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Guideline Education: Identifying, Investigating, and Treating Acute Limb Ischemia
August 13, 2018 | CME 0.25 CNE 0.25 COP 0.25 MOC 0.25

This activity was planned with a goal to change your competence in classifying and managing ALI according to the latest guidelines. This case was created in response to the 2016 AHA/ACC Guideline on the Management of Patients With Lower Extremity Peripheral Artery Disease.

Cardio-oncology Case Series: Radiation-induced CAD and Pericardial Disease
August 8, 2018 | CME 0.25 CNE 0.25 COP 0.25 MOC 0.25

This activity was planned with a goal to change your competence in identifying, diagnosing, and treating patients with radiation-induced heart disease. This case is part of the Cardio-oncology Case Series.

Screening for PAD: When and How
July 31, 2018 | CME 0.50 MOC 0.50 COP 0.50

This activity was planned with a goal to change your competence in screening for peripheral artery disease (PAD).

Initiating Medical Therapy for PAD Patients
July 31, 2018 | CME 0.25 MOC 0.25 COP 0.25

This activity was planned with a goal to change your competence in medical therapy for peripheral artery disease (PAD).

Multivessel PCI for Nonculprit Lesions in STEMI/ACS
July 13, 2018 | CME 0.25 CNE 0.25 COP 0.25 MOC 0.25

This activity was planned with a goal to advance your performance by updating your competence in the appropriateness of immediate revascularization of nonculprit lesions in the setting of STEMI/ACS. This case was created in response to the 2016 Appropriate Use Criteria for Coronary Revascularization in Patients With Acute Coronary Syndromes.

Management of DAPT in Patients Scheduled for Elective Noncardiac Surgery
July 2, 2018 | CME 0.25 COP 0.25 MOC 0.25

This activity was planned with a goal to better understand the peri-operative management of dual antiplatelet therapy. This case was created in response to the Clinical Focus Session at ACC.18 - DOACs Beyond AF: Management Strategies for VTE.

Guideline Education: Management of Congenital Long QT Syndrome (LQTS)
June 28, 2018 | CME 0.25 COP 0.25 MOC 0.25

This activity was planned with a goal to change your performance in treating patients with congenital LQTS. This case was created in response to the 2017 AHA/ACC/HRS Guidelines for Management of Patients with Ventricular Arrhythmias and Prevention of Sudden Cardiac Death.

Oral Anticoagulant Therapy in the Setting of Dual Antiplatelet Use
June 21, 2018 | CME 0.25 COP 0.25 MOC 0.25

This activity was planned with a goal to better understand the options for management of dual-antiplatelet therapy in patients requiring oral anticoagulant therapy. This case was created in response to the Clinical Focus Session at ACC.18 - DOACs Beyond AF: Management Strategies for VTE.

Chronic Total Occlusion (CTO) in Patients with Stable Ischemic Heart Disease
June 18, 2018 | CME 0.25 COP 0.25 MOC 0.25

This activity was planned with a goal to improve your competence in treating patients with CTO.

Lifelong Care of Patients With a Fontan Circulation
June 5, 2018 | CME 0.25 COP 0.25 MOC 0.25

This activity was planned with a goal to change your competence in treating patients with Fontan circulation especially, Fontan-associated liver disease. This case was created in response to the Fontan-Associated Liver Disease: Proceedings From the American College of Cardiology Stakeholders Meeting.

Cardio-oncology Case Series: Radiation-induced Heart Disease
May 29, 2018 | CME 0.25 CNE 0.25 COP 0.25 MOC 0.25

This activity was planned with a goal to change your competence in identifying, diagnosing, and treating patients with radiation-induced heart disease. This case is part of the Cardio-oncology case series.

Guideline Education: Preventing Sudden Death in Patients with ARVC
May 21, 2018 | CME 0.25 CNE 0.25 COP 0.25 MOC 0.25

This activity was planned with a goal to raise your competence in preventing sudden death in patients with arrhythmogenic right ventricular cardiomyopathy. This case was created in response to the 2017 AHA/ACC/HRS guidelines for Management of Patients with Ventricular Arrhythmias and Prevention of Sudden Cardiac Death.

Guideline Education: Diagnosis and Management of Hypertension
May 14, 2018 | CME 0.25 CNE 0.25 COP 0.25 MOC 0.25

This activity was planned with a goal to change your competence in treating patients with hypertension. This case was created in response to the 2017 ACC/AHA/et al Guideline for the Prevention, Detection, Evaluation and Management of High Blood Pressure in Adults.

Imaging Case Series: Diagnosis of Acute Myocarditis (Cardiac MRI)
May 7, 2018 | CME 0.25 CNE 0.25 COP 0.25 MOC 0.25

This activity was planned with a goal to change your competence in the evaluation of patients with myocarditis. This case is part of the Imaging Case Series.

Cardio-oncology Case Series: CVD in Long-term Cancer Survivors
April 27, 2018 | CME 0.25 COP 0.25 MOC 0.25

This activity was planned with a goal to change your competence in recognizing the incidence and prevalence of cardiovascular disease in long-term cancer survivors. This case is part of the Cardio-oncology case series.

Treating Heart Failure in the African American Patient
April 18, 2018 | CME 0.25 COP 0.25 MOC 0.25

This activity was planned with a goal to change your competence in treating HF in African Americans. This case is in response to the Cardiovascular Health in African Americans: A Scientific Statement From the American Heart Association.

Guideline Education: Evaluating and Treating Ventricular Arrhythmias
April 16, 2018 | CME 0.50 CNE 0.50 COP 0.50 MOC 0.50

This activity was planned with a goal to improve your competence in evaluating and treating ventricular arrhythmias. This case is in response to the 2017 AHA/ACC/HRS Guideline for Management of Patients With Ventricular Arrhythmias and the Prevention of Sudden Cardiac Death.

Professionalism Case Series: Equitable Care and Microaggressions Against Learners
April 4, 2018 | CME 0.25 COP 0.25 MOC 0.25

This activity was planned with a goal to change your competence in utilizing resources in an ethical manner. This case is part of the Professionalism Case Series.

Cardio-oncology Case Series: Recognize and Reduce Radiation Exposure in CCTA
March 27, 2018 | CME 0.25 CNE 0.25 COP 0.25 MOC 0.25

This activity was planned with a goal to improve your competence in discussing radiation exposure from CCTA with patients, and in reducing their concerns that CCTA is associated with an unacceptably high exposure. This case is part of the Cardio-oncology case series.

Women and Heart Disease Case Series: Atrial Fibrillation and Stroke Prevention
March 22, 2018 | CME 0.25 CNE 0.25 COP 0.25 MOC 0.25

This activity was planned with a goal to change your competence in treating patients with atrial fibrillation. This case is part of the Women and Heart Disease case series.

Imaging Case Series: Pleural and Pericardial Effusion on Nuclear Stress Test (Nuclear)
March 16, 2018 | CME 0.25 MOC 0.25 COP 0.25

This activity was planned with a goal to change your competence in identifying indications of nuclear stress testing, and recognizing the pattern of defect caused by a pleural effusion and by a pericardial effusion on a nuclear stress test. This case is part of the Imaging Case Series.

Guideline Education: Treating Hypertension in the African American Patient
March 5, 2018 | CME 0.25 CNE 0.25 MOC 0.25 COP 0.25

This activity was created with a goal to augment your competence in treating hypertension in African Americans. This case is in response to the 2017 ACC/AHA/AAPA/ABC/ACPM/AGS/APhA/ASH/ASPC/NMA/PCNA Guideline for the Prevention, Detection, Evaluation, and Management of High Blood Pressure in Adults.

69-Year-Old Woman with Stroke 2 Weeks After TAVR
February 26, 2018 | CME 0.5 CNE 0.5 MOC 0.5 COP 0.5

This activity was created with a goal to enhance competence in treating patients who had a transcatheter aortic valve replacement (TAVR) procedure. This case is in response to the 2017 Appropriate Use Criteria for Multimodality Imaging in Valvular Heart Disease.

Cardio-oncology Case Series: Radiation Exposure of Imaging Modalities for Chest Pain
February 20, 2018 | CME 0.25 MOC 0.25 COP 0.25

This activity was created with the goal of increasing your competence in understanding radiation exposure of imaging modalities used to evaluate low- to intermediate-risk chest pain and associated risk factors. This case is part of the Cardio-oncology Case Series.

Role of Ezetimibe in Secondary Prevention of CAD
February 13, 2018 | CME 0.25 MOC 0.25 COP 0.25

This activity was created with a goal to change your competence in recognizing the role of ezetimibe in the secondary prevention of coronary artery disease as presented in the 2017 Focused Update of the 2016 American College of Cardiology Expert Consensus Decision Pathway on the Role of Non-Statin Therapies for LDL-Cholesterol Lowering in the Management of Atherosclerotic Cardiovascular Disease Risk.

Women and Heart Disease Case Series: Acute Myocardial Infarction
February 2, 2018 | CME 0.5 MOC 0.5 COP 0.5 CNE 0.5

This activity was created with a goal to change your competence in treating acute myocardial infarction (AMI) in women, and to familiarize you with the American Heart Association Scientific Statement on AMI in Women. This case is part of the Women and Heart Disease case series.

Cardiac Magnetic Resonance Imaging for the Assessment of MR
January 29, 2018 | CME 0.25 MOC 0.25 COP 0.25

This activity was created with a goal to improve your competence in assessing asymptomatic patients with mitral regurgitation. This case is in response to the ACC/AATS/AHA/ASE/ASNC/HRS/SCAI/SCCT/SCMR/STS 2017 Appropriate Use Criteria for Multimodality Imaging in Valvular Heart Disease.

Guideline Education: Management of Ventricular Arrhythmias in Ischemic Heart Disease
January 23, 2018 | CME 0.25 MOC 0.25 COP 0.25

This activity was created with a goal to improve competence in treating patients with ventricular arrhythmias in the setting of ischemic heart disease. This case is in response to the 2017 AHA/ACC/HRS Guideline for Management of Patients With Ventricular Arrhythmias and the Prevention of Sudden Cardiac Death.

Guideline Education: Non-Pharmacologic Management of Hypertension
January 15, 2018 | CME 0.25 CNE 0.25 MOC 0.25 COP 0.25

This activity was created with a goal to give the reader a structured way to change your competence in the nonpharmacologic treatment of patients with hypertension. This case is in response to the 2017 Blood Pressure Guidelines.

Imaging Case Series: ECG-Gated SPECT Imaging: Nuclear Curriculum (Nuclear)
January 8, 2018 | CME 0.25 MOC 0.25 COP 0.25

This activity was created with a goal to give the reader a structured way to evaluate gated nuclear SPECT images, identify potential areas of acquisition and interpretation error, and provide tools to improve patient management through use of ECG gating. This case is part of the Imaging Case Series.

