Atrial fibrillation (AF) is the most common cardiac dysrhythmia and is an accelerating public health challenge. Challenges related to detection, management, and prevention of disability and dysfunction secondary to AF are increasingly apparent. The subspecialty of cardiology, cardiac electrophysiology, is primarily tasked with the treatment of AF. Patients with AF are often ambushed by the condition with approximately 28% to 38% of patients experiencing significant anxiety or depressive symptoms. Behavioral risk reduction can be targeted by achieving and maintaining a healthy BMI, abstaining from smoking, avoiding alcohol consumption, and sustaining regular physical activity. AF patients are also tasked with considering possible treatment options, adhering to medication regiments & lifestyle changes, utilizing wearable technologies, and managing emotional distress, to minimize health risks and optimize quality of life. Major medical organizations have called for integrated, multidisciplinary management as the treatment of choice for AF patients. Health psychologists bring valuable expertise but are not uniformly involved in the care of AF patients. The purposes of this article are to (a) review the existing research on the medical, psychological, and behavioral aspects of contemporary management of AF, (b) highlight the intersections between cardiac electrophysiology and clinical health psychology in managing AF, and (c) call for more health psychologists in this specialized area of cardiac electrophysiology. This opportunity for health psychologists may challenge the profession to further specialize as "cardiac psychologists" and mirror our medical colleagues.

Patients with a reduced ejection fraction of 35% or less and a history of myocardial infarction (MI) are at increased risk of sudden cardiac death (SCD). These patients have a class I indication for an implantable cardioverter‐defibrillator after allowing time for medical therapy optimization and potential cardiac recovery. The rates of SCD are highest in this “gap” period early after a cardiac event, and the wearable cardioverter‐defibrillator (WCD) is an intervention that can be used to protect against SCD during this time period. There has been a clinical trial that randomized patients with a reduced ejection fraction at the time of MI to a WCD versus control. Results of the trial showed no statistically significant difference in the primary endpoint of SCD. There are many intricacies to the interpretation of the trial, including the importance of patient adherence to WCD therapy, which is affected by the patient experience and psychological factors. Patients with a new cardiomyopathy are affected by a mix of psychological factors, including the feeling of safety and protection from a WCD contrasted by the WCD providing a reminder of awareness and fear of ventricular arrhythmias and SCD. Beyond the capabilities of a WCD to defibrillate a life‐threatening ventricular arrhythmia, the device can also provide activity and heart failure diagnostics monitoring. Patients need to be engaged in shared decision‐making conversations about a WCD, so that patients can make a decision based on their own values construct, ultimately increasing adherence among the patients that want a WCD.

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In this study, we present a case of progressive transcatheter aortic valve replacement thrombosis in a patient receiving warfarin that resolved with treatment with heparin and apixaban.

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