This Week in Cardiology

The ASPIRED syncope RCT, two studies in coronary artery calcium scoring, and the LEAP-Block trial of CSP vs RV pacing are the topics John Mandrola, MD, discusses in this week’s podcast.

This podcast is intended for healthcare professionals only.

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I Syncope

• ASPIRED Trial https://www.nejm.org/doi/full/10.1056/NEJMoa2605812
• REMOSYNCED Trial https://clinicaltrials.gov/study/NCT05066347

II TWO CAC Studies

• Atherosclerosis in Young Adults and Risk of Mortality Over 30 Years https://jamanetwork.com/journals/jamacardiology/fullarticle/2855732
• Predictive Utility of CAC Score Added to PREVENT Score https://jamanetwork.com/journals/jama/fullarticle/2853347

III Conduction System Pacing vs Standard RV Pacing for AV block

• LEAP-Block Trial https://jamanetwork.com/journals/jama/fullarticle/2855975
• Meta-analysis: CSP vs RV Pacing in Preserved or Mildly Reduced EF https://doi.org/10.1016/j.cjca.2026.04.009

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Listener feedback on the nonobstructive HCM trials, AI-enhanced visits, timing of non-culprit PCI in STEMI, new tricuspid valve intervention, and EP at a crossroads are the topics John Mandrola, MD, discusses in this week’s podcast.

This podcast is intended for healthcare professionals only.

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I Listener Feedback

Koelemen meta-analysis https://www.medrxiv.org/content/10.64898/2026.09.08.26362195v1.full.pdf

Improving SCD Risk Stratification in HCM https://pmc.ncbi.nlm.nih.gov/articles/PMC11026183/

II More on Nonobstructive HCM

Communication on Post-Hoc Analysis of ODYSSEY (mavacamten)

Mavacamten in Nonobstructive HCM 10.1016/j.jacc.2025.12.092

III Complete vs Staged PCI in STEMI With Multivessel Disease

Immediate vs Staged CR in Multivessel Disease and STEMI: Meta-Analysis https://doi.org/10.1016/j.jcin.2026.07.033

Timing of Nonculprit PCI for STEMI and Multivessel Disease: Editorial https://doi.org/10.1016/j.jcin.2026.08.009

COMPLETE Trial https://www.nejm.org/doi/full/10.1056/NEJMoa1907775

FLOWER MI Trial https://www.nejm.org/doi/full/10.1056/NEJMoa2104650

FRAME AMI Trial https://doi.org/10.1093/eurheartj/ehac763

iMODERN Trial https://www.nejm.org/doi/full/10.1056/NEJMoa2512918

COCUA Trial https://doi.org/10.1016/j.ahj.2023.01.020

MULTISTARS Trial https://www.nejm.org/doi/full/10.1056/NEJMoa2307823

OPTION STEMI Trial 10.1016/S0140-6736(25)01529-6 External Link

CULPRIT SHOCK Trial https://www.nejm.org/doi/full/10.1056/NEJMoa1710261

BioVasc Trial Substudy https://eurointervention.pcronline.com/article/immediate-versus-staged-complete-revascularisation-in-patients-presenting-with-stemi-and-multivessel-disease

Main BioVasc Trial 10.1016/S0140-6736(23)00351-3 External Link

FULL REVASC Trial https://www.nejm.org/doi/full/10.1056/NEJMoa2314149

IV A Call to Action for Electrophysiologists

Twenty Years at the Crossroads 10.1016/j.jacep.2026.09.023

EP at a Crossroads - Josephson 2007 https://doi.org/10.1016/j.hrthm.2006.12.045

EP at a Crossroads: A Revisit - Josephson 2016 https://doi.org/10.1016/j.hrthm.2016.07.024

V FDA Approves Another Tricuspid Valve Repair System

Press release https://www.edwards.com/newsroom/news/2026-10-21-fda-approval-of-edwards-lifesciences--pascal-preci

TRIC I HF Trial https://www.nejm.org/doi/full/10.1056/NEJMoa2606934

CLASP II TR Trial https://pubmed.ncbi.nlm.nih.gov/42855029/

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Some promising studies in amyloidosis, aficamten in nonobstructive HCM, costs of the microaxial flow pump in cardiogenic shock, and more on the VESALIUS trial of evolocumab are the topics John Mandrola, MD, discusses in this week’s podcast.