Guideline Education: Asymptomatic Patient Presents with Severe Primary Mitral Regurgitation
December 20, 2017 | CME 0.25 MOC 0.25 COP 0.25

This activity was created with a goal to change your competence in treating patients with severe primary mitral regurgitation. This activity was created in response to the 2017 AHA/ACC Focused Update of Valvular Heart Disease Guideline.

Atrial Fibrillation Ablation: Management of Anticoagulation
December 18, 2017 | CME 0.5 CNE 0.5 MOC 0.5 COP 0.5

The overall goal of this CME certified, online activity is to educate the learner about the management of anticoagulation during an atrial fibrillation ablation procedure.

Medical Therapy for Heart Failure with Preserved Ejection Fraction
December 12, 2017 | CME 0.25 MOC 0.25 COP 0.25

The overall goal of this CME certified, online activity is to change your competence in treating patients with HFpEF. This case was created in response to the 2017 ACC/AHA/HFSA Focused Update of the 2013 ACCF/AHA Guideline for the Management of Heart Failure.

TAVR in Intermediate Surgical Risk Category Patients
December 4, 2017 | CME 0.5 CNE 0.5 MOC 0.5 COP 0.5

This activity was created with a goal to present findings from a recent clinical trial, which further establishes TAVR in intermediate-surgical risk patients, and expands experience to include a self-expanding prosthesis.

ACHD Case Series: Truncus Arteriosus and Prior Rastelli Procedure
November 30, 2017 | CME 0.25 MOC 0.25 COP 0.25

The overall goal of this CME certified, online activity is to change your competence in monitoring and treating patients with truncus arteriosus. This case is part of the ACHD Case Series.

Guideline Education: Evaluation and Management of Athletes With Syncope
November 24, 2017 | CME 0.5 MOC 0.5 COP 0.5

This activity was created with a goal to change your competence in recognizing arrhythmic causes of syncope and evaluating and managing athletes with suspected syncope. This case was created in response to the 2017 ACC/AHA/HRS Guideline for the Evaluation and Management of Patients with Syncope.

The Pregnant Patient With Heart Disease
November 17, 2017 | CME 0.5 MOC 0.5 COP 0.5

This activity was created with a goal to change your competence in treating women with heart disease during pregnancy. This case was created in response to the Management of Pregnancy in Patients With Complex Congenital Heart Disease: A Scientific Statement for Healthcare Professionals From the American Heart Association.

Assessment and Management of STEMI Post-Thrombolytics
November 10, 2017 | CME 0.25 MOC 0.25 COP 0.25

This activity was created with a goal to improve competence in managing patients with ST-segment elevation myocardial infarction after administration of thrombolytic agents. This case was created in response to the ACC/AATS/AHA/ASE/ASNC/SCAI/SCCT/STS 2016 Appropriate Use Criteria for Coronary Revascularization in Patients With Acute Coronary Syndromes.

Biomarkers for Heart Failure Prevention and Risk Stratification
October 31, 2017 | CME 0.25 MOC 0.25 COP 0.25

This activity was planned with a goal to familiarize learners with the role of biomarkers in heart failure prevention and risk stratification, as described in the 2017 ACC/AHA/HFSA Focused Update Guideline for the Management of Heart Failure.

Treatment and Management of Venous Thromboembolic Disease
October 26, 2017 | CME 0.25 MOC 0.25 COP 0.25

This activity was planned with a goal to change your competence in the management of venous thromboembolism.

FOURIER: Utilizing PCSK9 Inhibitor Therapy for Secondary Prevention Patients
October 14, 2017 | CME 0.25 MOC 0.25 COP 0.25

This activity was planned with a goal to change your competence in utilizing PCSK9 inhibitor therapy for secondary prevention patients.

Imaging Case Series: Multimodality Imaging Evaluation of an Abnormal ECG (Cardiac MRI)
October 10, 2017 | CME 0.25 MOC 0.25 COP 0.25

This activity was created with a goal to improve the clinical recognition of the apical variant of hypertrophic cardiomyopathy and its associated high-risk features that are associated with clinical adverse outcomes (increased risk of strokes, ventricular arrhythmias, heart failure, and sudden death). This case is part of the Imaging Case Series.

Professionalism Case Series: Inappropriate Treatment of Subordinates
October 4, 2017 | CME 0.25 MOC 0.25 COP 0.25

This activity was planned with a goal to improve your competence in managing lapses in professionalism that occur during interactions among fellows-in-training and supervising cardiologists. This case is part of the Professionalism Case Series.

ACHD Case Series: Single Ventricle Physiology with a History of Fontan Operation
September 29, 2017 | CME 0.25 MOC 0.25 COP 0.25

The overall goal of this CME certified, online activity is to change your competence in monitoring and treating patients with single ventricle physiology with a history of Fontan operation. This case is part of the ACHD Case Series.

Identifying and Treating Frail Patients with Aortic Stenosis with TAVR
September 28, 2017 | CME 0.5 CNE 0.5 MOC 0.5 COP 0.5

This activity was created with a goal to improve competence in identifying patients that are appropriated for TAVR, as well as treating frail patients with aortic stenosis by TAVR. This case was created in response to the 2017 ACC Expert Consensus Decision Pathway for Transcatheter Aortic Valve Replacement in the Management of Adults With Aortic Stenosis.

The Heart Team Approach in Patients with Unprotected Left Main CAD
September 19, 2017 | CME 0.25 MOC 0.25 COP 0.25

This activity was created with a goal to advance your competence in treating patients with unprotected left main CAD, and to improve your communication skills when using the Heart Team approach to providing the best possible care to each individual patient.

Imaging Case Series: SPECT Imaging With Prone Positioning (Nuclear)
September 14, 2017 | CME 0.25 MOC 0.25 COP 0.25

This activity was created with a goal to help improve your competence in interpreting nuclear SPECT studies. This case is part of the Imaging Case Series.

Guideline Education: A 19-Year-Old Basketball Player Presents With Recurrent Syncope While Exercising
September 11, 2017 | CME 0.25 MOC 0.25 COP 0.25

This activity was created with a goal to raise your competence in management of patients with catecholaminergic polymorphic ventricular tachycardia. This case was created in response to the 2017 ACC/AHA/HRS Guideline for the Evaluation and Management of Patients With Syncope.

TAVR Pathways: A Framework for Success in the Evaluation and Care of TAVR Patients
August 31, 2017 | CME 0.5 MOC 0.5 COP 0.5

This activity was created with a goal to improve the learner’s competence in the management of patients being considered for TAVR. This case was created in response to the 2017 ACC Expert Consensus Decision Pathway for Transcatheter Aortic Valve Replacement in the Management of Adults With Aortic Stenosis: A Report of the American College of Cardiology Task Force on Clinical Expert Consensus Documents.

Guideline Education: Symptomatic PAD with Intermittent Claudication
August 25, 2017 | CME 0.5 MOC 0.5 COP 0.5 CE 0.5

This activity was created with a goal to change your competence in the symptomatic treatment of patients with PAD who are experiencing intermittent claudication. This case was created in response to the 2016 AHA/ACC Guideline on the Management of Patients with Lower Extremity Peripheral Artery Disease.

Managing Patients with Suspected Constrictive Pericarditis
August 22, 2017 | CME 0.5 MOC 0.5 COP 0.5 CE 0.25

This activity was created with a goal to change your competence in managing patients with suspected constrictive pericarditis (CP).

Managing Patients with High Risk NSTEMI: Patient Presents with Recurrent Chest Pain and Troponin Elevation
August 11, 2017 | CME 0.25 MOC 0.25 COP 0.25

This activity was created with a goal to improve your ability in managing patients with high risk NSTEMI by promoting early revascularization. This case was created in response to the ACC/AATS/AHA/ASE/ASNC/SCAI/SCCT/STS 2016 Appropriate Use Criteria for Coronary Revascularization in Patients With Acute Coronary Syndromes.

Professionalism Case Series: Patient Autonomy in End-of-Life Care
July 26, 2017 | CME 0.25 MOC 0.25 COP 0.25

Overview: The overall goal of this CME certified, online activity is to change your competence in treating patients with heart disease in end-of-life situations. This case is part of the Professionalism Case Series.

ACHD Case Series: Repaired Tetralogy of Fallot
July 24, 2017 | CME 0.25 MOC 0.25 COP 0.25

The overall goal of this CME certified, online activity is to change your competence in monitoring and treating patients with repaired tetralogy of Fallot. This case is part of the ACHD Case Series.

Imaging Case Series: Coronary CT Angiography in CAD
July 20, 2017 | CME 0.25 MOC 0.25 COP 0.25

This activity was created with a goal to change your competence in managing patients with suspected coronary artery disease using coronary computed tomography angiography.

CardioMEMS HF System for Reduction in HF Hospitalization
July 10, 2017 | CME 0.25 MOC 0.25 COP 0.25 CE 0.25

This activity was planned with a goal to familiarize learners with the Food and Drug Administration approved CardioMEMS HF System (May 2014) as an option to decrease HF hospitalizations in select patients.

Congenital Heart Disease and New or Progressive HF in Pregnancy
June 30, 2017 | CME 0.25 MOC 0.25 COP 0.25 CE 0.25

This activity was planned with a goal to improve your competence in evaluating and treating adults with congenital heart disease and new or progressive heart failure.

Imaging Case Series: Left Main Disease (Nuclear)
June 28, 2017 | CME 0.25 MOC 0.25 COP 0.25

This activity was planned with a goal to change your competence in recognizing left main disease on SPECT myocardial perfusion imaging. This case is part of the Imaging Case Series.

Professionalism Case Series: Raising Concerns Without Fear of Intimidation
June 20, 2017 | CME 0.25 MOC 0.25 COP 0.25

This activity was planned with a goal to change provider behavior and professionalism. This case is part of the Professionalism Case Series and intended for cardiovascular physicians, adult physicians, pediatric physicians, and surgeons.

Guideline Education: Medical Therapy and ICD Placement in Patients with HFrEF
June 14, 2017 | CE 0.25 CME 0.25 MOC 0.25 COP 0.25

This activity was planned with a goal to improve your competence in managing patients with HFrEF and your clinical decision making involving guideline-directed medical therapy and ICD placement. This activity was created in response to the 2016 AHA/ACC Clinical Performance and Quality Measures for Prevention of Sudden Cardiac Death.

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Cardiovascular Disease Prevention by Diet Modification: JACC Health Promotion Series (JACC August 2018)
August 13, 2018 | CME 1 COP 1 ECME 1 MOC 1

Governments should focus on cardiovascular disease as a global threat and enact policies that will reach all levels of society and create a food environment wherein healthy foods are accessible, affordable, and desirable. Health professionals should be proficient in basic nutritional knowledge to promote a sustainable pattern of healthful eating for cardiovascular disease prevention for both healthy individuals and those at higher risk.

Safety of the Deferral of Coronary Revascularisation Based on iFR and FFR Measurements in Stable Coronary Artery Disease and Acute Coronary Syndromes (JACC: Cardiovascular Interventions August 2018)
August 6, 2018 | CME 1 COP 1 MOC 1

Assessment of coronary stenosis severity with pressure guidewires is recommended to determine the need for myocardial revascularization.

