This Week in Cardiology Jun 13 2025 This Week in Cardiology
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Jun 13, 2025 Listeners weigh in on cardiac sarcoidosis and the use of imaging for risk assessment. The podcast tackles the complexities of sinus node ablation and the need for careful treatment approaches. It also dives into the challenges faced in recruiting patients for critical cardiovascular trials, shedding light on the implications for study outcomes and evidence validity. Additionally, there's a discussion on surgical atrial fibrillation ablation during CABG, highlighting the need for more robust research.
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Cardiac Sarcoidosis Risk Nuance
- Patients with cardiac sarcoidosis presenting with AV block have high risk of ventricular arrhythmias even with normal EF.
- Early disease may show positive PET but negative MRI, complicating risk stratification for ICD implantation.
Avoid Sinus Node Ablation in IST
- Avoid sinus node ablation for inappropriate sinus tachycardia due to uncertain causes and high long-term risks.
- Empathize with patients, offer reassurance, and prioritize research on IST causes over ablation attempts.
Surgical AF Ablation Evidence Gaps
- Surgical AF ablation during CABG shows a survival advantage in observational studies but lacks randomized trial confirmation.
- Mortality reduction without stroke reduction is puzzling and calls for well-designed RCTs to clarify benefits.