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I Light Chain Amyloidosis – A Potentially Helpful Drug

Anselamimab Does Not Reduce Light-Chain Amyloidosis Deaths

https://www.medscape.com/viewarticle/anselamimab-does-not-reduce-light-chain-amyloidosis-deaths-2026a1000z79

II Aficamten in Nonobstructive HCM: The ACACIA trial

III Microaxial Flow Pump Cost Analysis of Danger Shock

IV More on Evolocumab at ESC: Vesalius Trial Substudies

The Bob Harrington Show with the Stephen and Suzanne Weiss Dean of Weill Cornell Medicine, Robert A. Harrington, MD. https://www.medscape.com/author/bob-harrington

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Listener feedback on POET II, sham control trials in atrial fibrillation, ICDs in HCM, and agenda laundering are the topics John Mandrola, MD, discusses in this week's podcast.

This podcast is intended for healthcare professionals only.

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I Listener Feedback

POET II Response-Tailored or Standard-Duration ABX for Infectious Endocarditis

• POET I Trial https://www.nejm.org/doi/10.1056/NEJMoa1808312
• POET II Trial https://www.nejm.org/doi/full/10.1056/NEJMoa2607887

II PVI-SHAM-AF trial Back in the News

• GAP-AF Trial https://www.ahajournals.org/doi/10.1161/circep.115.003337
• PVI-SHAM-AF Trial 10.1016/S0140-6736(26)01558-8 External Link
• Why Sham Studies Are a Sham in 2026 10.1016/j.hrthm.2026.09.056 External Link
• The Indispensable Role of Sham Controls in Evaluating Interventional Therapies 10.1016/j.hrthm.2026.10.001 External Link

III ICDs in HCM

• I CDs for the Prevention of SCD in High-Risk Patients with HCM https://www.ahajournals.org/doi/10.1161/CIRCULATIONAHA.125.078597
• ICDs in HCM: Editorial https://www.ahajournals.org/doi/10.1161/CIRCULATIONAHA.126.079687

IV Agenda Laundering

• How Commercial “Agenda Laundering” Shapes Critical Care https://www.bmj.com/content/395/bmj-2026-100963

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Listener feedback on DANISH-CRT, the POET II trial, a mechanistic study in obesity and AF, the DANCODE trial of slowing CAC progression, and more on GLP-1 drugs are the topics John Mandrola, MD, discusses in this week's podcast.

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I Listener Feedback

• DANISH-CRT Trial 10.1016/S0140-6736(26)01597-7
• Identifying LV Posterior Wall Delay in RBBB Using Lead V8 https://doi.org/10.1016/j.jacep.2026.03.009
• Using Lead V8 as a Tool to Improve Patient Selection in CRT https://doi.org/10.1093/europace/euaf194

II POET II Response-Tailored or Standard-Duration Antibiotics for Endocarditis

• POET I https://www.nejm.org/doi/10.1056/NEJMoa1808312
• POET II https://www.nejm.org/doi/full/10.1056/NEJMoa2607887

III Obesity and AF – A Neat Study from the Team in Prague

• LA Remodeling and Functional Maladaptations in Obesity https://www.ahajournals.org/doi/10.1161/CIRCHEARTFAILURE.126.014509

IV Reducing CAC: The DANCODE Trial

• DANCODE Trial https://www.ahajournals.org/doi/10.1161/CIRCULATIONAHA.126.082363

V Two Big RCTs of New GLP-1 Drugs

• TRIUMPH-1 Trial https://www.nejm.org/doi/full/10.1056/NEJMoa2604169
• SYNCHRONIZE-2 Trial https://www.nejm.org/doi/full/10.1056/NEJMoa2607219

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Listener feedback, pulmonary embolism intervention, simple vs complex in BiV pacing, exercise in AF, and TAVR for paradoxical low-flow, low-gradient aortic stenosis are the topics John Mandrola, MD, discusses in this week's podcast.

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I Listener Feedback LBBP ICD Lead

• LEADR LBBAP Trial https://pubmed.ncbi.nlm.nih.gov/41110529/

TRIC-I-HF trial

• TRIC-I-HF Trial https://www.nejm.org/doi/full/10.1056/NEJMoa2606934
• Growth of Tricuspid Interventions in Germany https://www.jacc.org/doi/10.1016/j.jcin.2025.05.030

II Treatment of Acute Intermediate-High Risk PE – the PRAGUE-26 Trial

• PRAGUE-26 Trial https://www.nejm.org/doi/full/10.1056/NEJMoa2608012

III Targeting CS leads in CRT devices – DANISH-CRT Trial

• DANISH-CRT Trial 10.1016/S0140-6736(26)01597-7

IV Exercise for AF, Especially When There Is LA Disease

• Physical Activity and Risk of Incident AF in Atrial Cardiomyopathy https://www.jacc.org/doi/10.1016/j.jacadv.2026.102999

V Paradoxical Low-Flow, Low-Gradient AS – REBOOT-PARADOX

• REBOOT-PARADOX trial 10.1016/j.jacc.2026.08.017
• ROTAS Trial https://heart.bmj.com/content/110/20/1223

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Another ESC recap, listener feedback on two trials, and a paper on GLP-1 effects on inflammation from the SELECT trial are the topics John Mandrola, MD, discusses in this week's podcast.