Contemporary Role of Echocardiography for Clinical Decision Making in Patients During and After Cancer Therapy (JACC: Cardiovascular Imaging August 2018)
August 6, 2018 | CME 1 COP 1 MOC 1

Early recognition of cancer therapy–related cardiac dysfunction (CTRCD) provides an opportunity to mitigate cardiac injury and risk of developing late cardiac events. Echocardiography serves as the cornerstone in the detection and surveillance of CTRCD in patients during and after cancer therapy. Guidelines from professional societies and regulatory agencies have been published on approaches to surveillance, diagnosis, and treatment of CTRCD, although adoption as standard of care remains limited given the lack of evidence on the prognostic value of asymptomatic left ventricular (LV) dysfunction in the oncology population. The frequency of cardiac monitoring and the appropriateness of the Food and Drug Administration (FDA)–recommended cardiac monitoring schedule in all patients receiving trastuzumab for breast cancer has been challenged. Interruption versus continuation of oncological therapy in the setting of asymptomatic LV dysfunction remains a clinical conundrum given the uncertain balance of the risk of cardiac dysfunction and benefit of oncology efficacy. Despite their limitations, echocardiographic measures of LV function continue to play a pivotal role in clinical decision making, with global longitudinal strain emerging as a promising tool in informing and facilitating the selection of cancer treatment and optimizing cardiovascular outcomes. This review highlights the key recommendations of the existing guidelines and discusses recent developments in cardio-oncology imaging practices with the aim of providing practical guidance on the role and use of echocardiography in challenging clinical cases in cardio-oncology.

Expert Scientific Panel on Heart Failure with Preserved Ejection Fraction: HFpEF: Current Controversies and Implications for Clinical Trials (JACC: Heart Failure August 2018)
July 30, 2018 | CME 1 MOC 1 COP 1

The number of persons with heart failure (HF) has continued to rise over the last several years. Approximately half of those living with HF have HF with preserved ejection fraction (HFpEF), but critical unsolved questions remain across the spectrum of basic, translational, clinical, and population research in HFpEF. In this manuscript, we summarize existing knowledge, persistent controversies, and gaps in evidence with regard to our understanding of HFpEF. Our analysis is based on an expert panel discussion "Think Tank" meeting that included representatives from academia, the National Institutes of Health, the U.S. Food and Drug Administration, the Centers for Medicare & Medicaid Services, and industry.

Clinical Genetic Testing for Familial Hypercholesterolemia: JACC Scientific Expert Panel (JACC August 2018-1)
July 30, 2018 | CME 1 MOC 1

Although awareness of familial hypercholesterolemia (FH) is increasing, this common, potentially fatal, treatable condition remains underdiagnosed. Despite FH being a genetic disorder, genetic testing is rarely employed. The Familial Hypercholesterolemia Foundation convened an international expert panel to assess the utility of FH genetic testing.

Management of Arrhythmias and Cardiac Implantable Electronic Devices in Patients with Left Ventricular Assist Devices (JACC: Clinical Electrophysiology July 2018)
July 16, 2018 | CME 1 COP 1 MOC 1

For patients with end stage heart failure, the use of mechanical circulatory support has increased in the last decade due to improved clinical outcomes with durable left ventricular assist devices (LVADs). The management of these complex patients requires coordinated care by a multidisciplinary heart team including cardiac electrophysiologists since atrial and ventricular arrhythmias are prevalent in this population. There have been an increasing number of studies that attempt to address issues regarding arrhythmia management in patients with LVADs. The purpose of this review is to provide electrophysiologists with an evidence-based approach to manage a broad spectrum of arrhythmia issues in these patients.

The Evolving Future of PCSK9 Inhibitors (JACC July 2018)
July 9, 2018 | CME 1 COP 1 ECME 1 MOC 1

Variants in proprotein convertase subtilisin/kexin type 9 (PCSK9) provide insights into mechanisms regulating low density lipoprotein (LDL) levels. Human monoclonal antibodies that target PCSK9 lower LDL cholesterol (LDL-C) levels by 55-72% in different high-risk patient groups. Clinical trials with PCSK9 inhibitors have demonstrated reductions in atherosclerotic cardiovascular (ASCVD) events, particularly in patients with recent acute coronary syndrome, multi-vessel coronary artery disease, or peripheral arterial disease. Commonly observed profound reductions in LDL-C to levels <25 mg/dL have been accompanied by even larger reductions in ASCVD events, thus supporting the concept that there may be no lower limit for LDL-C. Aggressive LDL-C lowering with fully human PCSK9 monoclonal antibodies has been accompanied by a safety profile superior to that of other classes of agents. Based on clinical trial evidence, LDL lowering with PCSK9 inhibitors is recommended for high-risk patients with LDL-C levels ≥70 mg/dL on maximally tolerated oral therapies including statins and/or ezetimibe.

Acute Cardiac Effects of Severe Pre-Eclampsia (JACC July 2018)
July 9, 2018 | CME 1 COP 1 ECME 1 MOC 1

Pre-eclampsia with severe features (PEC) is a pregnancy-specific syndrome characterized by severe hypertension and end-organ dysfunction and is associated with acute adverse cardiovascular events, including heart failure, pulmonary edema, and stroke.

Thoracic Aortic Calcification: Diagnostic, Prognostic and Management Considerations (JACC: Cardiovascular Imaging July 2018)
July 2, 2018 | CME 1 COP 1 MOC 1

Thoracic aortic calcification (TAC) is associated with adverse cardiovascular outcomes, and for the cardiovascular imager, is predominantly encountered in 4 settings: (1) incidentally, for example, during a coronary artery calcium scan; (2) as part of dedicated screening; (3) in the evaluation of an embolic event; or (4), in procedural planning. This review focuses on TAC in these contexts. Within atherosclerosis, TAC is common, variable in extent, and begins in the intima with a patchy distribution. In metabolic disorders, aortitis and radiation-associated cardiovascular disease, calcification preferentially involves the media and is often more concentric. As an incidental finding, atherosclerotic TAC provides limited incremental discriminative value, and current data do not support screening. After an embolic event, the demonstration of thoracic atheroma provides diagnostic clarity, but has limited treatment implications. Prior to procedures, the plan often changes if the most severe form of TAC, a porcelain aorta, is discovered.

Long-Term Clinical Outcomes and Optimal Stent Strategy in Left Main Coronary Bifurcation Stenting (JACC: Cardiovascular Interventions July 2018)
July 2, 2018 | CME 1 COP 1 MOC 1

Limited data are available to assess long-term clinical outcomes after stenting, including use of current-generation drug-eluting stent (C-DES) for treatment of left main coronary artery (LMCA) bifurcation lesions.

The Role of the Clinical Examination in Patients with Heart Failure (JACC: Heart Failure July 2018)
June 25, 2018 | CME 1 COP 1 MOC 1

Despite advances in biomarkers and technology, the clinical examination (i.e., a history and physical examination) remains central in the management of patients with heart failure. Specifically, the clinical examination allows noninvasive assessment of the patient's underlying hemodynamic state, based on whether they have elevated ventricular filling pressures and/or an inadequate cardiac index.

Alterations in Titin Properties and Myocardial Fibrosis Correlate with Clinical Phenotypes in Hemodynamic Subgroups of Severe Aortic Stenosis (JACC: Basic to Translational Science June 2018)
June 25, 2018 | CME 1 COP 1 MOC 1

Titin-isoform expression, titin phosphorylation, and myocardial fibrosis were studied in 30 patients with severe symptomatic aortic stenosis (AS). Patients were grouped into “classical” high-gradient, normal-flow AS with preserved ejection fraction (EF), “paradoxical” low-flow, low-gradient AS with preserved EF, and AS with reduced EF. Nonfailing donor hearts served as controls. AS was associated with increased fibrosis, titinisoform switch toward compliant N2BA, and both total and site-specific titin hypophosphorylation, compared to controls. All AS subtypes revealed titin and matrix alterations. The extent of myocardial remodeling in “paradoxical” AS was no less severe than in other AS subtypes, thus explaining the unfavorable prognosis.

Role of Contact Force Sensing in Catheter Ablation of Cardiac Arrhythmias: Evolution or History Repeating Itself? (JACC: Clinical Electrophysiology June 2018)
June 18, 2018 | CME 1 MOC 1

Adequate catheter-tissue contact facilitates efficient heat energy transfer to target tissue. Tissue contact is thus critical to achieving lesion transmurality and success of radiofrequency (RF) ablation procedures, a fact recognized over 2 decades ago. The availability of real time contact force (CF)-sensing catheters has re-invigorated the field of ablation biophysics and optimizing lesion formation. The ability to measure and display CF came with the promise of dramatic improvement in safety and efficacy. However, CF quality was noted to have just as important an influence on lesion formation as absolute CF quantity. Multiple other factors have emerged as key elements influencing effective lesion formation including catheter stability, lesion contiguity and continuity, lesion density, contact homogeneity across a line of ablation, spatiotemporal dynamics of contact governed by cardiac and respiratory motion, contact directionality, and anatomic wall thickness, in addition to traditional ablation indices of power and RF duration. There is greater appreciation of surrogate markers as a guide to lesion formation such as impedance fall, loss of pace capture, and change in unipolar electrogram morphology. In contrast, other surrogates such as tactile feedback, catheter motion, and electrogram amplitude are notable poor predictors of actual contact and lesion formation. This review aims to contextualize the role of CF-sensing in lesion formation with respect of fundamental principles of biophysics of RF ablation and summaries the state-of-the-art evidence behind the role of CF in optimizing lesion formation.

Stroke Prevention in Non-Valvular Atrial Fibrillation (JACC June 2018)
June 11, 2018 | CME 1 COP 1 MOC 1

Ischemic stroke in patients with atrial fibrillation is associated with substantial morbidity and mortality. The growing epidemic of atrial fibrillation worldwide has raised concerns about the dire need for effective stroke prevention systems in these patients. Fortunately, the last decade has witnessed a plethora of data on novel stroke prevention methods in patients with non-valvular atrial fibrillation. However, optimal selection and effective implementation of these preventative strategies require an integrative approach that takes into account not only the available clinical data but also the perspective of each of the stakeholder involved (patient, physician, society). This review aims to discuss the contemporary issues surrounding stroke prevention in atrial fibrillation from the perspective of these three major stakeholders.

Multimodality Imaging of Thoracic Aortic Diseases in Adults (JACC: Cardiovascular Imaging June 2018)
June 4, 2018 | CME 1 COP 1 MOC 1

In diagnosing and following patients with acute aortic syndromes (AAS) and thoracic aortic aneurysms (TAA), high-quality imaging of the thoracic aorta is indispensable. Mainstay modalities for thoracic aortic imaging are echocardiography, computed tomographic angiography (CTA), and magnetic resonance angiography (MRA). For any given clinical scenario, the imaging modality and protocol chosen will have a significant impact on sensitivity and specificity for the aortic diagnosis of concern. Imaging can also provide important ancillary information regarding myocardial performance, aortic valve morphology and function, and endorgan perfusion. Surveillance of patients following thoracic aortic surgery with serial imaging studies can identify complications that may require reintervention, and imaging has played an integral role in development of new surgical and interventional methods. Emerging techniques in thoracic aortic imaging include positron emission tomography (PET), which addresses vessel wall inflammation, and 4-dimensional MRA, which illustrates flow dynamics.

