This Week in Cardiology

AF ablation vs rate control in HF, TAVI vs SAVR, atherosclerosis, and surrogate endpoints in observational studies 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 – AF ablation vs Rate Control RAFT-AF, Despite Itself, Hints at Advantage for Ablation Rhythm Control in Heart Failure With AF https://www.medscape.com/viewarticle/951326 • Randomized Ablation-Based Rhythm-Control Versus Rate-Control Trial in Patients with Heart Failure and Atrial Fibrillation: Results from the RAFT-AF trial https://www.ahajournals.org/doi/suppl/10.1161/CIRCULATIONAHA.121.057095 • Catheter Ablation for Atrial Fibrillation with Heart Failure https://www.nejm.org/doi/full/10.1056/nejmoa1707855 • Lenient versus Strict Rate Control in Patients with Atrial Fibrillation https://www.nejm.org/doi/full/10.1056/nejmoa1001337 II – TAVI vs SAVR Surgery Groups Push Back on VARC-3 Valve Trial Definitions https://www.medscape.com/viewarticle/970753 • Joint Surgical Associations (EACTS, LACES, ASCVTS, AATS, and STS) Position Statement Regarding the VARC-3 Definitions for Aortic Valve Clinical Research https://doi.org/10.1093/ejcts/ezac110 III – Atherosclerosis Medical Management Best for Atherosclerotic Stroke: New AAN Guidance https://www.medscape.com/viewarticle/970886 • Stroke Prevention in Symptomatic Large Artery Intracranial Atherosclerosis Practice Advisory https://n.neurology.org/content/98/12/486 IV – ECHO parameters with Rhythm Control Global Gains in Heart Function From Early AF Rhythm Control https://www.medscape.com/viewarticle/970329 • Restoring Sinus Rhythm Reverses Cardiac Remodeling and Reduces Valvular Regurgitation in Patients With Atrial Fibrillation https://doi.org/10.1016/j.jacc.2021.12.029 • Effects of Atrial Fibrillation and Sinus Rhythm on Cardiac Remodeling and Valvular Regurgitation https://doi.org/10.1016/j.jacc.2021.12.028 You may also like: Medscape editor-in-chief Eric Topol, MD, and master storyteller and clinician Abraham Verghese, MD, on Medicine and the Machine https://www.medscape.com/features/public/machine The Bob Harrington Show with Stanford University Chair of Medicine, Robert A. Harrington, MD. https://www.medscape.com/author/bob-harrington Questions or feedback, please contact news@medscape.net

AF screening, CTA, stroke prevention and broken observational studies, and medical writing 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 - AF Screening - Handheld ECGs Ease A-Fib Screening in the Very Elderly https://www.medscape.com/viewarticle/969846 - Screening for Atrial Fibrillation in Older Adults at Primary Care Visits: the VITAL-AF Randomized Controlled Trial https://www.ahajournals.org/doi/10.1161/CIRCULATIONAHA.121.057014 II - CTA - DISCHARGE: CTA Shows Safety Edge vs Cath in Intermediate-Risk Stable Chest Pain https://www.medscape.com/viewarticle/969732 - CT or Invasive Coronary Angiography in Stable Chest Pain https://www.nejm.org/doi/full/10.1056/NEJMoa2200963 III - Stroke Prevention post TAVI - Silver Lining Emerges for Embolic Protection in Post-TAVR Stroke https://www.medscape.com/viewarticle/969992 - Cerebral Embolic Protection and Stroke-Related Mortality Following Transcatheter Aortic Valve Replacement https://www.jacc.org/doi/full/10.1016/j.jcin.2022.01.007 - Safety and efficacy of cerebral protection devices in transcatheter aortic valve replacement: A clinical end-points meta-analysis https://pubmed.ncbi.nlm.nih.gov/29550047/ - Cerebral Embolic Protection and Outcomes of Transcatheter Aortic Valve Replacement: Results From the Transcatheter Valve Therapy Registry https://pubmed.ncbi.nlm.nih.gov/33619968/ IV - Medical Writing - Writing Program Asks Physicians to Explore Their Experiences https://www.medscape.com/viewarticle/969973 You may also like: Medscape editor-in-chief Eric Topol, MD, and master storyteller and clinician Abraham Verghese, MD, on Medicine and the Machine https://www.medscape.com/features/public/machine The Bob Harrington Show with Stanford University Chair of Medicine, Robert A. Harrington, MD. https://www.medscape.com/author/bob-harrington Questions or feedback, please contact news@medscape.net