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I Correction on PROFID Trial

II Listener Feedback

III Fifth Universal Definition of MI

• Fifth Universal Definition of MI https://doi.org/10.1093/eurheartj/ehag101
• Foy/Mandrola Editorial on Troponin Use and Interpretation https://jamanetwork.com/journals/jamainternalmedicine/fullarticle/2777967

IV New ESC HF Guidelines

• ESC Guidelines for Management of HF https://doi.org/10.1093/eurheartj/ehag100
• Sanjay Kaul on X https://x.com/kaulcsmc/status/2094959683215958158?s=20
• Geographic Disparities in TOPCAT https://pmc.ncbi.nlm.nih.gov/articles/PMC5065247/

V AIR STEMI Trial

• AIR-STEMI Trial https://www.nejm.org/doi/full/10.1056/NEJMoa2605373
• CR Strategies After MI https://www.jacc.org/doi/10.1016/j.jacc.2024.04.051
• PRAMI Trial https://www.nejm.org/doi/full/10.1056/NEJMoa1305520
• COMPLETE Trial https://www.nejm.org/doi/full/10.1056/NEJMoa1907775
• FULL REVASC Trial https://www.nejm.org/doi/full/10.1056/NEJMoa2314149

VI GLP-1 News – A SELECT Trial Secondary Analysis

• Semaglutide and hsCRP in Patients with CVD and Obesity https://www.ahajournals.org/doi/10.1161/CIRCULATIONAHA.125.074482

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A second ESC recap plus two breaking stories on the failure of an investigational Lp(a) reducing drug and a new FDA approval of an AI-ECG app are covered by John Mandrola, MD

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I Lp(a) Disappointment

• HORIZON https://clinicaltrials.gov/study/NCT04023552
• Press Release https://www.novartis.com/news/media-releases/novartis-announces-lpahorizon-phase-iii-topline-results-pelacarsen-patients-elevated-lpa-and-established-cardiovascular-disease-cvd
• Rationale paper https://doi.org/10.1016/j.ahj.2025.03.019

II FDA Clears AI-ECG for Acute MI Detection

• Accuracy of cath lab activation decisions for STEMI-equivalent and mimic ECGs: Physicians vs. AI (Queen of Hearts by PMcardio) 10.1016/j.ajem.2025.07.061
• AI-Enabled ECG Analysis Improves Diagnostic Accuracy and Reduces False STEMI Activations: A Multicenter U.S. Registry https://www.jacc.org/doi/10.1016/j.jcin.2025.10.018
• Queen of Hearts™ AI ECG App https://www.powerfulmedical.com/pmcardio-stemi/

III TARGET CTCA Trial

• Targeted Use of Computed Tomographic Coronary Angiography in Acute Chest Pain https://www.nejm.org/doi/10.1056/NEJMoa2608903

IV CorCal trial

• Press release https://www.escardio.org/news/press/press-releases/new-data-presented-on-the-use-of-coronary-artery-calcium-for-cardiovascular-risk-assessment/
• CorCal Outcomes: A randomized trial using the pooled cohort equation or coronary artery calcium to select statin therapy in primary prevention patients. Study design and baseline characteristics https://doi.org/10.1016/j.ahj.2026.107473

V AMUNDSEN Trial

• LDL Cholesterol Lowering With Evolocumab Before Percutaneous Coronary Intervention for Acute Myocardial InfarctionThe AMUNDSEN Randomized Clinical Trial https://jamanetwork.com/journals/jama/fullarticle/2853274

VI TRIC-I-HF trial

• Tricuspid Repair Cuts Death, HF Hospitalization in Severe TR https://www.medscape.com/viewarticle/tricuspid-repair-cuts-death-hf-hospitalization-severe-tr-2026a1000wvk
• Tricuspid-Valve Intervention in Heart Failure https://www.nejm.org/doi/full/10.1056/NEJMoa2606934

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ESC recaps on the SINGLE-AF trial, CMR Guide trial, two ATTR studies, PVI-SHAM-AF, STAREE, and an observational study of ICD benefit over the past decades are the topics John Mandrola, MD, discusses in this week's podcast.

