This Week in Cardiology

A second ESC roundup examines pelacarsen’s failure to reduce cardiovascular events and the FDA clearance of an AI-ECG tool for acute MI detection. The discussion also covers CT angiography and coronary calcium-guided statin decisions, early evolocumab after heart attack, and tricuspid repair results that raise questions about trial design.

A sharp review of major ESC trial results tackles anticoagulation for intermediate-risk AF, whether CMR scar can guide ICD decisions, and combination therapy in ATTR cardiomyopathy. Sham-controlled ablation data challenge assumptions about symptom relief, while STAREE examines statins in older adults. The discussion closes with questions about whether modern post-MI treatment has reduced the value of ICDs.

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. 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 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 You may also like: 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 Questions or feedback, please contact [email protected]

A critical look at mechanical CPR devices and the evidence behind their survival claims. A spirited discussion on why rigid atrial fibrillation performance measures can backfire. Close reads of recent LAAC trials and contrasting appraisals. A quick preview of upcoming ESC trial highlights on cardiac MRI and single‑risk AF management.

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. This podcast is intended for healthcare professionals only. To read a partial transcript or to comment, visit: https://www.medscape.com/twic 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 You may also like: 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 Questions or feedback, please contact [email protected]

A critical look at why posterior wall isolation keeps failing and what recent trials reveal. A skeptical review of first-line AF ablation research and methodological concerns. Questions raised about the EAST-AFNET 4 trial's conduct and data. A meta-analysis comparing left atrial appendage closure to anticoagulation. A trial assessing strategies to prevent acute kidney injury after cardiac surgery.

Discussion of the first oral PCSK9 inhibitor and its potential impact on cholesterol management. Review of safe MRI protocols for patients with nonconditional cardiac devices. Examination of the PFA-SHAM trial and its implications for atrial fibrillation treatment. Debate about orthopedic injuries and radiation protection practices in cath labs.

DAPT after stenting and how recent trial data might change practice. New evidence on blood clot prevention after hip and knee replacement. Fresh findings on sudden cardiac death causes and limits of screening. Updated heart failure definitions with new staging and trajectories. A controversial NICE decision on a new heart failure drug and its cost implications.

Listener mail on intracardiac echo versus TEE for atrial fibrillation procedures sparks debate. New angiography‑derived FFR trials and concerns about overuse get dissected. A meta‑analysis raises fresh safety questions about ticagrelor. A pragmatic polypill heart failure trial shows surprising hospitalization drops. Conserving versus liberal oxygen after cardiac arrest is reevaluated with null results.

Listener mail on valve imaging quirks and how echoes can vary with volume and reader bias. A critical look at a statin study linking drug starts to lower frailty, and why big samples can mislead. New trials show posterior left atrial wall isolation offers no clear benefit over standard ablation. A trial on displaying test results uses interval likelihood ratios to boost correct decisions. AI ECG hype versus basic ECG skill discussed.