An update to CardioMEMs post, ARBs and cancer, troponins, empagliflozin, and low-value care are the topics discussed by John Mandrola, MD, 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 – Invasive Monitoring for HF - FDA Expands Eligibility for CardioMEMS Heart Failure System https://www.medscape.com/viewarticle/969004 - Haemodynamic-guided management of heart failure (GUIDE-HF): a randomised controlled trial https://doi.org/10.1016/S0140-6736(21)01754-2 II – ARBs and Cancer - ARBs and Cancer Risk: New Meta-Analysis Raises Questions Again https://www.medscape.com/viewarticle/969510 - Risk of cancer with angiotensin-receptor blockers increases with increasing cumulative exposure: Meta-regression analysis of randomized trials https://doi.org/10.1371/journal.pone.0263461 - Marciniak Meta-analysis in FDA Medical Review 206316Orig1Orig2s000 https://rb.gy/myhlvy III – Troponins and Cardiac Surgery - What Troponin Level Indicates Injury After Cardiac Surgery? https://www.medscape.com/viewarticle/969617?src= - High-Sensitivity Troponin I after Cardiac Surgery and 30-Day Mortality https://www.nejm.org/doi/full/10.1056/NEJMoa2000803 - Five-Year Outcomes after PCI or CABG for Left Main Coronary Disease https://www.nejm.org/doi/full/10.1056/nejmoa1909406 IV – Empagliflozin in HFpEF - FDA Okays Empagliflozin for HF Regardless of Ejection Fraction https://www.medscape.com/viewarticle/969118 - Empagliflozin in Heart Failure with a Preserved Ejection Fraction https://www.nejm.org/doi/full/10.1056/NEJMoa2107038 - Angiotensin-Neprilysin Inhibition in Heart Failure with Preserved Ejection Fraction https://www.nejm.org/doi/full/10.1056/NEJMoa1908655 V – Low-Value Care - AHA Targets 'Low-Value' Heart Care in New Scientific Statement https://www.medscape.com/viewarticle/969107 - Strategies to Reduce Low-Value Cardiovascular Care: A Scientific Statement From the American Heart Association https://www.ahajournals.org/doi/abs/10.1161/HCQ.0000000000000105 You may also like: Medscape editor-in-chief Eric Topol, MD, and master storyteller and clinician Abraham Verghese, MD, on Medicine and the Machine https://www.medscape.com/features/public/machine The Bob Harrington Show with Stanford University Chair of Medicine, Robert A. Harrington, MD. https://www.medscape.com/author/bob-harrington Questions or feedback, please contact news@medscape.net

FDA approval of CardioMEMS, statins, VT storm, and fish oil and AF are the topics covered by John Mandrola, MD, 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 - Invasive Monitoring for HF - FDA Expands Eligibility for CardioMEMS Heart Failure System https://www.medscape.com/viewarticle/969004 - Haemodynamic-guided management of heart failure (GUIDE-HF): a randomised controlled trial https://doi.org/10.1016/S0140-6736(21)01754-2 - Wireless pulmonary artery haemodynamic monitoring in chronic heart failure: a randomised controlled trial https://doi.org/10.1016/S0140-6736(11)60101-3 II - Statin Use in Primary Prevention - USPSTF Tweaks Primary Prevention Statin Recommendations in New Draft Guidance https://www.medscape.com/viewarticle/968963 - Statin Use for the Primary Prevention of Cardiovascular Disease in Adults: Preventive Medication https://www.uspreventiveservicestaskforce.org/uspstf/document/draft-evidence-review/statin-use-primary-prevention-cardiovascular-disease-adults - The Case Against Coronary Artery Calcium Scoring for Cardiovascular Disease Risk Assessment https://www.aafp.org/afp/2019/1215/p734.html III - VT-Storm - Transcutaneous Magnetic Stimulation Promising Against VT Storm https://www.medscape.com/viewarticle/968955 - Effect of Transcutaneous Magnetic Stimulation in Patients With Ventricular Tachycardia Storm https://jamanetwork.com/journals/jamacardiology/fullarticle/2788915 IV - Fish Oil and AF risk - Fish Oil Supplements May Increase the Risk for Atrial Fibrillation: What Does This Mean? https://www.medscape.com/viewarticle/967159 You may also like: Medscape editor-in-chief Eric Topol, MD, and master storyteller and clinician Abraham Verghese, MD, on Medicine and the Machine https://www.medscape.com/features/public/machine The Bob Harrington Show with Stanford University Chair of Medicine, Robert A. Harrington, MD. https://www.medscape.com/author/bob-harrington Questions or feedback, please contact news@medscape.net