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I SINGLE-AF Trial

To Anticoagulate or Not in Intermediate-Risk AF: The SINGLE-AF Trial https://www.medscape.com/viewarticle/anticoagulate-or-not-intermediate-risk-af-single-af-trial-2026a1000uko

• SINGLE-AF https://www.nejm.org/doi/10.1056/NEJMoa2607978

II Scar as an ICD risk stratifier

Is Scar on CMR an Indication for ICD? CMR Guide Leaves Doubts

https://www.medscape.com/viewarticle/scar-cmr-indication-icd-cmr-guide-leaves-doubts-2026a1000ukq

• CMTR GUIDE Trial https://jamanetwork.com/journals/jama/fullarticle/2853395
• MADIT II Trial https://www.nejm.org/doi/full/10.1056/NEJMoa013474

III Single vs Dual Therapy in ATTR-CM

• HELIOS-B Trial Sub-analysis https://www.sciencedirect.com/science/article/pii/S0735109726072086
• HELIOS-B Sub-analysis Editorial https://www.sciencedirect.com/science/article/pii/S0735109726073766#bib8
• HELIOS-B main trial https://www.nejm.org/doi/10.1056/NEJMoa2409134
• CARDIO-TTRansform Trial https://www.nejm.org/doi/full/10.1056/NEJMoa2608510

IV A Stunning Result of another Sham-controlled AF ablation trial

Does AF Ablation Work? That's in Question After PVI-SHAM-AF https://www.medscape.com/viewarticle/does-af-ablation-work-s-question-after-sham-pvi-af-2026a1000uli

• PVI-SHAM-AF Trial 10.1016/S0140-6736(26)01558-8 External Link
• SHAM-PVI Trial https://jamanetwork.com/journals/jama/fullarticle/2823283
• PFA-Sham Trial https://www.ahajournals.org/doi/10.1161/CIRCULATIONAHA.126.079484

V Should Older Adults Take Statins: The STAREE trial.

STAREE Strengthens Case for Over-the-Counter Statins https://www.medscape.com/viewarticle/staree-strengthens-case-over-counter-statins-2026a1000vrw

• STAREE Trial https://www.nejm.org/doi/full/10.1056/NEJMoa2607314

VII Declining ICD Benefit After MI

• Mortality Reduction with ICD for Prevention of SCD Post-MI https://academic.oup.com/eurheartj/advance-article/doi/10.1093/eurheartj/ehag706/8768943
• CONTEMP-ICD Trial https://clinicaltrials.gov/study/NCT06543446
• PROFID-EHRA Trial https://profid-project.eu/profid-ehra-trial/

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Listener feedback on mechanical CPR devices, PFA and stroke, the Lindy effect in adopting new technology, and an ESC preview are the topics John Mandrola, MD, discusses in this week's podcast.

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I Listener Feedback on Mechanical Compression Devices for OHCA

• Mechanical CPR Device Use and Cardiac Arrest Survival

https://www.ahajournals.org/doi/10.1161/CIRCULATIONAHA.126.079272

• PARAMEDIC trial https://www.thelancet.com/article/S0140-6736(14)61886-9/fulltext
• CIRC trial https://www.resuscitationjournal.com/article/S0300-9572(14)00128-2/fulltext
• LINC trial https://jamanetwork.com/journals/jama/fullarticle/1774037
• Cochrane Review – Mechanical vs Manual Chest Compressions for Cardiac Arrest https://pmc.ncbi.nlm.nih.gov/articles/PMC6953326/

II PFA and Stroke

• Risk of Stroke and TIA With PFA vs RF Ablation https://www.ahajournals.org/doi/epub/10.1161/CIRCULATIONAHA.126.081092
• AVANT GUARD Trial https://www.nejm.org/do/10.1056/NEJMdo008538/full/
• EMBOL-AF Registry https://academic.oup.com/eurheartj/advance-article/doi/10.1093/eurheartj/ehag217/8566008

III A New ICD Lead

• LEADR LBBAP Trial https://doi.org/10.1016/j.hrthm.2026.08.030

IV ESC Preview

• Mandrola's Preview of the European Society of Cardiology 2026 https://www.medscape.com/viewarticle/mandrolas-preview-european-society-cardiology-2026-2026a1000tfi

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Mechanical CPR devices, the dangers of AF performance measures, two scholarly articles on CLOSURE and CHAMPION, and a little ESC preview are the topics John Mandrola, MD, discusses in this week's podcast.

