild pain at the incision site for a few days following the procedure. It takes time to fully recover from TAVR, but most patients can gradually return to normal daily activities in a matter of weeks.

We at Connected Cardiovascular Care Associates are committed to providing the highest level of care to our patients- in diagnosis, treatment, and support. Should you have any questions regarding TAVR or are experiencing anxiety associated with a scheduled TAVR procedure, please let us know. Our C3 Team is here to support you and your heart health.

https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2724778

Researchers from Harvard and Indiana Universities assessed the “push-up” capacity of over 1000 male firefighters in Indiana. They divided these men into 5 categories based on the number of push-ups they were able to complete without stopping: 0-10, 11-20, 21-30, 31-40, and >40. The men were followed for 10 years and assessed for the development of cardiovascular disease.

Researchers found that the more push-ups the subjects were able to do, the less likely they were to develop cardiovascular disease. Specifically, those subjects who could do more than 40 push-ups in one attempt had a 96% lower chance of developing cardiovascular disease compared to those who could do less than 10 push-ups. The subjects who could do the most push-ups also had lower blood pressure, less diabetes, better cholesterol profiles, and were less likely to smoke (all of which may have contributed to their better cardiovascular health).

Can’t manage 40 push-ups in a row? There’s good news! Even those subjects who could do greater than 10 pushups had a much lower incidence of cardiovascular disease than those who could do less than 10.

It’s important to emphasize that this study was done in an overall young, healthy, and physically fit population. But it still highlights the importance of strength training in addition to aerobic exercise, good nutrition, control of blood pressure, and control of cholesterol in preventing cardiovascular disease.

We at C3 are dedicated to your heart health in every phase of life. If you have cardiovascular health concerns, or just want some advice about your heart health, schedule an appointment with us today! Now, I’m going to go do some push-ups.

Currently, one of the most talked-about crazes is the ketogenic diet. This is not an entirely new fad (remember Atkins? that was essentially a less restrictive ketogenic diet), but it has recently exploded in popularity. If you search “ketogenic” on amazon.com, you’ll return over 20,000 results and likely see ads for ketogenic products every subsequent time you use the internet.

So what is the ketogenic diet? Does it “work”? The answer to the first question is easy. The answer to the second question is…complicated.

The ketogenic diet can take on a few different forms. A sample ketogenic diet will be heavy in meat, butter, cheese, yogurt, eggs, and vegetables; and lacking in cereals, breads, pasta, starches, etc. At its core, this diet centers around restricting carbohydrates and replacing them with dietary fat in the form of triglycerides. In the classic ketogenic diet, 90% of all calories should come from fat. Most people following a ketogenic diet will use a “modified form” of the diet, where medium-chain triglycerides are used as the fat source. Medium-chain triglycerides are abundant in palm and coconut oil, which explains why these oils are so popular today. These oils are also more easily absorbed, so less total fat intake is needed.

Many people who follow the ketogenic diet find it difficult to stick with the meal plan for reasons of cost, variety of foods, gastrointestinal distress, etc. These factors are even a challenge for patients enrolled in clinical studies of the diet, causing adherence to the diet to wane over time. This makes the data even more difficult to interpret, along with the fact that some patients restrict calories and experience weight loss while others do not restrict their caloric intake and either maintain their current weight or even gain weight. These factors make it incredibly challenging to develop generalizations about the risks/benefits of ketogenic diets.

Here is what we can say with reasonable certainty: The ketogenic diet will worsen your cholesterol profile if you increase your saturated fat intake, specifically raising your LDL cholesterol (“bad cholesterol”) and your non-HDL cholesterol (“also bad cholesterol”). These are significant risk factors for the development of cardiovascular disease, including heart attacks, strokes, and peripheral arterial disease. If you have diabetes, the ketogenic diet may improve the long term control of your blood sugars and may help you lose weight, but this is an unclear effect overall and subject to a large degree of variation from person to person. Many studies focused on weight loss follow patients for a short duration of a few months, which is not long enough to make firm conclusions regarding this diet long-term.

On the balance, it is difficult to recommend a ketogenic diet purely from a cardiovascular health perspective.

Phew! That is a lot to digest (pun intended). We at Connected Cardiovascular Care Associates are deeply committed to improving your heart health at every stage of life. If you have concerns about your risk for developing cardiovascular disease, or if you have already been diagnosed with cardiovascular disease, we are excited to partner with you to help keep your heart as healthy as possible.

