In episode 416, James and Mike talk about the recently released CABANA study, the largest and longest trial done on catheter ablation for symptomatic atrial fibrillation. We find that in general the ablation group had fewer negative clinical outcomes and an improved quality of life. At the end we briefly discuss a paper that evaluated the level of evidence that supports the ~ 6000 recommendations in the cardiology guidelines from ACC/AHA/ESC.

Show notes

1) Effect of Catheter Ablation vs Antiarrhythmic Drug Therapy on Mortality, Stroke, Bleeding, and Cardiac Arrest Among Patients With Atrial Fibrillation: The CABANA Randomized Clinical Trial

JAMA. 2019 Mar 15. doi: 10.1001/jama.2019.0693

2) Effect of Catheter Ablation vs Medical Therapy on Quality of Life Among Patients With Atrial Fibrillation The CABANA Randomized Clinical Trial

JAMA. 2019 Mar 15. doi: 10.1001/jama.2019.0692

3) Levels of Evidence Supporting American College of Cardiology/American Heart Association and European Society of Cardiology Guidelines, 2008-2018

JAMA. 2019 Mar 19;321(11):1069-1080. doi: 10.1001/jama.2019.1122

In episode 415, Mike and James continue with an overview of the evidence around depression. In this episode we talk about the use of antipsychotics for depression or augmentation of antidepressants, stopping antidepressants and the chances of withdrawal, and non-medication treatments.

Show notes

Handout

In episode 414, Mike and James continue with an overview of the evidence around depression. In this episode we talk about antidepressant management nuances from lower doses, to dose escalation, switching, and the time to response.

Show notes

Handout