Stroke Prevention in Atrial Fibrillation
Why is this important?
This module, Stroke Prevention in Atrial Fibrillation, addresses three primary strategies for reducing stroke: (1) diagnosis of atrial fibrillation (AF), (2) AF anticoagulation therapy, and (3) referral of complex AF patients for consultation with a cardiologist or electrophysiologist when it is clear that desired patient outcomes are not being met with prescribed therapy.
- Stroke is the leading preventable cause of disability in the United States.
- Stroke risk persists in patients with atrial fibrillation regardless of symptoms and/or rhythm management.
- Significant gaps exist in treating atrial fibrillation for the prevention of stroke.
- Anticoagulation can reduce the risk of stroke by 60 to 80 percent.
- Up to two-thirds of AF patients who had strokes were not prescribed anticoagulants or blood thinners.
How will these tools help?
- The tools may increase the comfort level of primary care physicians initiating anticoagulation.
- The tools help clinicians consider anticoagulation sooner in patients who are found to have atrial fibrillation with at least one risk factor for stroke.
- The tools help clinicians consider referral to cardiologist or electrophysiologist when it is clear that desired patient outcomes (rate, rhythm or symptom control) are not being met with prescribed therapy.
- Recognize atrial fibrillation in patients not yet diagnosed with the disorder, including those with comorbidities such as sleep apnea and thyroid disorders
- Apply the CHADS2; CHA2DS2-VASC; and HAS-BLED risk scoring systems to determine appropriate anticoagulation therapy based upon individual risk of stroke and bleeding
- Effectively communicate with patients regarding the pros and cons of different anticoagulation strategies; the risk of stroke and bleeding; and the importance of lifelong adherence to the prescribed therapy
- Refer appropriate patients to a cardiologist or electrophysiologist for consultation as soon as it is clear that desired patient outcomes for rate or rhythm control, symptom relief or stroke risk reduction are not being met with prescribed therapy.
Grant funding for this module was provided by Bristol-Myers Squibb
Practice Advisor Content Manager:
Jillian Schneider, MHA, Manager Practice Support, American College of Physicians
Andrew Dunn, MD, MPH, SFHM, FACP, Professor of Medicine, Chief, Division of Hospital Medicine, Mount Sinai Health System
Marcin Kowalski, MD, MBA, FACC, FHRS, Director of Cardiac Electrophysiology, Associate Director of Cardiology Fellowship Program, Staten Island University Hospital, Northwell Health System
Tara Parham, MSN, CRNP, Acute Care Nurse Practitioner, Cardiac Electrophysiology, Hospital of the University of Pennsylvania
Laura Blum Meisnere, Vice-President, Health Policy, Heart Rhythm Society
Michele Duchin-Watson, Associate, Center for Quality, American College of Physicians
Jillian Nash-Arot, Associate, Center for Patient Partnership in Healthcare, American College of Physicians
Wendy Nickel, MPH, Director Center for Patient Partnership, American College of Physicians
Anne Marie Smith, MBA, Vice-President, Quality Improvement Education, Heart Rhythm Society
Selam Wubu, MPH, Senior Associate, Center for Quality, American College of Physicians
The following have disclosed relationships with commercial companies or organizations:
Andrew Dunn, MD, MPH, SFHM, FACP
Bristol-Myers Squibb, Pfizer
Marcin Kowalski, MD, MBA, FACC, FHRS
Medtronic, St. Jude
All other individuals listed (manager, contributors, editors) have nothing to disclose.
The American College of Physicians is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians.
The American College of Physicians designates this PI CME activity, ACP Practice Advisor® module Stroke Prevention in Atrial Fibrillation, for a maximum of 20 AMA PRA Category 1 CreditsTM. Physicians should claim only the credit commensurate with the extent of their participation in the activity.
Successful completion of this CME activity, which includes participation in the evaluation component, enables the participant to earn up to 20 medical knowledge and practice assessment MOC points in the American Board of Internal Medicine’s (ABIM) Maintenance of Certification (MOC) program. Participants will earn MOC points equivalent to the amount of CME credit claimed for the activity. It is the CME activity provider’s responsibility to submit participant completion information to ACCME for the purpose of granting ABIM MOC credit.
Release Date: 6/29/2017
Termination Date: 6/29/2017
*To earn CME credit, you must attest after completion of the second module biopsy that you have:
- participated in the completion of the ACP Practice Biopsy
- participated in the review of the ACP Practice Biopsy results
- participated in identifying an action plan to improve our practice
- participated in the implementation of the plan
- participated in the follow-up ACP Practice Biopsy to measure improvement
When you have done so, follow the on-screen instructions to complete and submit the submission form.
- 20.00 AMA PRA Category 1 Credit™
- 1.00 Attendance
- 20.00 ABIM MOC