This Week In Cardiology

The treatment of asymptomatic aortic stenosis, the move to composite endpoints in trials, IFR vs FFR and high-frequency low tidal volume ventilation for AF ablation are the topics John Mandrola, MD, discusses in today's podcast. This podcast is intended for healthcare professionals only. To read a partial transcript or to comment, visit: https://www.medscape.com/twic I Aortic valve intervention for Asymptomatic AS Lindman editorial https://jamanetwork.com/journals/jamacardiology/fullarticle/2829881 Trends https://pmc.ncbi.nlm.nih.gov/articles/PMC11308430/ Podcast EARLY TAVR Nov 8, 2024 This Week in Cardiology Podcast https://www.medscape.com/viewarticle/1001865 Faith Healing and Subtraction Anxiety https://www.ahajournals.org/doi/10.1161/circoutcomes.118.004665 Early TAVR trial https://www.nejm.org/doi/10.1056/NEJMoa2405880 EVOLVED https://jamanetwork.com/journals/jama/fullarticle/2825540 AVATAR https://www.ahajournals.org/doi/10.1161/CIRCULATIONAHA.121.057639 II Trial Endpoints Shepshelovich https://jaman

Blanking period after AF ablation, periprocedural MI after PCI in non-STEMI, predicting AF after ischemic stroke, and the proper standards for mitral valve repair in primary mitral regurgitation are the topics John Mandrola, MD, discusses in today’s podcast. This podcast is intended for healthcare professionals only. To read a partial transcript or to comment, visit: https://www.medscape.com/twic I AF blanking period CIRCA DOSE Research letter https://www.ahajournals.org/doi/10.1161/CIRCEP.124.013232 Circa-Dose https://www.ahajournals.org/doi/10.1161/CIRCULATIONAHA.119.042622 COMPARE CRYO  https://doi.org/10.1016/j.jacep.2024.03.021 Mohanty et al  10.1016/j.hrthm.2024.08.011 Ruzieh, Foy, Mandrola Patients’ Lives Don’t Pause for Blanking Periods https://doi.org/10.1016/j.ahjo.2024.100497 II Periprocedural MI and Future events Circulation paper https://www.ahajournals.org/doi/10.1161/CIRCULATIONAHA.124.070729 III AI to detect AF related stroke eClinical Medicine Paper  https://www.thelancet.com/journals/ec

Silent cerebral embolism after LAAC, AI in ECG rhythm analysis, anti-thrombotic strategies in patients with AF and CAD, and subclinical AF are the topics John Mandrola, MD, covers in today’s podcast. This podcast is intended for healthcare professionals only. To read a partial transcript or to comment, visit: https://www.medscape.com/twic I. Silent Cerebral Embolism after LAAC JAHA Case Series  https://www.ahajournals.org/doi/10.1161/JAHA.124.037968 JACC  https://doi.org/10.1016/j.jacc.2018.12.039 II. AI Transforming Rhythm Monitor Reading Johnson and colleagues RCT https://www.nature.com/articles/s41591-025-03516-x III. Anticoagulation Alone or OAC plus antiplatelets in patients with CAD and AF Rashedi and colleagues Meta-analysis https://doi.org/10.1016/j.jacc.2024.12.030 AQUATIC https://clinicaltrials.gov/study/NCT04217447 IV. DOAC for Subclinical AF – A Subgroup Analysis of ARTESIA Anticoagulation Uncertainty in Embolic Stroke of Undetermined Source https://www.medscape.com/viewarticle/anticoagulati

