AFIB SUMMIT 2015

1. Joe Perez, D.O.
• Cardiologist at Cardiovascular
Group/Gwinnett Medical Group
• Board Certified in Internal
medicine.
• Cardiology fellowship at Nova
Southeastern
University/Palmetto General
Hospital in Hialeah
• Special interests include:
Adult echocardiography and
transesophageal
echocardiography, as well as
nuclear cardiology.
Medical School:
Nova Southeastern
University
Residency:
Mount Sinai Medical
Center
Fellowship:
Nova Southeastern
University

2. C R Y P T O G E N I C S T R O K E
JOSEPH PEREZ DO

3. S T R O K E D E N I N I T I O N
T O A S T
C L A S S I F I C A T I O N
AFIB SUMMIT

4. • Hemorrhagic
• Ischemic

5. ISCHEMIC
• Small vessel
• Large vessel athero embolism
• Embolic
• Systemic hypo perfusion

7. • Cryptogenic stroke
• Definition
• Importance
• Implication

8. • Role of undiagnosed atrial fibrillation
• Impact
• Challenges of detection
• Empiric treatment not feasible

9. Challenges in detection
• Intermittent nature
• Duration of monitor
• Inconvenience
• Invasive

10. • invasive nature of more prolonged monitoring vs
unknown yield
• fairly rare to detect with conventional monitoring
• Data from pacemakers gave us some idea

11. • Conventional strategy
• Embrace
• Crystal AF

31. QUESTIONS

32. Which of these patients meets the
criteria for cryptogenic stroke
according to the Toast classification?
a) Hypertensive patient with a sub cortical
stroke
b) patient with intra ventricular bleed and
midline shift
c) patient with multi territory infarct found to
have left atrial appendage clot on trans
esophageal echocardiogram
d) patient with multi territory stroke, atrial
fibrillation and evidence of significant
ipsilateral common carotid obstruction
e) none of these

33. How many patients are diagnosed with
cryptogenic stroke are diagnosed
yearly in the US?
a) 50,000
b) 150,000
c) 250,000
d) 500,000

34. Of these, what percentage are
preventable with adequate
thromboembolic prophylaxis?
a) 25%
b) 40%
c) 50%
d) 70%
e) 100%

35. Implanting a Reveal Linq will preclude
MRI for How long?
a) The device is not MRI compatible
b) you must wait 2 weeks
c) you must wait one month
d) there is no wait time, MRI may be performed at
any time post implantation

36. what percentage of eligible
patients were placed on
anticoagulant therapy post afib
detection?
a) 50%
b) 80%
c) 90%
d) 100%

37. QUESTIONS?