Incidence, Determinants and Outcomes of Left and Right Radial Access Use in Patients Undergoing Percutaneous Coronary Intervention in the United Kingdom, A National Perspective Using the British Cardiovascular Intervention Society (BCIS) Dataset (JACC: Cardiovascular Interventions June 2018)
June 4, 2018 | CME 1 COP 1 MOC 1

Left radial access (LRA) has been shown to offer procedural advantages over right radial access (RRA) in PCI although few data exist from a national perspective around its use and association with clinical outcomes.

Venoarterial Extracorporeal Membrane Oxygenation in Cardiogenic Shock (JACC: Heart Failure June 2018)
May 28, 2018 | CME 1 COP 1 MOC 1

Venoarterial extracorporeal membrane oxygenation (VA-ECMO) has emerged as a viable treatment for patients in cardiogenic shock with biventricular failure and pulmonary dysfunction. Advances in pump and oxygenator technology, cannulation strategies, patient selection and management, and durable mechanical circulatory support have contributed to expanded utilization of this technology. However, challenges remain that require investigation to improve outcomes.

Clinical Spectrum of SCN5A Mutations: Long QT Syndrome, Brugada Syndrome, and Cardiomyopathy (JACC: Clinical Electrophysiology May 2018)
May 21, 2018 | CME 1 COP 1 MOC 1

This Review summarizes currently available knowledge about the pathophysiological mechanisms of SCN5A mutations and describes how this knowledge can be used to manage patients suffering from potentially lethal cardiac diseases.

Imaging Needs in Novel Transcatheter Tricuspid Valve Interventions (JACC: Cardiovascular Imaging May 2018)
May 7, 2018 | CME 1 COP 1 MOC 1

The advent of novel transcatheter therapies for severe tricuspid regurgitation has attracted much attention. Novel 3-dimensional imaging techniques have permitted analysis of the tricuspid valve anatomy from unparalleled views and better understanding the underlying pathophysiology of the tricuspid regurgitation. Grading tricuspid regurgitation and assessment of right ventricular function remain challenging and, although 2-dimensional echocardiography is the mainstay imaging technique to evaluate patients with severe tricuspid regurgitation, the use of 3- dimensional echocardiography and cardiovascular magnetic resonance is increasing. The number of transcatheter interventions for tricuspid regurgitation is growing and the procedural success relies significantly on the pre-procedural evaluation of the anatomy of the tricuspid valve, etiology and severity of tricuspid regurgitation, right ventricular size and function and importantly, the anatomical relationships of the tricuspid valve. The role of multi-modality imaging in patient selection and procedural planning for transcatheter tricuspid valve repair will be reviewed.

Mortality Following Non-emergent, Uncomplicated Target Lesion Revascularization After PCI: An Individual Patient Data Pooled Analysis of 21 Randomized Trials and 32,524 Patients (JACC: Cardiovascular Interventions May 2018)
May 7, 2018 | CME 1 COP 1 MOC 1

Restenosis requiring target lesion revascularization (TLR) after percutaneous coronary intervention (PCI) is generally considered a benign event.

Oral Anticoagulation in Patients with Liver Disease (JACC May 2018)
May 7, 2018 | CME 1 COP 1 MOC 1

In this review, we discuss the risk-benefit profile, pharmacokinetic profiles, and clinical studies evaluating the effectiveness and safety of OACs in patients with liver disease and provide a practical clinically-oriented approach to the management of OAC in this population.

Clinical Spectrum and Management of Heart Failure in Hypertrophic Cardiomyopathy (JACC: Heart Failure May 2018)
April 30, 2018 | CME 1 MOC 1

Heart failure (HF), characterized by excessive exertional dyspnea, is a common complication within the broad clinical spectrum of hypertrophic cardiomyopathy (HCM). HF has become an increasingly prominent management issue with reduction in sudden deaths due to use of implantable defibrillators in this disease. Exertional dyspnea ranges in severity from mild to severe (NYHA classes II to IV) and not uncommonly becomes refractory to medical management, leading to progressive disability, but largely in the absence of pulmonary congestion and volume overload requiring hospitalization.

Plasma Ceramides as Prognostic Biomarkers and Their Arterial and Myocardial Tissue Correlates in Acute Myocardial Infarction (JACC: Basic to Translational Science April 2018)
April 30, 2018 | CME 1 MOC 1

Plasma ceramides predict mortality in coronary artery disease but their association with other cardiovascular events is less established. Moreover, the primary tissue source of plasma ceramides in AMI is uncertain.

Life-threatening Event Risk in Children with Wolff-Parkinson-White Syndrome (JACC: Clinical Electrophysiology April 2018)
April 16, 2018 | CME 1 MOC 1 COP 1

Children with WPW syndrome are at risk of sudden death.

Impact of Cardiovascular Risk on the Relative Benefit and Harm of Intensive Treatment of Hypertension (JACC April 2018)
April 9, 2018 | CME 1 MOC 1 COP 1

In SPRINT, those with lower baseline CVD risk had more harm than benefit from intensive treatment, while those with higher risk had more benefit. With 2017 ACC/AHA blood pressure treatment guidelines, this analysis may help providers and patients make decisions regarding the intensity of blood pressure treatment.

Mitral Valve Regurgitation in the Contemporary Era: Insights into Diagnosis, Management, and Future Directions (JACC: Cardiovascular Imaging April 2018)
April 2, 2018 | CME 1 MOC 1 COP 1

Mitral valve regurgitation (MR) is the most common valvular heart disease. Primary MR is a disease of the mitral valve apparatus whereas secondary MR is a disease of the left ventricle. Diagnosing and managing MR is often challenging and requires a structured approach, integrating findings on history, physical examination, and imaging. Decisions regarding treatment are dependent upon knowledge of the etiology, natural history, and outcome of interventions for these patients with mitral valve disease. The optimal timing of intervention requires a comprehensive two-dimensional and Doppler echocardiogram in each patient to determine the cause of the mitral valve disease, the severity of the regurgitation, the effect of the volume overload on the left ventricle, as well as to determine if a durable valve repair can be performed. Advances in both surgical and catheter-based therapies have resulted in recommendations for lower thresholds for operation and extension of interventional treatments for the older, sicker MR patients. In this review, we will discuss the pathophysiological rationale for current diagnostic and management strategies in MR.

Effect of Procedure and Coronary Lesion Characteristics on Clinical Outcomes Among Atrial Fibrillation Patients Undergoing Percutaneous Coronary Intervention: Insights from the PIONEER AF-PCI Trial (JACC: Interventions April 2018)
April 2, 2018 | CME 1 MOC 1 COP 1

Among stented AF patients, the impact of procedural access strategies or lesion characteristics on antithrombotic safety and efficacy outcomes is unclear.

Indications for CRT - A Comparison of the Major International Guidelines (JACC: Heart Failure April 2018)
March 26, 2018 | CME 1 MOC 1 COP 1

CRT has been shown to reduce morbidity and mortality in selected patients with systolic heart failure. Cardiology societies provide guidelines regarding the indications for CRT. As evidence evolves, it is challenging for the guideline committees to review the impact of newer evidence in a timely fashion.

VT in Hypertrophic Cardiomyopathy and LV Aneurysm (JACC: Clinical Electrophysiology March 2018)
March 19, 2018 | CME 1 MOC 1

Monomorphic VT in patients with HCM and left ventricular AA has been reported. However, outcome data of RFCA are insufficient.

Radiation Exposure of Operators Performing Transesophageal Echocardiography During Percutaneous Structural Cardiac Interventions (JACC March 2018)
March 12, 2018 | CME 1 MOC 1

Transesophageal echocardiography (TEE) operators provide critical imaging support for percutaneous structural cardiac intervention procedures. They stand close to the patient and source associated risks from radiation. This article seeks to investigate TEE operator radiation dose during percutaneous structural cardiac intervention.

A Multidisciplinary Approach on the Perioperative Antithrombotic Management of Patients with Coronary Stents undergoing Surgery: Surgery after Stenting 2 (JACC: Cardiovascular Interventions March 2018)
March 5, 2018 | CME 1 MOC 1 COP1

Perioperative management of antithrombotic therapy in patients treated with coronary stents undergoing surgery remains poorly defined. Importantly, surgery represents a common reason for premature treatment discontinuation, which is associated with an increased risk in mortality and major adverse cardiac events. However, maintaining antithrombotic therapy to minimize the incidence of perioperative ischemic complications may increase the risk of bleeding complications. Although guidelines provide some recommendations with respect to the perioperative management of antithrombotic therapy, these have been largely developed according to the thrombotic risk of the patient and a definition of the hemorrhagic risk specific to each surgical procedure, key to defining the trade-off between ischemia and bleeding, is not provided. These observations underscore the need for a multidisciplinary collaboration among cardiologists, anesthesiologists, hematologists and surgeons to reach this goal. The present document is an update on practical recommendations for standardizing management of antithrombotic therapy management in patients treated with coronary stents (Surgery After Stenting 2) in various types of surgery according to the predicted individual risk of thrombotic complications against the anticipated risk of surgical bleeding complications. Cardiologists defined the thrombotic risk using a "combined ischemic risk" approach, while surgeons classified surgeries according to their inherent hemorrhagic risk. Finally, a multidisciplinary agreement on the most appropriate antithrombotic treatment regimen in the perioperative phase was reached for each surgical procedure.

Trials and Tribulations of Assessing New Imaging Protocols: Combining Vasodilator Stress with Exercise (JACC: Cardiovascular Imaging March 2018)
March 5, 2018 | CME 1 MOC 1

Among all patients referred for stress myocardial perfusion imaging (MPI), a substantial proportion in contemporary practice cannot exercise. Another group of patients are those who are thought to possibly be able to achieve an adequate workload with treadmill (or bicycle) exercise, but do not achieve at least 85% of maximum predicted heart rate without developing symptoms. For such patients, there has been substantial interest and literature on the adjunctive use of vasodilator stress during the same visit for patients who do not exercise adequately, in order to generate best quality results. Current American Society of Nuclear Cardiology Guidelines recommend the possibility of using a vasodilator stress agent to supplement exercise in those patients who do not achieve target heart rate. However, optimal timing of administration is not clear. Herein we summarize literature to date on the combination of vasodilator and exercise stress testing in light of the recently published “Exercise to Regadenoson in Recovery Trial” (EXERRT).