Sugar-sweetened beverages, the epidemiology of driving after an ICD, BP measurements, and massive EBM lesson in EVT for acute stroke are the topics John Mandrola, MD, discusses in today's podcast. This podcast is intended for healthcare professionals only. To read a partial transcript or to comment, visit: https://www.medscape.com/twic I. Sugar-Sweetened Beverages Sugary Drinks Fuel Millions of Diabetes and CVD Cases https://www.medscape.com/viewarticle/sugary-drinks-fuel-millions-diabetes-and-cvd-cases-2025a10002wr Nature Medicin;e Epidemiologic Study https://www.nature.com/articles/s41591-024-03345-4 JAMA-Network Open;  Beverage Tax Observational Study https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2829505 Lancet Regional Health; Beverage Tax Philadelphia EHR 10.1016/j.lana.2024.100906 II. Driving With an ICD JACC Electrophysiology paper https://doi.org/10.1016/j.jacep.2024.12.002 Earlier HEART paper https://heart.bmj.com/content/110/24/1401 III. Blood Pressure Measurements and Simple RCTs

Another negative AF ablation trial, predicting AF after stroke, the value of RCTs, troponin testing in the ED and surgical aortic valve choice are the topics John Mandrola, MD, discusses this week. This podcast is intended for healthcare professionals only. To read a partial transcript or to comment, visit: https://www.medscape.com/twic I AF ablation Coronary Sinus Isolation for High-Burden Atrial Fibrillation: A Randomized Clinical Trial https://doi.org/10.1016/j.jacep.2024.09.017 Approaches to Catheter Ablation for Persistent Atrial Fibrillation (STAR AFII) https://www.nejm.org/doi/full/10.1056/NEJMoa1408288 Effect of Catheter Ablation With Vein of Marshall Ethanol Infusion vs Catheter Ablation Alone on Persistent Atrial Fibrillation: The VENUS Randomized Clinical Trial https://doi.org/10.1001/jama.2020.16195 Hybrid Convergent Procedure for the Treatment of Persistent and Long-Standing Persistent Atrial Fibrillation: Results of CONVERGE Clinical Trial https://www.ahajournals.org/doi/10.1161/CIRCEP.120.0092

Familial hypercholesterolemia, cardiac arrest therapy, Factor XI inhibition, and tricuspid valve interventions are the topics John Mandroa, MD, discusses in this week’s podcast. This podcast is intended for healthcare professionals only. To read a partial transcript or to comment, visit: https://www.medscape.com/twic I. Familial hypercholesterolemia Danish Registry Study: https://doi.org/10.1093/eurheartj/ehae912 II. Cardiac Arrest Vallentin and Colleagues RCT https://www.nejm.org/doi/full/10.1056/NEJMoa2407616 III. Factor XI AZALEA https://www.nejm.org/doi/full/10.1056/NEJMoa2406674 OCEANIC https://www.nejm.org/doi/full/10.1056/NEJMoa2407105 VTE Study of Abelacimab 2021 https://www.nejm.org/doi/10.1056/NEJMoa2105872 IV. Tricuspid Valve Interventions TRILUMINATE 1-year Study https://doi.org/10.1016/j.jacc.2024.10.086 Stone Editorial https://doi.org/10.1016/j.jacc.2024.11.045 TRISCEND Main Paper https://www.nejm.org/doi/full/10.1056/NEJMoa2401918 QOL Paper https://doi.org/10.1016/j.jacc.2024.10.067 PAST

Renal denervation, the obesity paradox, JACC and the FINEARTS trial of finerenone in HFpEF, a setback for a PFA system, and coffee are the topics Jon Mandrola, MD, covers this week. This podcast is intended for healthcare professionals only. To read a partial transcript or to comment, visit: https://www.medscape.com/twic I. RDN CMS https://www.cms.gov/medicare-coverage-database/view/ncacal-tracking-sheet.aspx?ncaid=318 Messerli https://doi.org/10.1016/j.jacc.2024.09.1244 Filippone https://doi.org/10.1016/j.amjmed.2023.05.010 II. Finerenone FINEHEARTS -HF NEJM https://www.nejm.org/doi/full/10.1056/NEJMoa2407107 FIDELIO-DKD https://www.nejm.org/doi/full/10.1056/NEJMoa2025845 FIGARO-DKD https://www.nejm.org/doi/full/10.1056/NEJMoa2110956 Why Have We Not Been Able to Demonstrate Reduced Mortality in Patients With HFmrEF/HFpEF? https://doi.org/10.1016/j.jacc.2024.08.033 Regional Variation TOPCAT https://www.ahajournals.org/doi/10.1161/circulationaha.114.013255 Time from WHF Subanalysis https://doi.org/10.1016/j