Spinal cord stimulation to prevent post-cardiac surgery AF, statin intolerance, heart failure with preserved ejection fraction, and Vitamin D are discussed by John Mandrola, MD, 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 Post-Cardiac Surgery AF Spinal Cord Stimulation May Cut AF After Cardiac Surgery https://www.medscape.com/viewarticle/968478 • Autonomic Neuromodulation for Atrial Fibrillation Following Cardiac Surgery: JACC Review Topic of the Week https://www.jacc.org/doi/10.1016/j.jacc.2021.12.010 • Temporary Spinal Cord Stimulation to Prevent Postcardiac Surgery Atrial Fibrillation: 30-Day Safety and Efficacy Outcomes https://www.jacc.org/doi/10.1016/j.jacc.2021.08.078 II – Statin Intolerance Statin Intolerance 'Overestimated and Overdiagnosed' https://www.medscape.com/viewarticle/968627 • Prevalence of statin intolerance: a meta-analysis https://doi.org/10.1093/eurheartj/ehac015 III – HFpEF Risk in Preserved-EF HF Varies With Normal vs High Natriuretic Peptides https://www.medscape.com/viewarticle/968748 • Heart failure with preserved ejection fraction in patients with normal natriuretic peptide levels is associated with increased morbidity and mortality https://doi.org/10.1093/eurheartj/ehab911 • Universal definition and classification of heart failure: a report of the Heart Failure Society of America, Heart Failure Association of the European Society of Cardiology, Japanese Heart Failure Society and Writing Committee of the Universal Definition of Heart Failure: Endorsed by the Canadian Heart Failure Society, Heart Failure Association of India, Cardiac Society of Australia and New Zealand, and Chinese Heart Failure Association https://pubmed.ncbi.nlm.nih.gov/33605000/ Features: Why Is Vitamin D Hype So Impervious to Evidence? https://www.medscape.com/viewarticle/968682 You may also like: Medscape editor-in-chief Eric Topol, MD, and master storyteller and clinician Abraham Verghese, MD, on Medicine and the Machine https://www.medscape.com/features/public/machine The Bob Harrington Show with Stanford University Chair of Medicine, Robert A. Harrington, MD. https://www.medscape.com/author/bob-harrington Questions or feedback, please contact: news@medscape.net

LDL equations, stroke interventions, post-PCI antiplatelets, the transitive function and network meta-analysis, and lipoprotein(a) 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 - LDL-C Equations: - Standard LDL Equations Yield Discordant Results https://www.medscape.com/viewarticle/968112 - Discordance Between Standard Equations for Determination of LDL Cholesterol in Patients With Atherosclerosis https://www.jacc.org/doi/10.1016/j.jacc.2021.11.042 - LDL-C Estimation: The Perils of Living With Imperfection https://www.jacc.org/doi/10.1016/j.jacc.2021.12.005 II - Acute Stroke Care - Endovascular Therapy Benefits Stroke With Larger Ischemic Core? https://www.medscape.com/viewarticle/968203 - Endovascular Therapy for Acute Stroke with a Large Ischemic Region https://www.nejm.org/doi/full/10.1056/NEJMoa2118191 III - Post PCI Antiplatelet Regimens - Study Parses Out Merits of Short DAPT, De-escalation in ACS https://www.medscape.com/viewarticle/968050 - Short Duration of DAPT Versus De-Escalation After Percutaneous Coronary Intervention for Acute Coronary Syndromes https://www.jacc.org/doi/10.1016/j.jcin.2021.11.028 IV - Lipoprotein (a) - Positive Topline Results for siRNA in Raised Lipoprotein(a) https://www.medscape.com/viewarticle/968278 You may also like: Medscape editor-in-chief Eric Topol, MD, and master storyteller and clinician Abraham Verghese, MD, on Medicine and the Machine https://www.medscape.com/features/public/machine The Bob Harrington Show with Stanford University Chair of Medicine, Robert A. Harrington, MD. https://www.medscape.com/author/bob-harrington Questions or feedback, please contact news@medscape.net