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I Mechanical Compression Devices for OHCA

· Mechanical CPR Device Use Cardiac Arrest Survival

https://www.ahajournals.org/doi/10.1161/CIRCULATIONAHA.126.079272

· PARAMEDIC Trial https://www.thelancet.com/article/S0140-6736(14)61886-9/fulltext

· CIRC Trial https://www.resuscitationjournal.com/article/S0300-9572(14)00128-2/fulltext

· LINC trial https://jamanetwork.com/journals/jama/fullarticle/1774037

· Cochrane Review of Mechanical vs Manual Chest Compressions for Cardiac Arrest https://pmc.ncbi.nlm.nih.gov/articles/PMC6953326/

II ACC AF Performance Measures

· 2026 AHA/ACC Clinical Performance for Patients With AF https://www.jacc.org/doi/10.1016/j.jacc.2026.05.032#sec-3

III Two Critical Appraisals of the recent LAAC trials

· Reappraising CHAMPION-AF 10.1016/j.hrthm.2026.07.048 External Link

· CHAMPION and CLOSURE: Reconciling Contrast Results https://doi.org/10.1093/eurheartj/ehag608

ESC Early Preview

· CMR Guide trial https://pmc.ncbi.nlm.nih.gov/articles/PMC6931571/

· SINGLE AF Trial 10.1016/j.hroo.2025.12.008 External Link

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Listener feedback, the ZEUS trial fails, a fascinating statin trial, more on GLP-1 drugs, and radiation safety in the EP lab are the topics John Mandrola, MD, discusses in this week's podcast.

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I ZEUS Fails

Rethinking Inflammation and ASCVD: Four Lessons From the ZEUS Trial

https://www.medscape.com/viewarticle/rethinking-inflammation-and-ascvd-four-lessons-zeus-trial-2026a1000rlm

• ZEUS Trial https://doi.org/10.1001/jamacardio.2025.4491

II Statins and the Elderly

• SAGA/SITE trial 10.1016/j.lanhl.2026.100884 External Link

III GLP-1 and CV Risk

• SURMOUNT-1 Trial https://www.nejm.org/doi/10.1056/NEJMoa2206038
• SURMOUNT-1 Post Hoc Analysis https://www.jacc.org/doi/10.1016/j.jacc.2026.04.044
• Reframing GLP-1s as Cardiometabolic Health Drugs: Editorial https://www.jacc.org/doi/10.1016/j.jacc.2026.06.039

IV Radiation Exposure to the Uterus in the EP Lab

• Occupational Radiation Safety in EP During Pregnancy https://www.ahajournals.org/doi/epub/10.1161/CIRCULATIONAHA.126.080556
• Survey: Working in Cath Lab During Pregnancy https://www.surveymonkey.com/share/d5c1edf7-6d99-49d4-a9fa-e9168f63ab55

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Another failure of LA posterior wall isolation, first-line AF ablation, a revelation on EAST-AFNET 4 trial, an LAAC meta-analysis, and preventing AKI post-cardiac surgery are the topics John Mandrola, MD, discusses in this week's podcast.

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I Listener Feedback

• DAPT-MVD Trial https://www.nejm.org/doi/full/10.1056/NEJMoa2517588

II Another Failure of Posterior Wall Isolation

• CORNERSTONE-AF Trial https://doi.org/10.1093/eurheartj/ehag486
• CAPLA Trial https://jamanetwork.com/journals/jama/fullarticle/2800186
• PVIOTAL IDE Trial 10.1016/j.hrthm.2025.08.018 External Link

III First Line AF ablation – One new study and a discovery about a second one

• Catheter Ablation vs AAD for First-line Treatment of AF 10.1016/j.hrthm.2025.07.061 External Link

• EAST-AFNET 4 Trial https://www.nejm.org/doi/full/10.1056/NEJMoa2019422
• Cardiology Trials Substack https://cardiologytrials.substack.com/p/summary-and-discussion-of-east-afnet

IV Left Atrial Appendage Closure Meta-analysis

• Long-Term Efficacy and Safety of LAAC vs OAC -- Meta-analysis https://academic.oup.com/europace/article/28/7/euag159/8739567

