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The management of anticoagulation in patients undergoing surgical procedures is challenging and a common problem. About one quarter of anticoagulated patients requires temporary cessation for a planned intervention within 2 years.

NOAC interruption periods may require adaptation based on the individual benefit/risk ratio, based on thrombotic risk vs. bleeding risk.

This is a talk by Dr Saeed Oraii, from Tehran Arrhythmia Center, during the 22^nd international congress on cardiovascular updates, 2023. In this case-based lecture the different clinical scenarios where interruption of anticoagulation could be challenging are discussed along with the latest clinical recommendations.

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Novel Oral Anticoagulants (NOACs) are recommended as a class I indication for anticoagulation in various clinical settings of patients with atrial fibrillation who are candidate for stroke prevention. The anti-platelet drugs such as Aspirin or Clopidogrel are also recommended in patients with coronary artery disease. The combination of NOACs with anti-platelet drugs, however, may expose patients to an increased risk of bleeding complications. This case-based talk was presented by Dr Saeed Oraii from Tehran Arrhythmia Center in a meeting held in the beautiful city of Shiraz in 2022. Current recommendations on combined use of these drugs as well as specific gray zone scenarios where NOACs maybe indicated are discussed.

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Atrial fibrillation, also called as Delirium Cordis, is described as an epidemiologic time bomb. One out of every three people will be affected by AF during their lifetime. AF is the most common sustained cardiac arrhythmia, is the most common cause of arrhythmia induced cardiomyopathy and is one of the major causes of embolic stroke.

Daily Cardiology Symposium is held every year, thanks to the great efforts of our outstanding colleagues, Dr. Hasan Riahi and Dr. Reza Ghanavati. This is a talk presented by Dr. Saeed Oraii from Tehran Arrhythmia Center about the updates on atrial fibrillation. An exemplary patient with atrial fibrillation is presented and the various diagnostic and therapeutic options are discussed on a step by step basis, along with the discussion of the latest scientific guidelines.

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Heart failure is a major and growing public health problem. It is the number one cause of hospital admission in patients over 65 years old. Unfortunately, without treatment the prognosis is very poor. The heart failure mortality is estimated to be over 3 times the number of breast and prostate cancer deaths combined.

There has been a huge advancement in the treatment of heart failure during the last decade. New heart failure drugs are proved to be effective in the improvement of both symptoms and mortality. Cardiac resynchronization therapy, first introduced in 1994, has also had a major impact in the treatment of patients with heart failure and left bundle branch block who are refractory to medical therapy.

Daily Cardiology Symposium is held every year, thanks to the great efforts of our outstanding colleagues, Dr. Hasan Riahi and Dr. Reza Ghanavati. This is a talk

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For the first time in Iran, the pacemaker and electrophysiology department and arrhythmia clinic were founded in Rajaii Heart Hospital in the year 2000. After leaving the Heart Hospital in 2002, Tehran Arrhythmia Center was established as the first private subspecialty center for the comprehensive diagnosis and treatment of cardiac arrhythmias. Since 2020, the original mission is being followed in the current organization.