Paul Langlois – Mastering Cardiac Care: Interventions, Atrial Fibrillation, and Output Optimization

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Paul Langlois – Mastering Cardiac Care: Interventions, Atrial Fibrillation, and Output Optimization

Cardiac patients often have complex medical histories and comorbidities… and managing these complexities while providing personalized care can be demanding.

Cardiac emergencies require swift, accurate decisions… and you must act quickly and efficiently to save lives. Cardiac technologies and treatment options are rapidly evolving… making it difficult to stay current.

This course will help you navigate these challenges, ensuring you are prepared to provide high-quality care to your patients.

During this comprehensive training event, you can expect to learn:

• Red flags for when cardiac testing is needed stat
• Radiology options as an assessment AND intervention
• Implications of overlooked genetic cardiac tests
• Lifesaving cardiac therapeutics — including the PROMeNADe study
• Up-to-date guidelines for cardiac interventions
• The impact of common medications on cardiac testing

This course is for all clinicians who care for patients with cardiovascular conditions… including NPs, PAs, MDs, Dos, CNS, nurses, and other healthcare providers.

Meet Your Faculty

Paul Langlois, APN, PhD, CCRN, CCNS, is a critical care clinical specialist in the surgical, medical, neurologic, burn, CCU, and trauma ICUs of Cook County Hospital, Chicago. Drawing on over 40 years of experience assessing and managing patients with life-threatening diseases, Dr. Langlois provides advanced-level training to nurses, physician assistants, nurse practitioners, respiratory therapists, and physicians.

Dr. Langlois is committed to providing the highest quality of care to patients through advanced education. His presentations are evidence-based, timely, and provide participants with numerous case studies to facilitate critical thinking. As a bedside clinical nurse specialist, he has developed several institution-wide protocols for the multidisciplinary assessment and management of infectious disease and multi-system organ failure patients.

His presentations are enthusiastically delivered and offer highly practical tips that help make the most challenging concepts easy to understand. Linking knowledge to clinical practice is the goal of every educational program.

Cardiac Diagnostics and Interventions Course

Paul Langlois, APN, PhD, CCRN, CCNS

Here’s what this intensive online course covers:

Electrocardiogram and Electrophysiology

• What you must know when looking at a 12-lead ECG
• When medications do not work – now what?
• Six red flags which indicate greater testing is required

Laboratory Blood and Urine Tests

• Troponins
• B-type natriuretic peptide
• D-dimer
• Electrolytes
• Thyroid function
• Lipid panel
• Arterial blood gas interpretation
• Urine for catecholamines and protein

Genetic Testing for Cardiac Conditions – Often Overlooked

• Inherited cardiac genetic tests for arrhythmias, pulmonary hypertension, familial hypercholesterolemia & more
• Risk stratification of the cardiac condition for potential parents
• What are the therapeutic options based on genetic tests?

Echocardiography is THE Test You Must Know

• When to order an ECHO – what does this really tell the practitioner?
• Five steps to ECHO cardiogram interpretation
• The ECHO colors tell you so much
• What do ECHO bubble studies inform us about the heart

Radiology: An Assessment and Intervention for the Cardiac Patient

• Chest radiograph – what do you need to look for in your cardiac patient?
• Computerized tomography
• Magnet resonance imaging of the heart
• Cardiac angiography – it is more than just vessels
• Positron emission tomography – what will this test tell you?

Interventional Cardiology

• Cardiac catheterization –clarity of blood flow
• Balloon angioplasty and stent placement – difference in the type of stents?
• Cardioversion and ablation – patient selection criteria is vital
• MAZE procedure
• Cardiac stress testing – the dos and don’ts
• Mechanical thrombectomy – patient assessment pre- and post-procedure
• Valvular treatments: transcatheter aortic valve replacement, balloon valvuloplasty and open-heart surgery

Life-Saving Cardiac Therapeutics

• Intra-aortic balloon pump considerations
• Ventricular assist device – not just for the ICU patient anymore
• Extracorporeal membrane oxygenation – selecting between the three types
• Impella Heart Pump: indications, contraindications and monitoring
• Pacemaker and implantable cardiac defibrillator cardioverter; some ICD are MRI compatible (PROMeNADe study)

Plus, you get four BONUS SESSIONS

Atrial Fibrillation and Cardiovascular Implantable Electronic Devices: Latest Research, Treatments & Conundrums

Rebecca Bierle, MSN, APRN, ENP, is an electrophysiology nurse practitioner at Regional Health Heart and Vascular Institute in Rapid City, South Dakota. Rebecca has been recognized for her clinical excellence and leadership in heart failure.

Management of atrial fibrillation

• Rhythm control vs rate control
• Stroke prevention (DOAC, warfarin & left atrial appendage closure device)
• Risk for tachyarrhythmia induced heart failure
• Pharmacological treatment
• Non-pharmacological treatment
• Trials
• Guidelines
• Patient education

Convergent procedure overview

• CV surgery part
• Electrophysiology part

Cardiovascular implantable electronic devices

• Implantable cardiac monitors
• Cardiac resynchronization therapy
• Shocks
• • Emergency department presentation
  • Phantom
  • Appropriate vs inappropriate
• MRI conditional vs nonconditional
• Infections
• End-of-life care/deactivation
• Patient education

Cardiac Output Manipulations for Hemodynamic Stability

Cyndi Zarbano, MSN-Ed, CCRN, CMSRN, LNC, has been a nurse for nearly 30 years specializing in intensive care. A nationally known speaker, She works for Mayo Clinic in Minnesota continuing her passion for bedside nursing in critical care.