V Prevention of AKI after Cardiac Surgery: MERCURI-2

• MERCURI-2 Study https://jamanetwork.com/journals/jama/fullarticle/2852324

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The first oral PCSK9 inhibitor, another study finding safe MRI scanning in patients with nonconditional CIEDs, the PFA-SHAM trial, and the curious case of orthopedic injuries in cardiology 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 Enlicitide Approved

First Oral PCSK9 Inhibitor Welcomed for Potential Primary Care Impact https://www.medscape.com/viewarticle/first-oral-pcsk9-inhibitor-welcomed-potential-primary-care-2026a1000own

• Dr Gregory Katz Substack https://gregorykatz.substack.com/p/are-we-sure-mercks-new-cholesterol
• CORALreef Lipids Trial https://www.nejm.org/doi/full/10.1056/NEJMoa2511002
• CORALreef HeFH Trial https://jamanetwork.com/journals/jama/fullarticle/2841258
• CORALreef Outcomes Trial https://clinicaltrials.gov/study/NCT06008756

II MRI Scans in Non-conditional CIEDs

Specialized Nurse Practitioners Safely Manage MRI in Patients With Cardiac Implantable Devices https://www.medscape.com/viewarticle/specialized-nurse-practitioners-safely-manage-mri-patients-2026a1000ozt

• Nurse Practitioner-Led CIED Monitoring During MRI 10.1016/j.hroo.2026.04.031 External Link
• MRI in Nonconditional Pacemakers and ICDs https://academic.oup.com/europace/article/22/2/288/5717383
• Heart Rhythm Society Consensus Document 10.1016/j.hrthm.2017.04.025 External Link

III PFA-SHAM trial

• PFA-SHAM Trial https://www.ahajournals.org/doi/10.1161/CIRCULATIONAHA.126.079484
• SHAM-PVI Trial https://jamanetwork.com/journals/jama/fullarticle/2823283

IV Orthopedic Injuries in Cardiology

What Will It Take to Make Fluoroscopy Labs Safer?

https://www.medscape.com/viewarticle/what-will-it-take-make-fluoroscopy-labs-safer-2026a1000ox6

• Expert Consensus Statement on Enhanced Radiation Protection https://www.jacc.org/doi/10.1016/j.jcin.2026.06.011
• 'Shed the Lead' and the Injuries. Should Cath Labs Go Lead-Free? https://www.medscape.com/viewarticle/shed-lead-and-injuries-should-cath-labs-go-lead-free-2024a1000hnb
• Health Hazards of Working in the Interventional Laboratory https://doi.org/10.1016/j.jacc.2014.11.056

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DAPT back in the news, a practice-changing trial in VTE therapy, new knowledge in sudden cardiac death, heart failure definitions updated, and a dumb decision by NICE in the UK are the topics discussed by John Mandrola, MD, in this week's podcast.

This podcast is intended for healthcare professionals only.

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I Antiplatelet Therapy After Stenting

• DAPT-MVD Trial https://www.nejm.org/doi/full/10.1056/NEJMoa2517588
• HOST-EXAM Trial at 2 years https://pubmed.ncbi.nlm.nih.gov/34010616/
• HOST-EXAM Trial at 10 years 10.1016/S0140-6736(26)00422-8 External Link
• Nick Kurzen on X https://x.com/ncurzen/status/2077676739463922151

II Aspirin Proves Its Mettle After Hip and Knee Replacement

• EPCAT III Trial https://www.nejm.org/doi/full/10.1056/NEJMoa2603649
• CRISTAL Trial https://jamanetwork.com/journals/jama/fullarticle/2795528

III New (and old) Knowledge in Sudden Cardiac Death

• Sudden Cardiac Death and its Relation to Cardiac Disease at Autopsy https://doi.org/10.1016/j.jacc.2026.01.029
• Sudden Cardiac Death Due to MI With Obstructive and Nonobstructive Coronary Arteries https://doi.org/10.1016/j.jacc.2026.01.030
• Frequency of Sudden Cardiac Death and Profiles of Risk https://www.ajconline.org/article/S0002-9149(97)00477-3/fulltext

IV Heart Failure Diagnosis

• AHA/ACC/ESC/WHF Expert Consensus Document http://jacc.org/doi/10.1016/j.jacc.2026.05.036

V NICE Makes a Dumb Decision

• NICE Recommends New Nonsteroidal MRA for Heart Failure

https://www.medscape.com/viewarticle/nice-recommends-new-nonsteroidal-mra-heart-failure-2026a1000nzv

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Listener feedback on ICE vs TEE in AF ablation, fractional flow reserve without a wire or catheter, more bad news for ticagrelor, the POLY-HF trial, and oxygen targets after cardiac arrest are the topics John Mandrola, MD, discusses in this week's podcast.