High Sensitivity Cardiac Troponin and New Onset Heart Failure: A Systematic Review and Meta-Analysis of 67,063 Individuals With 4,165 Incident Heart Failure Events (JACC: Heart Failure March 2018)
February 26, 2018 | CME 1 MOC 1 COP 1

Identification of individuals at high risk of heart failure and early risk factor modification with medications such as ACE inhibitors may delay the onset of heart failure. High-sensitivity cardiac troponin (hs-cTn) has been suggested as a prognostic marker for the incidence of first-ever heart failure in asymptomatic individuals.

Subcutaneous Furosemide in Heart Failure: Pharmacokinetic Characteristics of a Newly Buffered Solution (JACC: Basic to Translational Science February 2018)
February 26, 2018 | CME 1 MOC 1

Parenteral diuretics form the cornerstone of decongestion in heart failure. However, parenteral therapy routinely requires emergency room or inpatient care. A novel buffered furosemide formulation with neutral pH was developed to offer “hospital-strength” diuresis for outpatient use, including self-administration at home. Subcutaneous infusion using a biphasic delivery profile resulted in complete bioavailability (99.65%) and equivalent diuresis when compared to IV administration. Subcutaneous administration of buffered furosemide was well tolerated with no evidence of any drug-induced skin reactions. Subcutaneous infusion of buffered furosemide in the outpatient setting or home may help to reduce the burden of heart failure.

Abandoned Leads in Cardiac Device Infections (JACC: Clinical Electrophysiology February 2018)
February 19, 2018 | CME 1 MOC 1

Device infection is a serious consequence of cardiovascular implantable electronic devices (CIEDs) and necessitates removal of all hardware for attempted cure. The merits of extracting or retaining presumed sterile, but non-functioning leads, is a subject of ongoing debate.

New-Onset Atrial Fibrillation After PCI and CABG for Left Main Disease: Analysis From the EXCEL Trial (JACC February 2018)
February 12, 2018 | CME 1 MOC 1

There is limited information on the incidence and prognostic impact of new-onset atrial fibrillation (NOAF) following percutaneous coronary intervention (PCI) and coronary artery bypass grafting (CABG) for left main coronary artery disease (LMCAD). This article seeks to determine the incidence of NOAF following PCI and CABG for LMCAD and its effect on 3-year cardiovascular outcomes.

A Randomized Trial Comparing the NeoVas Sirolimus-Eluting Bioresorbable Scaffold and Metallic Everolimus-Eluting Stents (JACC: Cardiovascular Interventions February 2018)
February 5, 2018 | CME 1 MOC 1 COP 1

Bioresorbable scaffolds (BRS) have the potential to improve very late outcomes compared to metallic drug-eluting stents (DES). NeoVas is a new poly-L-lactic acid BRS which elutes sirolimus from a poly-D, L-lactide coating.

Assessment of Left Ventricular Function by Echocardiography: The Case for Routinely Adding Global Longitudinal Strain to Ejection Fraction (JACC: Cardiovascular Imaging February 2018)
February 5, 2018 | CME 1 MOC 1

GLS provides utility across the spectrum of heart failure (and EF) as well as in the evaluation of valvular heart disease. There is a strong case for incorporation of GLS into clinical decision-making. This review appraises the evidence addressing the utility of GLS as a complementary metric to LVEF for incorporation into mainstream clinical practice.

Low-dose Aspirin in Heart Failure not complicated by Atrial Fibrillation: A Nationwide Propensity Matched Study (JACC: Heart Failure February 2018)
January 29, 2018 | CME 1 MOC 1 COP 1

Despite lack of evidence, low-dose aspirin is widely used in patients with heart failure (HF) and sinus rhythm with and without prior ischemic heart disease (IHD).

Anti-thrombotic Therapy in Peripheral Artery Disease: Generating and Translating Evidence into Practice (JACC January 2018)
January 15, 2018 | CME 1 MOC 1 COP 1

This review outlines the inherent cardiovascular risks of patients with PAD, risk reduction strategies, emerging clinical trial data, and opportunities for the cardiovascular community to generate evidence in real-world settings and translate evidence into practice as new therapies become available.

Atrial Fibrosis and Reentrant Drivers in AF (JACC: Clinical Electrophysiology January 2018)
January 15, 2018 | CME 1 MOC 1 COP 1

The mechanisms involved in the sustenance of reentrant activity during atrial fibrillation (AF) are poorly understood.

Epidemiology of Left Ventricular Systolic Dysfunction and Heart Failure in the Framingham Study: An Echocardiographic Study Over Three Decades (JACC: Cardiovascular Imaging January 2018)
January 1, 2018 | CME 1 MOC 1

Temporal trends in the prevalence and management of major risk factors may impact the epidemiology of HF.

Sex-related Outcomes with TAVR (JACC: Interventions January 2018)
January 1, 2018 | CME 1 MOC 1 COP 1

Transcatheter aortic valve replacement (TAVR) is commonly performed in women. Previous studies have shown conflicting results with respect to sex differences in outcomes with TAVR. In addition, short-term outcomes have primarily been reported.

Sudden Cardiac Death in Athletes (JACC: Heart Failure January 2018)
December 25, 2017 | CME 1 MOC 1 COP 1

Sudden cardiac death is a tragedy at any age and in any circumstance, but perhaps most tragic when it claims the athlete, the individual who epitomizes health and a healthy lifestyle. Sports cardiologists from around the world have worked to quantitate the incidence of sudden cardiac death (SCD) in the athlete, identify risk factors, develop pre-participation screening tools and formulate plans to deal with on-field SCD. Progress has been made, but much remains to be done in order to make both competitive and recreational sports safer for both patients with known cardiac disease and athletes without known or suspected cardiac abnormalities.

Effects of LCZ696 in Myocardial Infarction (JACC: Basic to Translational Science December 2017)
December 25, 2017 | CME 1 MOC 1

LCZ696 lowers the risk of cardiovascular events in chronic heart failure. However, it is unclear whether LCZ696 can improve prognosis in patients with acute myocardial infarction (MI). The present study shows that LCZ696 can prevent cardiac rupture after MI, probably due to the suppression of MMP-9 activity and aldosterone production, and enhancement of natriuretic peptides in mice. The present study suggests the mechanistic insight of cardioprotective effects of LCZ696 against acute MI, resulting in the beneficial effects of LCZ696 on the prognosis after acute MI in the clinical setting.

Incessant SVT from Concealed Nodofascicular and Nodoventricular Tachycardias (JACC: Clinical Electrophysiology December 2017)
December 18, 2017 | CME 1 MOC 1

Incessant supraventricular tachycardias have been associated with tachycardia-induced cardiomyopathies and have been previously attributed to permanent junctional reciprocating tachycardias, atrial tachycardias, and atrioventricular nodal reentrant tachycardias. Incessant concealed nodofascicular and nodoventricular tachycardias have not been described previously.

Mechanical Intervention for Aortic Valve Stenosis in Patients with Heart Failure and Reduced Ejection Fraction (JACC December 2017)
December 11, 2017 | CME 1 MOC 1

In this review, we describe the epidemiology and pathophysiology of aortic stenosis with heart failure and reduced ejection fraction and summarize the current registry and clinical trial data applicable to this frequently encountered high risk group.

Doppler Echocardiography for the Estimation of LV Filling Pressure in Patients With Mitral Annular Calcification (JACC: Cardiovascular Imaging December 2017)
December 4, 2017 | CME 1 MOC 1 COP 1

Prediction of left ventricular filling pressure (LVFP) in the presence of mitral annular calcification (MAC) is difficult, as the annular calcifications alter the tissue Doppler velocity at the annulus as well as mitral inflow velocities.

Endothelial Barrier Protein Expression in Biodegradable Polymer Sirolimus-Eluting Versus Durable Polymer Everolimus-Eluting Metallic Stents (JACC: Interventions December 2017)
December 4, 2017 | CME 1 MOC 1 COP 1

Biodegradable polymer drug-eluting stents (BP-DES) have been purported to have biological advantages in vessel healing versus durable polymer DES (DP-DES) though clinical trial data suggest equipoise.

Cardiac Transplantation: Current Outcomes and Contemporary Controversies ( JACC: Heart Failure December 2017)
November 27, 2017 | CME 1 MOC 1 COP 1

Despite advances in pharmacologic and device treatment of chronic heart failure, long-term morbidity and mortality remain high and many patients progress to end-stage heart failure. Over the last five decades, heart transplantation (HTx) has become the preferred therapy for select patients with end-stage heart disease. However, while HTx has become standard of care for the management of end-stage heart failure, challenges continue to exist. The number of patients with end-stage heart failure is increasing, while the number of donor organs remains constant and a limiting factor in HTx. Not only are there more potential heart transplant candidates, but HTx candidates today are more complex: older, sensitized, and with mechanical circulatory support. Such candidates are at higher risk for poor outcomes including primary graft dysfunction and antibody mediated rejection. This article will focus on current post-transplant outcomes as well as recent advances in HTx that could address the current challenges. These advances include: 1) attempts to expand the donor pool; 2) proposed changes in HTx allocation policy for more equitable organ distribution; 3) a better understanding of the definition and management of primary graft dysfunction; and 4) advances in the management of sensitized HTx candidates. Developments in these areas could result in expansion and more equitable distribution of the donor pool and improved survival and quality of life for HTx recipients.

The "3B perspectives" in CRT ( JACC: Clinical Electrophysiology October 2017)
November 20, 2017 | CME 1 MOC 1 COP 1

Cardiac resynchronization therapy (CRT) is an established non-pharmacological treatment for patients with heart failure (HF), reduced left ventricular (LV) ejection fraction, and a wide QRS complex.

Ideal Cardiovascular Health Score and Fuster-Bewat Score for Predicting Subclinical Atherosclerosis in Low-Risk Individuals (JACC November 2017)
November 13, 2017 | CME 1 MOC 1 COP 1

Term of Approval/Date of CME/MOC Expiration: November 12, 2018

The ideal cardiovascular health score (ICHS) is recommended for use in primary prevention. Simpler tools not requiring laboratory tests, such as the Fuster-BEWAT score (FBS), are also available.

Quantitative Pericardial Delayed Hyperenhancement Informs Clinical Course in Patients with Recurrent Pericarditis ( JACC: Cardiovascular Imaging November 2017)
November 6, 2017 | CME 1 MOC 1 COP 1

Pericardial DHE on cardiac magnetic resonance imaging (CMR) may persist beyond the acute phase of pericarditis, suggesting continued pericardial inflammation.

Intracardiac Echocardiography from the Left Atrium for Procedural Guidance of Transcatheter Left Atrial Appendage Occlusion ( JACC: Interventions November 2017)
November 6, 2017 | CME 1 MOC 1 COP 1

TEE with general anesthesia is the current gold standard to guide LAAO. By the use of ICE from the LA, LAAO can be performed in local anesthesia and may potentially have advantages over TEE.

Fat and Sugar Consumption in HFpEF (JACC: Basic to Translational Science October 2017)
October 30, 2017 | CME 1 MOC 1 COP 1

Heart failure with preserved ejection fraction (HFpEF) is associated with obesity and, indirectly, with unhealthy diet.