Alcohol and cancer, GLP-1 trial representativeness, diagnosing CAD, changing stroke rates in patients with AF, blanking periods after AF ablation are the topics John Mandrola, MD, covers this week. This podcast is intended for healthcare professionals only. To read a partial transcript or to comment, visit: https://www.medscape.com/twic I. Surgeon General Causes Hoopla Regarding ETOH Warning Dry January: Should Doctors Make It Year-Round? https://www.medscape.com/viewarticle/dry-january-should-doctors-make-it-year-round-2025a100009t Surgeon General Warning https://www.hhs.gov/about/news/2025/01/03/us-surgeon-general-issues-new-advisory-link-alcohol-cancer-risk.html GBD 2016 Collaboration Lancet https://doi.org/10.1016/S0140-6736(18)31310-2 RCT Voskobonik and colleagues https://www.nejm.org/doi/full/10.1056/NEJMoa1817591 Marcus and colleagues; UCSF https://pubmed.ncbi.nlm.nih.gov/33516710/ Review of ETOH AF https://doi.org/10.1016/j.jacc.2016.08.074 II. GLP-1 Agonists for Obesity –Trial vs Real World Gener

Listener feedback, multiple studies in AF ablation, a DANISH trial substudy of ICDs in NICM, and more data on eye complications of GLP-1 agonists are the topics John Mandrola, MD, covers in this week’s podcast. This podcast is intended for healthcare professionals only. To read a partial transcript or to comment, visit: https://www.medscape.com/twic I. CCTA Feedback Foy meta-analysis https://jamanetwork.com/journals/jamainternalmedicine/fullarticle/2655243 DANCAVAS https://www.nejm.org/doi/full/10.1056/NEJMoa2208681 II. Listener Feedback on my negative take of the OPTION Trial. Option trial https://www.nejm.org/doi/pdf/10.1056/NEJMoa2408308 My Preview https://www.medscape.com/viewarticle/mandrola-previews-option-trial-most-worrisome-study-aha-2024-2024a1000kmz 4 Reasons to Question Percutaneous Left Atrial Appendage Closure After AF Ablation https://www.medscape.com/viewarticle/4-reasons-question-percutaneous-left-atrial-appendage-2024a1000l0u III. AF Ablation  PVI Add-Ons Provide Better Control of Persi

US doc's pay, the ticagrelor controversy and new RCTs, clopidogrel beats ASA, holding antiplatelets for non-cardiac surgery, and Prof Cleland and ASA dogma are the topics John Mandrola, MD, covers this week. This podcast is intended for healthcare professionals only. To read a partial transcript or to comment, visit: https://www.medscape.com/twic I. US Healthcare Mandrola’s Top 10 Stories in 2024 https://www.medscape.com/viewarticle/mandrolas-top-10-stories-2024-2024a1000mxe?_gl=1*dcvmkh*_gcl_au*MTgzOTY2ODQ0Ni4xNzI5MjU4NjUz CMS Proposal II. Ticagrelor Controversy New Investigation Casts Doubt on Landmark Ticagrelor Trial https://www.medscape.com/viewarticle/new-investigation-casts-doubt-landmark-ticagrelor-trial-2024a1000n1d Doshi Review https://www.bmj.com/content/387/bmj.q2550 PLATO https://www.nejm.org/doi/full/10.1056/NEJMoa0904327 ISAR REACT 5 https://www.nejm.org/doi/full/10.1056/NEJMoa1908973 Bates Review https://www.ahajournals.org/doi/epub/10.1161/JAHA.123.031606 Victor Serebuany and Dan Atar Edi