For further reading on this topic, see:

https://www.health.harvard.edu/

https://www.lipidjournal.com

Northwestern University’s February 2020 study (https://news.northwestern.edu/stories/2020/02/hot-cocoa-aids-walking-in-peripheral-artery-disease/) showed an improvement in walking distance of patients with peripheral arterial disease who drank hot cocoa. The clinical trial only studied 44 patients but was conducted with good scientific rigor.  Participants over 60 years old who consumed at least one tablespoon of cocoa three times a day showed a 20% improvement in walking distance.  This means participants who consumed cocoa (which contains the active ingredient epicatechin, a flavanol) walked approximately 42.6 meters (140 feet) further than those participants who did not consume cocoa.

This news of cocoa being of some benefit with peripheral arterial disease, coupled with the previously published benefit of red wine in cardiovascular disease, has led to great interest in the cardiovascular patient community!

On a more serious note, as of July 2018 the Centers for Medicare and Medicaid Services approved payment for Medicare beneficiaries for Supervised Exercise Therapy for Symptomatic Peripheral Arterial Disease (https://www.cms.gov/medicare-coverage-database/details/ncd-details.aspx?NCDId=371&ncdver=1&bc=AAAAgAAAAAAA&). This consists of sessions lasting 30-60 minutes that are conducted in an outpatient setting or a physician’s office. Our Connected Cardiovascular Care team fully supports this program and would love to help our patients get registered to participate, if appropriate.

The nurses, doctors and staff at Connected Cardiovascular Care Associates are dedicated to the treatment of peripheral arterial disease, and we will continue to share encouraging articles about walking, exercise, risk factor reduction and general wellbeing with our patients at C3. Check back soon as we continue our Medical Monday blog post series and bring you the latest news in cardiovascular health.

Dr. Tony Das is the only dual-board-certified interventional cardiologist (cardiology and endovascular) listed for 16 consecutive years as Best Cardiologists in Dallas by D Magazine. Dr. Das started Connected Cardiovascular Care Associates, the first cardiology practice in the U.S. dedicated to offering personalized remote physiologic monitoring for cardiovascular patients through telemedicine avoiding in-person visits during the pandemic and beyond. Dr. Das conducts a second opinion clinic, serves as the regional medical director, peripheral vascular interventions, innovation and Digital health for the BSW Heart Hospitals and is an active member of the American College of Cardiology committee for Innovation in the Wearables and Devices Section. He helped launch Vascular Interventional Advances.

EDUCATION

M.D., Baylor Medical School; Residency, Harvard Massachusetts General Hospital; Fellowship, Texas Heart Institute; LEAD Corporate Innovation Program, Stanford Business School

CONNECTED CARDIOVASCULAR CARE ASSOCIATES
12740 Hillcrest Road, Suite 265
Dallas, Texas 75230

1005 W. Ralph Hall Parkway, Suite 225 Rockwall, Texas 75032

214.814.1550 texasc3.com

So, what is it?

Atrial fibrillation is a specific type of abnormality in the electrical conduction system of the heart (“arrhythmia”). Normally, the electrical signals that result in a heartbeat follow a precise and defined route through the heart. In atrial fibrillation, this route is disrupted by a different electrical signal coming from the top chambers of the heart, or the “atria”. Because the electrical signals are not regular, the heart does not beat in rhythm.

Are there symptoms?

Some people can sense heartbeat irregularity and experience what we call “palpitations,” which can be described as the heart skipping beats, beating too fast, or beating too hard. For others, the only symptoms of atrial fibrillation are vague and can include fatigue, loss of energy, and shortness of breath. It is also possible to have no symptoms at all and discover atrial fibrillation through an EKG test, which is a 10 second snapshot of the heart’s electrical activity.

What are AFib risks and treatment?         

The risk factors for atrial fibrillation are generally the same as the overall risk factors for heart disease: smoking, high blood pressure, increased age, obesity, heavy alcohol use, stress, etc. Controlling these factors can decrease your risk of developing atrial fibrillation. There are also several medications for this arrhythmia, both designed to slow down the heart rate and to keep the heart in normal rhythm. For some patients, we may recommend an electrical shock procedure to restore normal heart rhythm. While for others, we may recommend a procedure called an ablation, which can eliminate the abnormal electrical signals responsible for atrial fibrillation. In addition, we may recommend blood thinning medications, as atrial fibrillation increases your risk of stroke.  

Have you been diagnosed with atrial fibrillation? Are you concerned about your risk for atrial fibrillation? Make an appointment with us at Connected Cardiovascular Care Associates to discuss your diagnosis and treatment options!

For further reading on atrial fibrillation, visit:

https://my.clevelandclinic.org/health/diseases/16765-atrial-fibrillation-afib