Heart Failure with Mid-Range (Borderline) Ejection Fraction: Clinical Implications and Future Directions (JACC: Heart Failure November 2017)
October 30, 2017 | CME 1 MOC 1 COP 1

Description: Heart failure (HF) with borderline ejection fraction (HFbEF) was first defined in 2013 in the American College of Cardiology/American Heart Association Guidelines as the presence of the typical symptoms of HF and a left ventricular ejection fraction (LVEF) of 41-49%.

Ablation Index and Surround Flow Catheter Irrigation: Impedance-Based Appraisal in Clinical Ablation - (JACC: Clinical Electrophysiology October 2017)
October 16, 2017 | CME 1 MOC 1 COP 1

In preclinical studies, ablation power and catheter irrigation are determinants of ablation efficacy: in this study their impact was assessed during clinical radiofrequency ablation using impedance drop.

Catheter Ablation Versus Medical Rate control in Atrial Fibrillation and Systolic Dysfunction (CAMERA-MRI) - (JACC October 2017)
October 9, 2017 | CME 1 MOC 1 COP 1

The restoration of sinus rhythm with CA results in significant improvements in ventricular function, particularly in the absence of ventricular fibrosis on CMR. This challenges the current treatment paradigm that rate control is the appropriate strategy in patients with AF and LVSD.

Role of Cardiac Magnetic Resonance in the Diagnosis and Prognosis of Non-Ischemic Cardiomyopathy (JACC: Cardiovascular Imaging October 2017)
October 2, 2017 | CME 1 MOC 1 COP 1

Cardiac magnetic resonance (CMR) is a valuable tool for the evaluation of patients with, or at risk for, heart failure and has a growing impact on diagnosis, clinical management, and decision-making. Through its ability to characterize the myocardium using multiple different imaging parameters, it provides insight into the etiology of the underlying heart failure and its prognosis. CMR is widely accepted as the reference standard for quantifying chamber size and ejection fraction. Additionally, tissue characterization techniques such as late gadolinium enhancement (LGE) and other quantitative parameters such as T1-mapping, both native and with measurement of extracellular volume fraction, T2-mapping, and T2-* mapping have been validated against histology in a wide range of clinical scenarios. In particular, the pattern of LGE in the myocardium can help determine the underlying etiology of the heart failure. The presence and extent of LGE determines prognosis in many of the non-ischemic cardiomyopathies. The use of CMR should increase as its utility in characterization and assessment of prognosis in cardiomyopathies is increasingly recognized.

Transcatheter and Surgical Management of Mitral Paravalvular Leak: Long-term Outcomes (JACC: Interventions October 2017)
October 2, 2017 | CME 1 MOC 1 COP 1

Percutaneous treatment of mitral PVL has emerged as an alternative to surgical treatment in high-risk surgical candidates. There are limited data on the utilization trends, safety, and efficacy of both procedures in the management of mitral PVL.

Sleep Disordered Breathing and Heart Failure - What Does The Future Hold? (JACC: Heart Failure October 2017)
September 25, 2017 | CME 1 MOC 1 COP 1

The majority of patients with heart failure (HF) have sleep disordered breathing (SDB) - with central (rather than obstructive) sleep apnea becoming the predominant form in those with more severe disease. Cyclical apnea and hypopneas are associated with sleep disturbance, hypoxemia, hemodynamic changes, and sympathetic activation. Such patients have a worse prognosis than those without SDB. Mask-based therapies of positive airway pressure targeted at SDB can improve measures of sleep quality and partially normalize the sleep and respiratory physiology, but recent randomized trials of cardiovascular outcomes in central sleep apnea in chronic HF with reduced ejection fraction have been neutral or suggested the possibility of harm, likely from increased sudden death. Further randomised outcome studies are required to determine whether mask-based treatment is appropriate for patients with chronic HFrEF and obstructive sleep apnoea; for those with heart failure with preserved ejection fraction; and for those with decompensated heart failure. New therapies for sleep apnea - such as implantable phrenic nerve stimulators - also require robust assessment. No longer can the surrogate endpoints of improvement in respiratory and sleep metrics be taken as adequate therapeutic outcome measures in patients with HF and sleep apnea.

ICD Efficacy in Non-ischemic Cardiomyopathy (JACC: Clinical Electrophysiology September 2017)
September 18, 2017 | CME 1 MOC 1 COP 1

The effect of ICD on mortality of patients with NICM and left ventricular ejection fraction (EF) ≤35% has recently been questioned. Prior randomized controlled trials (RCTs) evaluating ICD efficacy in patients with NICM have yielded conflicting results. Further, whether ICD therapy benefits NICM patients with concomitant CRT is unknown.

PCI versus CABG in Patients with Type 1 Diabetes and Multivessel Disease (JACC September 2017)
September 11, 2017 | CME 1 MOC 1 COP 1

It is unknown if coronary artery bypass grafting (CABG) or percutaneous coronary intervention (PCI) may offer a survival benefit in patients with type 1 diabetes (T1D) in need of multivessel revascularization. In an observational cohort study we included all patients with T1D who underwent a first multivessel revascularization in Sweden during 1995 to 2013. We used the SWEDEHEART register, the National Diabetes Register, and the Swedish National Patient Register to retrieve information about patient characteristics and outcomes.

Date of Release: September 11, 2017
Term of Approval/Date of CME/MOC Expiration:September 10, 2018

The Potential of Clinical Phenotyping of Heart Failure with Imaging Biomarkers for Guiding Therapies: A Focused Update (JACC: Cardiovascular Imaging September 2017)
Sept 4, 2017 | CME 1 MOC 1

The need for noninvasive assessment of cardiac volumes and ejection fraction (EF) ushered in the use of cardiac imaging techniques in heart failure (HF) trials that investigated the roles of pharmacological and device-based therapies. However, in contrast to HF with reduced EF, modern heart failure pharmacotherapy has not improved outcome in HF with preserved EF, largely attributed to patient heterogeneity and incomplete understanding of pathophysiological insights underlying the clinical presentations of HF with preserved EF. Modern cardiac imaging methods offer insights into myriad sets of changes in cardiac tissue structure and function that can precisely link etiology with cardiac remodeling at organ and tissue level to clinical presentations in HF. This has inspired investigators to seek a more comprehensive understanding of HF presentations using imaging techniques. This article summarizes the available evidence regarding the role of cardiac imaging in HF. We further discuss the value of cardiac imaging techniques in identifying patient subtypes in HF who share similar etiology and mechanistic pathways that can be targeted using specific HF therapies.

Date of Release: September 4, 2017
Term of Approval/Date of CME/MOC Expiration: August 31, 2018

Conduit- and Stent-Related Outcomes of TPV Replacement (JACC: Cardiovascular Interventions September 2017)
Sept 4, 2017 | CME 1 MOC 1

Stent fracture (SF) and right ventricular outflow tract (RVOT) reintervention are among the most important adverse outcomes after TPVR using the Melody valve (Medtronic, Minneapolis, MN). The conduit environment and conduit preparation practices vary among patients who undergo TPVR.

Medical Management of Patients with an LVAD for the Non-LVAD Specialist (JACC: Heart Failure September 2017)
Aug 28, 2017 | CME 1 MOC 1 COP 1

More than 2,400 continuous-flow left ventricular assist devices (LVADs) are implanted each year in the United States alone. Both the number of patients living with LVADs and the life expectancy of these patients are increasing. As a result, patients with LVADs are increasingly encountered by non-LVAD specialists who do not have training in advanced heart failure for general medical care, cardiovascular procedures, and other sub-specialty care. An understanding of the initial evaluation and management of patients with LVADs is now an essential skill for many health care providers. In this State-of-the-Art Review, we discuss current LVAD technology, summarize our clinical experience with LVADs, and review the current data on the medical management of patients living with LVADs.

Fast Virtual Fractional Flow Reserve (JACC: Basic to Translational Science August 2017)
Aug 28, 2017 | CME 1 MOC 1 COP 1

FFR-guided PCI is superior to standard assessment but remains underused. We have developed a novel pseudo-transient anslysis protocol for computing virtual FFR (vFFR) based upon angiographic images and steady-state computational fluid dynamics. This protocol generates vFFR results in 189s (cf>26h for transient analysis), on a desktop PC, with <1% error relative to full-transient CFD analysis. Sensitivity anslysis demonstrated that physiological lesion significance was influenced less by coronary/lesion anatomy (33%), and more by microvascular physiology (59%). If coronary microvascular resistance can be estimated, vFFR can be accurately computed in less time than it takes to measure invasively.

The Impact of the PR Interval on CRT outcomes (JACC: Clinical Electrophysiology August 2017)
Aug 21, 2017 | CME 1 MOC 1 COP 1

The baseline electrocardiogram (ECG) has important prognostic value to determine response to cardiac resynchronization of response and outcomes; however, the prognostic importance of the PR interval is less clear.

Risk of Arterial Thromboembolism in Patients with Cancer (JACC: August 2017)
Aug 14, 2017 | CME 1 MOC 1 COP 1

Cancer patients' risk of arterial thromboembolism is incompletely understood.

Peri-procedural Myocardial Injury Depends on Transcatheter Heart Valve Type but Does Not Predict Mortality in Patients after TAVI ( JACC: Cardiovascular Intervention August 2017)
Aug 7, 2017 | CME 1 MOC 1 COP 1

An increase of biomarkers of myocardial injury is a common finding after TAVI, but the clinical significance is unclear.

2018 Recent Advances in Clinical Nuclear Cardiology and Cardiac CT Meeting on Demand^™ Program
June 18, 2018 | CME 22.25 COP 22.25 MOC 22.25

The 2018 Recent Advances in Clinical Nuclear Cardiology and Cardiac CT Meeting on Demand^™ Program is perfect for you if you are:

• Wanting to have the latest information in nuclear cardiology and cardiac CT presented in compact 20-minute segments by a superb faculty
• Interested in earning your IAC accreditation requirements of 15 Nuclear Credit Hours
• Seeking to earn 22.25 Dual MOC/CME credits Preparing for the Nuclear (CBNC) and/or Cardiac CT (CBCCT) Boards
• Looking for a review of 100+ evidence-based cases focusing on technical and clinical problems commonly encountered in practice to increase your interpretive skills

Designed to meet the needs of professionals who perform or request nuclear cardiology, cardiac CT or cardiac MRI studies, this online course emphasizes the use of these modalities across the spectrum of patients with suspected or known coronary disease as well as other non-coronary cardiac disease states.

The faculty consists of expert cardiac imaging clinicians and scientists from across the country who guide you through the latest advances in nuclear cardiology, cardiac CT and other imaging modalities.