Tirzepatide vs semaglutide in obesity; GLP1a use is complicated; HF outcomes; the misuse of meta-analyses in HF; and a breakthrough in HF care are the topics John Mandrola, MD, covers this week. This podcast is intended for healthcare professionals only. To read a partial transcript or to comment, visit: https://www.medscape.com/twic I. SURMOUNT 5 Clinicaltrials.gov https://clinicaltrials.gov/study/NCT05822830 Press Release   II. Access to GLP-1 Agonist Drugs CMS statement https://www.cms.gov/newsroom/press-releases/biden-harris-administration-announces-medicare-advantage-and-medicare-part-d-prescription-drug III. SUMMIT TRIAL commentary Has Tirzepatide Scaled the HFpEF/Obesity SUMMIT? https://www.medscape.com/viewarticle/has-tirzepatide-scaled-hfpef-obesity-summit-2024a1000m2h IV. Blank Spot in HF Evidence – All cause hospitalizations   Sayed and colleagues What Is Success in HF Trials? https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2827168 EMPEROR-Preserved https://www.nejm.org/doi/full/

An AHA review: the OPTION, SUMMIT, VANISH 2, SARAH, and CLEAR trials are the topics John Mandrola, MD, discusses in this week’s podcast. This podcast is intended for healthcare professionals only. To read a partial transcript or to comment, visit: https://www.medscape.com/twic I. OPTION Trial For AF, LAA Rivals Anticoagulants After Ablation https://www.medscape.com/viewarticle/af-laa-rivals-anticoagulants-after-ablation-2024a1000l7n 4 Reasons to Question Percutaneous Left Atrial Appendage Closure After AF Ablation https://www.medscape.com/viewarticle/4-reasons-question-percutaneous-left-atrial-appendage-2024a1000l0u OPTION in NEJM https://www.nejm.org/doi/full/10.1056/NEJMoa2408308 II. SUMMIT Trial Tirzepatide Reduces Heart Failure Events in HFpEF With Obesity https://www.medscape.com/viewarticle/tirzepatide-reduces-heart-failure-events-hfpef-obesity-2024a1000kx5 SUMMIT in NEJM https://www.nejm.org/doi/full/10.1056/NEJMoa2410027 III. VANISH Trial New Trial Result Pushes Past Antiarrhythmic Therapy Afte

Tirzepatide, AF screening, and an AHA preview, including VT ablation, LAAC at the time of AF ablation, BP targets, and GLP1 agonists in HF are the topics John Mandrola, MD, covers in today's podcast. This podcast is intended for healthcare professionals only. To read a partial transcript or to comment, visit: https://www.medscape.com/twic I. Tirzepatide SURMOUNT 1 – Three-year results https://www.nejm.org/doi/full/10.1056/NEJMoa2410819 II. AF Screening GUARD AF https://www.jacc.org/doi/10.1016/j.jacc.2024.08.019 LOOP 10.1016/S0140-6736(21)01698-6 STROKE STOP 10.1016/S0140-6736(21)01637-8 III. LAAC with AF ablation  Mandrola Previews the OPTION Trial, the Most Worrisome Study at AHA 2024 https://www.medscape.com/viewarticle/mandrola-previews-option-trial-most-worrisome-study-aha-2024-2024a1000kmz The OPTION Trial Rationale https://doi.org/10.1016/j.ahj.2022.05.003 IV. Blood Pressure Targets BPROAD https://onlinelibrary.wiley.com/doi/10.1111/1753-0407.13411 ACCORD - https://www.nejm.org/doi/full/10.1056