Cardiac Findings

• Cardiac Output (CO) = Heart Rate (HR) x Stroke Volume (SV)
• Normal and abnormal values for multiple cardiac findings

Breaking down the equation to manipulate each component

• Heart Rate – too fast or too slow
• Stroke Volume
• Preload – “dry or over-tanked up”/Afterload – manipulating the pressure the heart pushes against to move blood forward
• Contractility – too much or too little squeeze

Fluids and Drugs

• How the initiation of drugs and fluid options can manipulate the equation

Measuring Cardiac Output to Drive Interventions

• Swan Ganz catheters
• FloTrac®/Vigileo Device

Mechanical Hemodynamic Support

• Intra-Aortic Balloon Pumps
• Impellas

Medications

• Understand the rationale behind medication selection

Prescribing Heart Failure Medications: The Latest Updates for Life-Saving Clinical Decisions

Stacie R. Ward-Santangelo, RN, MS, APN, CHFN, CCNS, works as an advanced practice nurse in cardiology and heart failure with Community Physicians. Additionally, she is charged with working with various facilities, and her esteemed colleagues, developing ‘skilled heart units’ in nursing and rehab facilities across the Chicagoland area. Stacie is board-certified in advanced heart failure and cardiology. She has extensive experience working in respected and growing cardiac programs in Chicago and the surrounding suburbs. She is responsible for the program development of cardiac transplantation and mechanical support programs, which are successful and viable today.

Neurohormonal Dysregulation 

• What is really causing the failure
• RAAS
• Shutting it down

Guideline Directed Medical Therapy (GDMT)

• The VIM’s:Beta adrenergic blockers
• The VIM’s:ACEi/ ARB’s
• The VIM’s:Where’s ALDO?
• The VIM’s:The new player:  ARNI
• The VIM’s:SGLT2 inhibition

What do they each do? 

• Critical importance of appropriate integration
• Tips and tricks for patient tolerance
• Monitoring

The VIM’s:  Stay in the Loop with Diuretics 

• Do HF patients ALWAYs need diuretics?
• Subclasses of diuretics to consider
• Thiazides and thiazide-like diuretics
• Carbonic anhydrase inhibitors
• Potassium-sparing diuretics
• Osmotic diuretics

Non-Pharmacologic Interventions for Heart Failure Management 

• Electrophysiology involvement
• • ICD’s
  • Pacemakers
  • BiV-ICD

• PA pressure system
• • Using monitoring to up-titrate GDMT

• Social media as patient support
• Support groups for patients with heart failure

Treatment Options

• Referral to HF specialist
• Treating the cause
• LVAD
• Cardiac transplantation

Pharmacological Decisions to Optimize Cardiac Outcomes

Cheryl Herrmann, RN, MS, APRN, CCRN, CCNS-CSC/CMC, works as an advanced practice nurse in cardiology and heart failure with Community Physicians. Additionally, she is charged with working with various facilities, and her esteemed colleagues, developing ‘skilled heart units’ in nursing and rehab facilities across the Chicagoland area. Stacie is board-certified in advanced heart failure and cardiology. She has extensive experience working in respected and growing cardiac programs in Chicago and the surrounding suburbs. She is responsible for the program development of cardiac transplantation and mechanical support programs, which are successful and viable today.

Heart Failure/Cardiomyopathy Pharmacology: Systolic vs. Diastolic vs Hypertrophic 

• ACE Inhibitors
• Angiotensin Receptor Blockers
• Angiotensin Receptor Neprilysin Inhibitor
• Betablockers
• Diuretics
• Nitrates and Hydralazine
• Sodium Glucose Cotransporter-2 (SGLT2) Inhibitors
• Optimizing outcomes with titrations of medications

Ischemic Heart Disease Pharmacology: STEMI vs. NSTEMI vs chronic angina 

• Fibrinolytics
• Antiplatelets
• Betablockers
• Statins
• Nitrates
• Calcium Channel Blockers

Narrow Complex Tachycardia Pharmacology: Atrial Fibrillation vs. Atrial Flutter vs Supraventricular Tachycardia (SVT) 

• Rhythm vs Rate Control
• Antiarrhythmics
• Calcium Channel Blockers
• Betablockers
• Digoxin
• Anticoagulants

Pharmacology Case Studies 

This course will change your career!

Register now and master the complex concepts you need to advance your skillset and save lives with real-life examples and case studies! Within days, or hours, you’ll get hundreds of proven techniques and methods that will help you:

• Improve the quality of life for heart failure patients and slow down readmissions.
• Skillfully identify challenging atypical cardiac presentations.
• Master 12-lead EKG concepts and respond more appropriately to crises.
• Incorporate clinical pearls of EKG interpretation into daily practice.
• Analyze challenging case studies to recognize the borderline and abnormal findings that you may have previously missed.
• Prescribe the best medications for your patients…and manage their response, side effects, and dosages.
• Implement new nonpharmacological treatments for heart failure patients in your clinical setting.
• Master the various cardiovascular implantable electronic devices.
• Be prepared to initiate cardiac resynchronization therapy, cardioversion, and ablation.
• Collaborate with the team for interventional cardiology such as cardiac catheterization, balloon angioplasty, and stent placement…

… and so much more!

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