DOACs Beyond AF_ Management Strategies for VTE
May 29, 2018 | CME 1.75 COP 1.75 MOC 1.75

Venous thromboembolism (VTE), encompassing pulmonary emboli (PE) and deep vein thrombosis (DVT), has been identified as a significant public health concern and a silent killer, as it is associated with substantial morbidity and mortality both in the US and globally. While improvements in the prevention and treatment of VTE have occurred over the past decade, significant gaps in preventing hospital acquired VTE persist and more needs to be done. Education can provide deeper insights into the current guideline recommendations for VTE prevention strategies in patients at risk for VTE as well as a discussion of various pharmaceutical options for VTE prevention currently available. Sharing pivotal findings in a timely and relevant way through dissemination of contemporary science, trial findings, and recent innovations to health care providers is a cornerstone of the American College of Cardiology’s mission. In this particular case, facilitating thoughtful review, discussion and application of clinical decision-making is a critical role education plays in the dynamic area of anticoagulation and VTE.

Listening to Their Legs: Strategies for Preventing, Detecting and Managing the Silent Killer of Peripheral Artery Disease
May 29, 2018 | CME 2.0 COP 2.0 MOC 2.0

The burden of peripheral artery disease (PAD) is substantial. The presence of PAD results in impaired function and quality of life, even among patients who do not report overt symptoms. The presence of PAD is often a marker of systematic atherosclerosis. In the multinational REACH registry, more than 60% of patients found to have PAD also had cerebrovascular disease, coronary artery disease, or both. This population is at particularly high risk of adverse CVD outcomes. Patients with both CAD and PAD, compared to CAD alone, have more than twice the 1-year risk of CV mortality. Aggressive risk factor management is therefore critically important in this population. PAD is prevalent in cardiovascular practices, but is often undetected. Low public awareness of PAD and its associated risk factors, symptom profile, and consequences is a significant barrier. To improve the timely detection of PAD, clinicians need greater vigilance and a higher index of suspicion when encountering patients with known ASCVD or with multiple risk factors. Current AHA/ACC guidelines strongly recommend routine vascular assessment of all patients at increased risk of PAD.

The New Reality is Here: The Why, Who, and How of Comprehensive Diabetes Care
May 29, 2018 | CME 2.0 COP 2.0 MOC 2.0

The management of patients with T2DM requires team based care from multiple providers across various specialties. Although these providers may vary in their care focus, ideally, cardiovascular specialists should be cognizant of the principles of diabetes management, mechanisms of action and profile of current T2DM therapies and be able to integrate this understanding into CVD risk and disease management. Cardiologists and the CV team need education to understand the rapidly expanding arsenal of T2DM pharmacotherapies and emerging evidence to manage high risk patients, and ultimately feel empowered to apply recent clinical trial data into the clinical decision making and individualized treatment plans.

The Cardiovascular Clinicians' Role in Managing Diabetes: Where Are We Headed?
February 8, 2018 | CNE 2.0 CME 2.0

The relationship between type 2 diabetes (T2D) pharmacotherapies and cardiovascular (CV) outcomes is complex, yet recent studies suggest that not only are newer agents not associated with adverse cardiovascular effects, but that some demonstrate a cardioprotective effect. Although the evidence base is still growing, these relationships reshape the paradigm for selecting and titrating T2D therapies. Previously, the focus of the cardiovascular care team was not necessarily on the medical management of diabetes, but instead on reducing patient’s multiple risk factors associated with cardiac disease.

ACC.17 Clinical Focus Session: The Great K Debate Continues: Updates and Controversies in Heart Failure Management
June 26, 2017 | MOC 2.0 CNE 2.0 CME 2.0 COP 2.0

With updated Heart Failure guidelines, new drugs and side-effect management concerns, the Great K Debate continues with this Meeting on Meeting on Demand™ Program. Join us for this highly interactive session carefully planned to help providers understand how to overcome the challenge of patient side-effect concerns, particularly hyperkalemia, while allowing for the optimization HF pharmacotherapies, including a look at the new drugs for treating hyperkalemia and management strategies for their administration.

ACC.17 Clinical Focus Session: Complex Decisions in Mitral Valve Care: Individualizing Assessment, Diagnosis and Treatment
June 26, 2017 | MOC 2.0 CNE 2.0 CME 2.0 COP 2.0

During this Meeting on Demand™ Program, Complex Decisions in Mitral Valve Care: Individualizing Assessment, Diagnosis and Treatment, learners will gain a better understanding of the current barriers and complexities of mitral valve care, learn best practices and strategies and see the guidelines in practice during challenging case presentations and discuss recent advances and the future of valve care with an expert faculty panel.

ACC.17 Clinical Focus Session: Recent Trends in Combination Therapy: Managing Cholesterol Even in the Most Resistant
June 26, 2017 | MOC 2.0 CNE 2.0 CME 2.0 COP 2.0

Managing cholesterol levels effectively, particularly in the most resistant patients, can be a challenge. Recent trends call for incorporating evidence-based nonstatin therapies into treatment plans, yet providers and patients seem to struggle with this combination therapy approach. This interactive session reviews how clinicians are doing in the treatment of high-risk patients and why they might be struggling with prescribing evidence based therapies. The patient’s perspectives and patient related adherence issues or barriers are included also in the discussion followed by the systems of care stumbling blocks. Review, analyze and view discussions on how to build a friendlier system of care for clinicians and patients.

ACC.17 Clinical Focus Session: Next Steps to Optimal Medical Therapy for Heart Failure Patients
June 26, 2017 | MOC 2.0 CNE 2.0 CME 2.0 COP 2.0

Heart failure represents a significant source of morbidity and mortality in the US population and worldwide. It is estimated that the number of persons with heart failure in the U.S. will soon approach 8 million and the toll on life and quality of life will continue to rise. In 2015, the US Food and Drug Agency (FDA) approved two HF medications—the first new pharmacologic therapies for HF in more than a decade. We now have a plethora of drugs and devices appropriate for heart failure and the complexity of care has increased. After two years now of clinical use of the newest agents and coupled with the recent release of updated guidelines, clinicians have questions and need practical guidance on the new pharmacotherapies and how they should be incorporated into individualized treatment regimens with consideration for ethnic/racial and other clinically relevant attributes of patients with HF. Education on the role of guideline-driven MT,(GDMT), including appropriate use of both newer and more familiar medications, is a crucial tool in achieving desired chronic HF outcomes, including reduced hospitalization and readmission rates as well as overall reduced morbidity and mortality.

ACC.17 Clinical Focus Session: Breakthrough Therapies: Your Role in Protecting the Heart of Your Patient with Diabetes
June 26, 2017 | MOC 2.0 CNE 2.0 CME 2.0 COP 2.0

Whether heart disease or diabetes came first, caring for patients with these conditions is complex and places demands on cardiovascular clinicians to stay up-to-date on new findings and pharmaceutical agents and how they may affect or alter care of their patients. This dynamic, interactive session will feature a review of glycemic management and cardiovascular disease, an evaluation of the latest findings of cardiotoxic and cardio-protective profiles of pharmacological diabetes agents and their effectiveness in preventing ASCVD in diabetes. The activity closed with some pragmatic conversations about the cardiovascular clinician’s role and responsibility in caring for the patient with diabetes. With the growing number of T2DM patients in the population, all cardiovascular providers should find this evening session useful and informative.

Insights on Access Barriers and Overcoming Administrative Burdens for New Therapies
Mar 22, 2017

Prior authorization and claim denials continue to be some of the top challenges facing physicians. According to a 2012 Kaiser Family Foundation study, U.S. physicians spend more than 868 million hours annually on prior authorization activities—a trend that is only likely to continue.

In October 2016, CardioSurve participants were asked questions related to access and usage of new cardiovascular drug therapies. This research was designed to develop a general understanding from U.S. cardiologists of their perceptions of access to new therapies and usage for their patients with a focus specifically on angiotensin receptor-neprilysin inhibitor (ARNIs), Proprotein convertase subtilisin/kexin type 9 inhibitors (PCSK9i) and Novel Oral Anticoagulants (NOACs). The survey was sent to 405 current, active fellows of the American College of Cardiology, and 151 panelists completed the survey for an overall response rate of 37%.

Guideline Driven Heart Failure: Contemporary Perspectives and Future Considerations with a focus on China
Mar 10, 2017 | COP 1.5

This enlightening Meeting on Demand^™ discusses the medical management of heart failure with a particular focus on China. Current treatment considerations and perspectives are covered, along with a discussion surrounding caring for heart failure patients in the future. The videos were recorded at the Great Wall International Congress of Cardiology in Beijing, China on October 15, 2016. The session was chaired by Zhang Jian, MD, FACC and Lee Goldberg, MD, FACC and featured JoAnn Lindenfeld, MD, FACC, and Tong Liu, MD as speakers. We have included links to the Guideline, the Focused Update, an extensive Heart Failure Workbook, and Patient Education materials. After completing the brief post-test associated with these materials, you will receive a certificate of completion from the American College of Cardiology (ACC). ACC would like to thank Novartis for sponsoring the ACC Global Heart Failure Series through an educational grant.

Guideline Driven Heart Failure: Contemporary Perspectives and Future Considerations with a focus on Mexico
Dec 08, 2016

This enlightening Meeting on Demand^™ discusses the medical and surgical treatment and management of heart failure with a particular focus on Mexico. Current treatment considerations and perspectives are covered, along with a discussion surrounding caring for heart failure patients in the future. The videos were recorded at the World Congress of Cardiology in Mexico City, Mexico on June 5, 2016. The session was chaired by President of the Mexican Society of Cardiology Erick Alexanderson, MD, FACC and Robert Bonow, MD, FACC and featured Daniel Piñeiro, MD, FACC, John McMurray, MD, FACC, and Adolfo Chavez Meñdoza, MD as speakers. In addition to the session, as part of the MOD, you also have access to video from ACC.16. We have included links to the Guideline, the Focused Update, an extensive Heart Failure Workbook, and Patient Education materials. ACC would like to thank Novartis for sponsoring the ACC Global Heart Failure Series through an educational grant.

2016 Interventional Cardiology Overview and Board Prep Meeting on Demand^™ Program
Sep 19, 2016

Intensive, comprehensive and informative — this Meeting on Demand^™ Program will ensure you are prepared for the Boards and for your patients!

The Interventional Cardiology Overview and Board Preparatory Course Meeting on Demand^™ Program combines the relevant review you need for your daily practice with proven learning techniques to help you pass your Boards. Presentations from an expert faculty plus interactive multiple-choice questions enable you to quickly identify and address your learning gaps.

Providing the most up-to-date, evidence-based review of interventional cardiology available, this educational offering’s esteemed faculty will engage you in discussions of ABIM exam guidelines that focus on the main content areas tested on the Boards:

• Case Selection and Management
• Pharmacology
• Catheter-based Management of Noncoronary disease
• Cardiac Imaging and Assessment
• Complications of Coronary Intervention
• Basic Science
• Anatomy, Anatomic Variants, Anatomic Pathology

Additionally, the faculty also discusses HOT TOPICS — what you won’t see on the Boards but need to know! This year’s hot topics include CTO and TAVR.

In addition to the expert presentations listed above, this product includes:

• Online practice exam featuring over 300 questions so you can test your knowledge.
• Printable PDFs of all lectures.
• Downloadable MP3s of all audio presentations.