The EARLY TAVR trial, colchicine after MI, and the TRISCEND II trial of tricuspid valve replacement are the topics John Mandrola, MD, covers in this week’s podcast. This podcast is intended for healthcare professionals only. To read a partial transcript or to comment, visit: https://www.medscape.com/twic I. Early TAVR EARLY TAVR https://www.acc.org/latest-in-cardiology/clinical-trials/2024/10/24/14/42/early-tavr Rationale https://doi.org/10.1016/j.ahj.2023.11.019 AVATAR https://www.ahajournals.org/doi/10.1161/CIRCULATIONAHA.121.057639 RECOVERY https://www.nejm.org/doi/full/10.1056/NEJMoa1912846 FAME 2 https://www.nejm.org/doi/full/10.1056/NEJMoa1205361 Rajkumar; Faith Healing in Unblinded Trials https://pubmed.ncbi.nlm.nih.gov/29530888/ PARTNER 3 trial https://www.nejm.org/doi/full/10.1056/NEJMoa2307447 EARLY TAVR: A Positive Trial That Fails to Inform Clinical Decisions https://www.medscape.com/viewarticle/early-tavr-positive-trial-fails-inform-clinical-decisions-2024a1000kec II. Colchicine Meta-analysis

Listener feedback on PFA and STEMI/NSTEMI paradigm, oral semaglutide, symptomatic vs asymptomatic AF, and the win-ratio are the topics John Mandrola, MD, discusses in this week's podcast. This podcast is intended for healthcare professionals only. To read a partial transcript or to comment, visit: https://www.medscape.com/twic I. Listener Feedback Oct 18, 2024 This Week in Cardiology Podcast https://www.medscape.com/viewarticle/1001769 Pulsed Field Ablation https://www.hrsonline.org/guidance/safety-alerts/boston-scientific-cardiac-cryoablation-system STEMI/NSTEMI https://doi.org/10.1016/j.jacadv.2024.101314 II. Oral Semaglutide Press Release: https://www.novonordisk.com/content/nncorp/global/en/news-and-media/news-and-ir-materials/news-details.html?id=171480 Rationale Paper SOUL trial III. Symptomatic vs Asymptomatic AF Meta-analysis in EHJ   Meta-analysis of rate vs rhythm-control strategies https://doi.org/10.1016/j.jacep.2024.03.006 IV. The Win Ratio Pocock and colleagues https://doi.org/10.1093

Listener feedback on the c-statistic, atherosclerotic plaque imaging, WATCHMAN implant decisions in the US, and deprescribing are the topics John Mandrola, MD, discusses in this week’s podcast. This podcast is intended for healthcare professionals only. To read a partial transcript or to comment, visit: https://www.medscape.com/twic I.Listener Feedback Oct 11, 2024 This Week in Cardiology Podcast https://www.medscape.com/viewarticle/1001735 Nancy Cook; C-statistic https://doi.org/10.1161/CIRCULATIONAHA.106.672402 II. Plaque Imaging New Evidence That Plaque Buildup Shouldn't Be Ignored https://www.medscape.com/viewarticle/new-evidence-plaque-buildup-shouldnt-be-ignored-2024a1000ihw Fuster and colleagues; Imaging vs CAC   III. WATCHMAN Decisions Zeitler and colleagues. Long-term Outcomes IV. Deprescribing Cognitive Decline and Antihypertensive Use: New Data https://www.medscape.com/viewarticle/cognitive-decline-and-antihypertensive-use-new-data-2024a1000isw?form=fpf Jing and colleagues. You may also

Reader feedback on cardiac devices and PFA, a new paradigm in the language of MI, sudden cardiac death, and measuring blood pressure are the topics John Mandrola, MD, discusses in this week’s podcast. This podcast is intended for healthcare professionals only. To read a partial transcript or to comment, visit: https://www.medscape.com/twic I. Listener Feedback Sep 20, 2024 This Week in Cardiology Podcast https://www.medscape.com/viewarticle/1001631 Cardiac Devices https://www.acpjournals.org/doi/10.7326/ANNALS-24-00724 Impact of PFA on Intraluminal Esophageal Temperature https://onlinelibrary.wiley.com/doi/10.1111/jce.16096 II. Towards a New Classification of MI McLaren and colleagues; From STEMI to OMI https://doi.org/10.1016/j.jacadv.2024.101314 III. Sudden Death After MI. EHJ Paper; SCD After MI https://doi.org/10.1093/eurheartj/ehae326 Barsheshet and colleagues; Risk Score to Predict Benefit of ICD https://doi.org/10.1016/j.jacc.2012.02.036 Zegard and colleagues; Myocardial Fibrosis and SCD 10.10