This podcast is intended for healthcare professionals only.

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I Listener Feedback

Oct 10, 2025 This Week in Cardiology Podcast

https://www.medscape.com/viewarticle/1002990

• ICE vs TEE in Atrial Fibrillation Ablation https://jamanetwork.com/journals/jamacardiology/fullarticle/2839370

II FFR Without the Wire – Angiography-Derived FFR to Guide PCI

• ALL-RISE Trial https://www.nejm.org/doi/full/10.1056/NEJMoa2600949
• FAST III Trial https://www.nejm.org/doi/full/10.1056/NEJMoa2601841
• FAVOR III Trial 10.1016/S0140-6736(24)02175-5 External Link
• FAME 2 Trial https://www.nejm.org/doi/full/10.1056/NEJMoa1205361
• Venk Murthy on X https://x.com/venkmurthy/status/2074849421452329456?s=20

III More Bad News for Ticagrelor

Jul 11, 2025 This Week in Cardiology Podcast https://www.medscape.com/viewarticle/1002704

• Prasugel, Ticagrelor, or Clopidogrel After PCI https://jamanetwork.com/journals/jamacardiology/fullarticle/2849614

IV The Polypill in Heart Failure

• POLY-HF trial https://www.nature.com/articles/s41591-026-04504-5

V Oxygen Targets After Cardiac Arrest

• LOGICAL Trial https://www.nejm.org/doi/full/10.1056/NEJMoa2513814
• ICU-ROX Trial https://link.springer.com/article/10.1007/s00134-020-06196-y
• Secondary Analysis of the PILOT Trial https://journal.chestnet.org/article/S0012-3692(25)00553-7/fulltext
• Oxygen Targets in Comatose Survivors of Cardiac Arrest https://www.nejm.org/doi/10.1056/NEJMoa2208686

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Listener feedback on valvular heart disease, statins and frailty, left atrial posterior wall ablation fails again, interpreting medical tests and AI ECG reading are the topics John Mandrola, MD, discusses in this week's podcast.

This podcast is intended for healthcare professionals only.

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I Listener Feedback

• PREVUE-VALVE Study https://www.jacc.org/doi/10.1016/j.jacc.2026.02.5137

II Statins and Frailty

Statin Initiation Tied to Lower Frailty Risk in Older Adults https://www.medscape.com/viewarticle/statin-initiation-tied-lower-frailty-risk-older-adults-2026a1000lec

• Statins and Survival Free of Incident Frailty https://doi.org/10.1093/eurheartj/ehag451

III LA Posterior Wall Isolation Fails Again

• CORNERSTONE Trial https://doi.org/10.1093/eurheartj/ehag486
• CAPLA Trial https://jamanetwork.com/journals/jama/fullarticle/2800186

IV Does the Display of Test Results Improve Clinical Decisions?

• Interval Likelihood Ratios for Clinical Decsion-Making https://evidence.nejm.org/doi/full/10.1056/EVIDoa2500249
• Making Sense of Health Statistics https://journals.sagepub.com/doi/full/10.1111/j.1539-6053.2008.00033.x

V AI and the ECG and Saving Doctors

• Case Report — AI-Enhanced Diagnostics https://www.nature.com/articles/s41591-026-04454-y
• The New York Times article https://www.nytimes.com/2026/06/22/health/artificial-intelligence-heart-damage.html

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Listener feedback, more long-term data on the TAVR/SAVR question, population prevalence of valvular heart disease in the US, and a CMS proposal to expand TAVR coverage 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:

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I Listener Feedback

• ICD Trends and Outcomes: 15-Year Analysis https://doi.org/10.1093/europace/euag110
• MADIT-RIT https://www.nejm.org/doi/full/10.1056/NEJMoa1211107