2016 Recent Advances in Clinical Nuclear Cardiology and Cardiac CT Meeting on Demand^™ Program
Jul 27, 2016

The 2016 Recent Advances in Clinical Nuclear Cardiology and Cardiac CT Meeting on DemandTMProgram is perfect for you if you are:

• Interested in earning your IAC accreditation requirements of 15 Nuclear Credit Hours
• Preparing for the Nuclear (CBNC) and/or Cardiac CT (CBCCT) Boards
• Looking for a review of 101 evidence-based cases focusing on technical and clinical problems commonly encountered in practice to increase your interpretive skills

Designed to meet the needs of professionals who perform or request nuclear cardiology, cardiac CT or cardiac MRI studies, this online course emphasizes the use of these modalities across the spectrum of patients with suspected or known coronary disease as well as other non-coronary cardiac disease states.

Join a faculty of expert cardiac imaging clinicians and scientists from across the country who will guide you through the latest advances in nuclear cardiology, cardiac CT and other imaging modalities while you:

• Explore the latest instrumentation/protocols to improve accuracy and reduce radiation
• Discover the latest imaging procedures to improve patient outcomes and/or reduce costs
• Discuss the evidence supporting value-based imaging

ACC's MOC Guidelines Module 5 - 2017 ACC/AHA/HFSA Focused Update for the Management of Heart Failure
Nov 2017 | CME: 2.5 MOC: 2.5 COP: 2.5

ACC's Maintenance of Certification Guidelines Module 5: 2017 ACC/AHA/HFSA Focused Update for the Management of Heart Failure Receive one new question a day or wait and answer all at once! ACC’s MOC modules feature ABIM-quality questions that not only allow you to assess your current level of knowledge, but help you learn from a detailed commentary that accompanies each question. Our convenient online format allows you to get feedback on each question as you go and submit your scores to the ABIM for 2.5 MOC points in just a few easy clicks.

This module includes new functionality that unlocks one question for you each day, beginning on the day you first access the program. You can choose whether to answer one question a day, or wait and answer all of them at once. You’ll be notified by email whenever a new question is available and you can simply click a link to access it directly from your desktop, laptop or mobile device.

ACCF MOC Collection in General Cardiology Module - 15
Jan 2016 | CME: 1.5 MOC: 10 COP: 1.5

Let ACC help you earn points toward the ABIM’s Maintenance of Certification program AND learn valuable information in the process! ACC’s MOC modules feature ABIM-quality questions that not only allow you to assess your current level of knowledge, but help you learn from a detailed commentary that accompanies each question explaining why the right answer is the best choice, and also why the other answer choices are suboptimal. Our convenient online format allows you to get feedback on each question as you go and submit your scores to the ABIM for MOC credit in just a few easy clicks.

ACCF MOC: Medical Professionalism Module
Sept 2015 | CME: 1.5 MOC: 10 COP: 1.5

ACC’s MOC modules feature ABIM-quality questions that not only allow you to assess your current level of knowledge, but help you learn from a detailed commentary that accompanies each question. Our convenient online format allows you to get feedback on each question as you go and submit your scores to the ABIM for 10 MOC points in just a few easy clicks. This module features 30 multiple-choice questions on the topic of medical professionalism.

Journal Club 2018: Barbershop Trial
July 20, 2018 | CME 2 COP 2 MOC 2

ACC’s educational program, ACC Journal Club offers opportunities to challenge emerging science, critique applicability to practice, consider practical point-of care solutions and cultivate future research opportunities that collective lead to improved cardiovascular health.

This activity is in response to A Cluster-Randomized Trial of Blood-Pressure Reduction in Black Barbershops.

Journal Club 2018: SECURE-PCI
July 20, 2018 | CME 2 COP 2 MOC 2

ACC’s educational program, ACC Journal Club offers opportunities to challenge emerging science, critique applicability to practice, consider practical point-of care solutions and cultivate future research opportunities that collective lead to improved cardiovascular health.

This activity is in response to the Effect of Loading Dose of Atorvastatin Prior to Planned Percutaneous Coronary Intervention on Major Adverse Cardiovascular Events in Acute Coronary Syndrome: The SECURE-PCI Randomized Clinical Trial.

Journal Club 2017
March 1, 2018 | CME 20 MOC 20 COP 20

The continual stream of published science coupled with emphasis on practice improvement requirements has created a need for consensus building conversations that can guide practical practice change delivered at the point-of-care. However, finding the time to critically appraise the evidence or consider the practice implications has led the ACC to seek solutions not only for their members but all cardiovascular providers.

ACC’s educational program, ACC Journal Club offers opportunities to challenge emerging science, critique applicability to practice, consider practical point-of care solutions and cultivate future research opportunities that collective lead to improved cardiovascular health.

Preparticipation Cardiovascular Screening for Adolescent and Young Adult Athlete
July 31, 2017 | CME 2.5 MOC 2.5 CNE 2.5

The target audience of the Preparticipation Cardiovascular Screening for Adolescent and Young Adult Athletes module is the medical provider who cares for athletes. The aim of the module is to provide solid background information on cardiac adaptations to athletics, common etiologies of sudden cardiac death in athletes, and important questions to help identify the athlete who may be at increased cardiac risk. The goal is to equip medical providers with the knowledge that may help them to better screen the athletes for whom they care.

The Role of Non-Statin Therapies for LDL-Cholesterol Lowering in the Management of Atherosclerotic Cardiovascular Disease Risk — A Dialogue With the Experts
Mar 03, 2017

This activity was planned with a goal to optimize patients on their current statin treatment strategies to achieve desired LDL reduction, and to identify patients who truly need the addition of non-statin therapies in order to reach "acceptable LDL thresholds."

Journal Club 2016
Dec 16, 2016 | CME 20 MOC 20

The continual stream of published science coupled with emphasis on practice improvement requirements has created a need for consensus building conversations that can guide practical practice change delivered at the point-of-care. However, finding the time to critically appraise the evidence or consider the practice implications has led the ACC to seek solutions not only for their members but all cardiovascular providers.

ACC’s educational program, ACC Journal Club offers opportunities to challenge emerging science, critique applicability to practice, consider practical point-of care solutions and cultivate future research opportunities that collective lead to improved cardiovascular health.

Self-Assessment Programs Refresh your knowledge of cardiovascular medicine with ACC’s Self-Assessment Programs (SAPs)! Each SAP provides a core curriculum on its topic in a comprehensive yet concise way, featuring text, presentations, images, case studies, and self-assessment questions written by the experts. They’re a great resource for staying up to date, preparing for the Boards, and/or earning CME and MOC credit.   Self-Assessment Programs Clinical Cardiac Electrophysiology Self-Assessment Questions and Board Prep Program Oct 06, 2016 | CME 12.5 MOC 12.5 Are you planning to take the ABIM exam in Clinical Cardiac Electrophysiology, or just looking for a way to identify your areas of strength and weakness in the field? ACC’s new Self-Assessment Questions & Board Prep Program can help you! This product features: 151 questions that allow you to assess your current level of knowledge and help you learn from a detailed commentary that accompanies each question. A convenient online format that gives you feedback after you answer each question. An option to print the questions in pdf format to review offline. Questions written and rigorously peer reviewed by experts in the field to reflect the ABIM blueprint. Advanced Heart Failure and Transplant Cardiology Self-Assessment Questions and Board Prep Program Aug 03, 2016 | CME 12.5 MOC 12.5 Are you planning to take the ABIM exam in Advanced Heart Failure and Transplant Cardiology, or just looking for a way to identify your areas of strength and weakness in the field? ACC’s new Self-Assessment Questions & Board Prep Program can help you! This product features: 152 questions that allow you to assess your current level of knowledge and help you learn from a detailed commentary that accompanies each question. A convenient online format that gives you feedback after you answer each question. An option to print the questions in pdf format to review offline. Questions written and rigorously peer reviewed by experts in the field to reflect the ABIM blueprint. ACCSAP9 Online and Print Mar 24, 2016 Pass the Boards! Use ACCSAP 9 to prepare for the Boards: Familiarize yourself with the ABIM blueprint Hear expert tips on taking the exam Take a simulated Board exam session & identify areas of needed study Learn from educational text and lectures Practice with hundreds of ABIM-style questions with rationale and references Take additional simulated Board exam sessions to see your progress Repeat as necessary and keep track of your progress with ACCSAP’s user-friendly dashboard ACC's General Cardiology Module 15 Jan 04, 2016 | CME 1.5 MOC 10 Let ACC help you earn points toward the ABIM’s Maintenance of Certification program AND learn valuable information in the process! ACC’s MOC modules feature ABIM-quality questions that not only allow you to assess your current level of knowledge, but help you learn from a detailed commentary that accompanies each question explaining why the right answer is the best choice, and also why the other answer choices are suboptimal. Our convenient online format allows you to get feedback on each question as you go and submit your scores to the ABIM for MOC credit in just a few easy clicks. Each module in our series features approximately 30 multiple-choice questions and offers 10 points toward Part II (Self-Assessment of Medical Knowledge) of the ABIM’s MOC program. ACC’s Medical Professionalism MOC Module Sep 18, 2015 | CME 1.5 MOC 10 ACC’s MOC modules feature ABIM-quality questions that not only allow you to assess your current level of knowledge, but help you learn from a detailed commentary that accompanies each question. Our convenient online format allows you to get feedback on each question as you go and submit your scores to the ABIM for 10 MOC points in just a few easy clicks. This module features 30 multiple-choice questions on the topic of medical professionalism, including: Integrity and accountability Fair and ethical stewardship of healthcare resources Evaluating professionalism Self-regulation Commitment to excellence based on: The six Core Competencies created by the Accreditation Council for Graduate Medical Education and the American Board of Medical Specialties for quality patient care with special attention to the Core Competency of Professionalism. The three Fundamental Principles and Ten Commitments proposed by the American Board of Internal Medicine Foundation, the American College of Physicians, and the European Federation of Internal Medicine as developed in the Physician Charter on Medical Professionalism. PLEASE NOTE: This module requires pop-up blockers be turned off as it will open in a separate window. If you have difficulty opening the program, please don't hesitate to contact our technical support: Technical support for online education is available Monday-Friday, 7:00 am to 1:00 am, and Saturday-Sunday, 8:00 am to 8:00 pm (Eastern). You may contact our technical support team by email (acc@romnet.com) or call toll-free 800-461-3994, or call 617-746-2985. Adult Congenital Heart Disease Self-Assessment Questions and Board Prep Program Jul 09, 2015 | CME 5 Are you planning to take the ABIM exam in Adult Congenital Heart Disease, or just looking for a way to identify your areas of strength and weakness in the field? ACC’s new ACHD Self-Assessment Questions & Board Prep Program can help you! This product features: More than 100 questions that allow you to assess your current level of knowledge and help you learn from a detailed commentary that accompanies each question. A convenient online format that gives you feedback after you answer each question. An option to print the questions in pdf format to review offline. Up to 5 AMA PRA Category 1 CME Credits. Questions written and rigorously peer reviewed by experts in the field to reflect the ABIM blueprint.