Reader feedback on LGE pre-ICDs, PFA for AF ablation, CTO-PCI, endovascular ablation of the greater splanchnic nerve in HFpEF, and data sharing are the topics John Mandrola, MD, covers this week. This podcast is intended for healthcare professionals only. To read a partial transcript or to comment, visit: https://www.medscape.com/twic I. Listener Feedback Sept 27, 2024 This Week in Cardiology Podcast https://www.medscape.com/viewarticle/1001666 JAMA Meta-analysis https://jamanetwork.com/journals/jama/fullarticle/2823869/ II. Pulsed Field Ablation for AF Feb 02, 2024 This Week in Cardiology Podcast https://www.medscape.com/viewarticle/999995 ADMIRE Trial https://www.ahajournals.org/doi/10.1161/CIRCULATIONAHA.124.070333 ADVENT Trial https://www.nejm.org/doi/full/10.1056/NEJMoa2307291 III. PCI for CTO EuroCTO One Year SAQ Results https://doi.org/10.1093/eurheartj/ehy220 EuroCTO Hard Outcomes https://eurointervention.pcronline.com/article/three-year-outcomes-of-eurocto-a-randomized-multicentre-trial-compari

Surgical clearance, NICM assessment, dueling perspectives on PCI as first-line therapy for angina, GDMT in HFrEF are the topics John Mandrola, MD, discusses in this week's podcast. This podcast is intended for healthcare professionals only. To read a partial transcript or to comment, visit: https://www.medscape.com/twic I. New ACC Peri-operative Guidelines Released ACC Guideline document https://www.jacc.org/doi/10.1016/j.jacc.2024.06.013 J Vasc Surg https://www.jvascsurg.org/article/S0741-5214(21)00335-9/fulltext McFalls and colleagues; CARP https://www.nejm.org/doi/full/10.1056/NEJMoa041905 II. NICM – We may be doing it wrong in Selecting ICDs JAMA Meta-analysis https://jamanetwork.com/journals/jama/fullarticle/2823869/ German CMR ICD Trial https://www.clinicaltrials.gov/study/NCT04558723 BRITISH CMR trial https://www.hra.nhs.uk/planning-and-improving-research/application-summaries/research-summaries/britishusing-cmr-scar-as-risk-indication-tool-in-nicm-and-severe-lvsd/ III. When Should PCI be Used in C

Listener feedback, K levels post cardiac surgery, cardiac device safety, disparities in preventive care, stopping trials early, and a SHAM-PVI update are the topics John Mandrola, MD, covers this week. This podcast is intended for healthcare professionals only. To read a partial transcript or to comment, visit: https://www.medscape.com/twic I. Listener Feedback Sep 13, 2024 This Week in Cardiology Podcast https://www.medscape.com/viewarticle/1001596 Sripal Bangalore Tweet on Yusef Meta-analysis https://x.com/SripalBangalore/status/1750116964893094125 II. Post Cardiac Surgery AF TIGHT K Trial https://jamanetwork.com/journals/jama/fullarticle/2823246 III. Evidence Base for New Cardiac Devices Annals of IM Survey Observational Study https://www.acpjournals.org/doi/10.7326/ANNALS-24-00724 IV. Disparities in Care JAMA Network Open Paper on Insurer Denials of Preventive Care https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2823677 V. Stopping Trials Early Kaul and Butler; Insights on Recent CK