II More Long Term Data on TAVR vs SAVR

• PARTNER 2 Trial https://www.jacc.org/doi/10.1016/j.jacc.2026.03.169
• 10-Year Outcomes of SAPIEN 3 TAVR or SAVR in Intermediate-Risk Patients https://doi.org/10.1016/j.jacc.2026.03.170
• TAVR at a Decade: Editorial https://doi.org/10.1016/j.jacc.2026.04.042
• EVOLUT Trial https://www.jacc.org/doi/10.1016/j.jacc.2026.02.5063
• Updated 5-year Outcomes of TAVR vs SAVR in AS https://heart.bmj.com/content/early/2026/02/11/heartjnl-2025-327092
• NOTION Trial https://doi.org/10.1093/eurheartj/ehae043
• PARTNER 3 Trial https://www.nejm.org/doi/full/10.1056/NEJMoa2509766
• NOTION 2 Trial https://academic.oup.com/eurheartj/article/45/37/3804/7673297
• TAVR vs SAVR Editorial : https://academic.oup.com/eurheartj/advance-article-abstract/doi/10.1093/eurheartj/ehag407/8708044

III The PREVUE-VALVE Study

• PREVUE-VALVE Study https://www.jacc.org/doi/10.1016/j.jacc.2026.02.5137

IV CMS has Proposed New Coverage for TAVR

• CMS Proposal Document https://www.cms.gov/medicare-coverage-database/view/ncacal-decision-memo.aspx?proposed=Y&ncaId=321

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Listener feedback, transcatheter tricuspid valve replacement, a new metabolic disease called CKM, the ARISE-FLUIDS Trial, the BIHCA trial, and temporal trends in ICD therapies are the topics John Mandrola, MD, discusses in this week's podcast.

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I Listener Feedback

• LOSE-AF Trial https://jamanetwork.com/journals/jama/fullarticle/2849335
• ARREST-AF Trial https://jamanetwork.com/journals/jamacardiology/fullarticle/2840225
• POP-AF Trial https://doi.org/10.1093/eurheartj/ehaf689
• PRAGUE-25 Trial https://www.jacc.org/doi/10.1016/j.jacc.2025.04.042

II Transcatheter Tricuspid Valve Replacement

• TRISCEND Cost Study https://doi.org/10.1016/j.shj.2026.101049
• TRISCEND II Trial https://www.nejm.org/doi/full/10.1056/NEJMoa2401918

III More Disease Creation – the CKM Syndrome

ACC/AHA Release First-Ever Guideline for CKM Syndrome https://www.medscape.com/viewarticle/acc-aha-release-first-ever-guideline-ckm-syndrome-2026a1000jbs

• CKM Guideline in Circulation https://www.ahajournals.org/doi/10.1161/CIR.0000000000001447

IV Two Trials That Teach Important EBM Lessons

• ARISE-FLUIDS Trial https://www.nejm.org/doi/full/10.1056/NEJMoa2516225
• Dr Josh Farkas Post on X https://x.com/PulmCrit/status/2065064796270022845?s=20

V Bicarbonate for Inpatient Cardiac Arrest –The BIHCA trial

• BIHCA Trial https://jamanetwork.com/journals/jama/fullarticle/2850405

VI The Decline of VT in Heart Failure

• Trends and Outcomes in ICD Recipients: 15-Year Analysis https://doi.org/10.1093/europace/euag110
• Declining Risk of Sudden Death in HF https://www.nejm.org/doi/full/10.1056/NEJMoa1609758

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Chemical cardioversion in the ED, HF monitoring, weight loss in AF, and surgical LAA excision 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:

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I Chemical Cardioversion of AF in the ED: The FLECA-ED Trial

• FLECA-ED Rationale paper https://pmc.ncbi.nlm.nih.gov/articles/PMC10299428/
• FLECA-ED ESC Slides https://esc365.escardio.org/presentation/321209
• Review on Flecainide Use Despite CAST https://doi.org/10.1016/j.hrthm.2025.08.034
• RACE 7 ACWAS Trial https://www.nejm.org/doi/full/10.1056/NEJMoa1900353

II Heart Failure Monitoring – The ALLEVIATE-HF Trial

• ALLEVIATE-HF Trial https://doi.org/10.1016/j.jacc.2026.03.075
• CHAMPION Trial https://doi.org/10.1016/S0140-6736(11)60101-3
• GUIDE HF Trial https://doi.org/10.1016/S0140-6736(21)01754-2
• ALLEVIATE-HF Editorial: Alerts Are Not Treatment https://doi.org/10.1016/j.jacc.2026.04.014

• Steve Stiles Medscape report on CHAMPION https://www.medscape.com/viewarticle/755189

III A Negative Weight Loss Study in AF

• LOSE-AF Trial https://jamanetwork.com/journals/jama/fullarticle/2849335

IV Surgical LAA Excision

• OPINION Trial https://doi.org/10.1093/eurheartj/ehaf674
• LAAOS 3 trial https://www.nejm.org/doi/full/10.1056/NEJMoa2101897

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