The most common sustained arrhythmia, with an ever-increasing prevalence in our population, atrial fibrillation demands prompt and effective intervention.
 
In this edition of GP Connect, we review the key issues GPs need to know: the basic principles of AF management; pharmacologic alternatives to warfarin anticoagulation; and left atrial appendage occlusion devices, a non-pharmacologic stroke prevention strategy for patients in whom oral anticoagulation is considered an unacceptably high bleeding risk.
 

Access the online version of GP Connect Autumn 2012 here.

What is new in AF? Introduction from Dr Bill Petrellis

In this short video, Sydney Cardiology’s Dr Bill Petrellis introduces the Autumn 2012 issue of GP Connect. From key developments and news in atrial fibrillation to upcoming training opportunities with Sydney Cardiology, Dr Petrellis outlines the prime issues in AF that Australian GPs need to know.

Hypertension is a burden for so many people and in this issue we look at why recognising it and treating it is important, how Sydney Cardiology services address it, and the CPD events and online training that focus on the subject.

You can access the online version of GP Connect here.

Why is hypertension so difficult to treat?

In this short video, Sydney Cardiologist Dr James Wong says that not only is hypertension the major player in the spectrum of cardiovascular disease but the startling fact is that most people with hypertension are either unaware of their elevated blood pressure or if diagnosed are undertreated.

Did you know that about 50% of acute myocardial infarctions (AMIs) occur in people with no known history of symptomatic coronary artery disease (CAD)? Of these 40% will die. And with an AMI occurring every 11 minutes that’s more than three times the number of deaths attributed to the March 2011 Japanese earthquake and tsunami.

It’s well understood from autopsy studies, and more recently by a new intracoronary imaging technique (optical frequency domain imaging) that CAD involves rupture of atherosclerotic plaques covered by a thin fibrous cap (‘vulnerable plaque’) and superimposed thrombus.

However, it is increasingly recognised that the issue is not the ‘vulnerable plaque’ but the ‘vulnerable patient’ – the patient with underlying, undetected and untreated subclinical, asymptomatic atherosclerotic CAD.

These are the patients with a ticking time bomb who often have no idea that they may be at risk.

How can early atherosclerotic disease be diagnosed? The answer is that there have recently been huge advances in this area. Read more about two of these developments – coronary calcium scoring and CT coronary angiography – in the attached clinical review.

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Learning objectives

In this module, the use of various tools to better assess hypertension will be discussed and the management of obstructive sleep apnoea, secondary hypertension and resistant or difficult to control hypertension will be the focus of the education.

At the completion of this active learning module participants will be able to:

1. Recall new options for diagnosing hypertension.
2. Define patients with difficult to treat hypertension.
3. Systematically identify possible options for the management of difficult to control hypertension.
4. Define patients with secondary causes of hypertension.
5. Systematically identify possible options for the management of patients with secondary causes of hypertension.
6. Understand the cardio metabolic consequences of obstructive sleep apnoea.

What to do

1. Please complete Part 1 and Part 2 of the module. These are interactive, Flash-based presentations with embedded reading materials, video, case studies and quizzes. The module is viewable in any browser but not on an iPad, as it doesn’t support Flash.
2. After you have completed both parts, please complete the feedback form. It will be emailed to Sydney Cardiology who in turn will send your details to the RACGP. The RACGP will then issue your 40 CPD points.  

Please note that you do not need to complete this activity in one sitting. You can close the activity at any time and any answers you have submitted will be saved.

If you have any problems please email: cpd@sydneycardiology.com.au.