Interatrial shunt therapy, the power of the RCT, chronic stress, anxiety and cardiometabolic risk, and TAVR, are the topics covered by John Mandrola, MD, 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 - Interatrial Shunt - Interatrial Shunt Falters in Preserved, Mid-Range LVEF Heart Failure: REDUCE LAP-HF 2 https://www.medscape.com/viewarticle/967792 - Atrial shunt device for heart failure with preserved and mildly reduced ejection fraction (REDUCE LAP-HF II): a randomised, multicentre, blinded, sham-controlled trial https://doi.org/10.1016/S0140-6736(22)00016-2 II - Chronic Stress - Chronic Stress Accelerates Aging: Epigenetic Evidence https://www.medscape.com/viewarticle/967828 - Psychological and biological resilience modulates the effects of stress on epigenetic aging https://www.nature.com/articles/s41398-021-01735-7 - DNA methylation GrimAge strongly predicts lifespan and healthspan https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6366976/ III – Anxiety, Neuroticism, and CardioMetabolic Risk Factors - Anxiety in Men Tied to Risk Factors for CVD, Diabetes https://www.medscape.com/viewarticle/967811 - Neuroticism, Worry, and Cardiometabolic Risk Trajectories: Findings From a 40‐Year Study of Men https://www.ahajournals.org/doi/full/10.1161/JAHA.121.022006 IV - TAVR Implant Success - VARC-3 TAVR Technical Failure Definition 'Highly Clinically Relevant https://www.medscape.com/viewarticle/967717 - Validation of the Valve Academic Research Consortium 3 Technical Success Definition in Patients Undergoing TAVR https://www.jacc.org/doi/full/10.1016/j.jcin.2021.11.013 You may also like: Medscape editor-in-chief Eric Topol, MD, and master storyteller and clinician Abraham Verghese, MD, on Medicine and the Machine https://www.medscape.com/features/public/machine The Bob Harrington Show with Stanford University Chair of Medicine, Robert A. Harrington, MD. https://www.medscape.com/author/bob-harrington Questions or feedback, please contact news@medscape.net

AF Screening, alcohol, sports-related sudden death, non-MD-led healthcare, and CPR 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 - AF Screening - USPSTF Says Evidence Still Lacking for AF Screening in Asymptomatic Patients https://www.medscape.com/viewarticle/967275 - Screening for Atrial Fibrillation US Preventive Services Task Force Recommendation Statement https://jamanetwork.com/journals/jama/fullarticle/2788340 - Screening for Atrial Fibrillation—New Devices, Same Challenges https://jamanetwork.com/journals/jamainternalmedicine/fullarticle/2788475 - Implantable loop recorder detection of atrial fibrillation to prevent stroke (The LOOP Study): a randomised controlled trial https://doi.org/10.1016/S0140-6736(21)01698-6 II - Vaccine Induced Myocarditis - Hong Kong, US, Israeli Data Illuminate COVID Vaccine Myocarditis https://www.medscape.com/viewarticle/967355 III - Alcohol and Heart - No Amount of Alcohol Safe for the Heart: WHF https://www.medscape.com/viewarticle/967124 IV - Sports Related Sudden Cardiac Arrest - Survival Improving in Sports-Related Sudden Cardiac Arrest https://www.medscape.com/viewarticle/967061 - Evolution of Incidence, Management, and Outcomes Over Time in Sports-Related Sudden Cardiac Arrest https://www.jacc.org/doi/full/10.1016/j.jacc.2021.11.011 V - Non MD vs MD-led Care - This Doc Still Supports NP/PA Led Care ... With Caveats https://www.medscape.com/viewarticle/967073 VI - CPR - Should We Always Offer CPR? https://www.medscape.com/viewarticle/966886 You may also like: Medscape editor-in-chief Eric Topol, MD, and master storyteller and clinician Abraham Verghese, MD, on Medicine and the Machine https://www.medscape.com/features/public/machine The Bob Harrington Show with Stanford University Chair of Medicine, Robert A. Harrington, MD. https://www.medscape.com/author/bob-harrington Questions or feedback, please contact news@medscape.net

Olive oil, breastfeeding and CV health, informed consent during stroke, and controversy regarding revascularization guidelines 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 – Olive Oil - Olive Oil Intake Tied to Reduced Mortality https://www.medscape.com/viewarticle/966366 - Consumption of Olive Oil and Risk of Total and Cause-Specific Mortality Among U.S. Adults https://www.jacc.org/doi/full/10.1016/j.jacc.2021.10.041 - Can Small Amounts of Olive Oil Keep the Death Away? https://www.jacc.org/doi/10.1016/j.jacc.2021.11.006 II – Breastfeeding and CV Maternal Health - Breastfeeding Linked to Lower CVD Risk in Later Life https://www.medscape.com/viewarticle/966767 - Breastfeeding Is Associated With a Reduced Maternal Cardiovascular Risk: Systematic Review and Meta‐Analysis Involving Data From 8 Studies and 1 192 700 Parous Women https://www.ahajournals.org/doi/10.1161/JAHA.121.022746 - Meta-analysis: pitfalls and hints https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3868184/ III – Informed Consent - New Guidance on Consent in Acute Ischemic Stroke https://www.medscape.com/viewarticle/966889 - Consent Issues in the Management of Acute Ischemic Stroke https://n.neurology.org/content/98/2/73 - The Case Against Thrombolytic Therapy in Stroke https://www.medscape.com/viewarticle/895159 - tPA in Stroke: 'The Facts Are Clear' https://www.medscape.com/viewarticle/895370 IV – Controversy in Revascularization Guidelines - 'Incomprehensible' CABG Recommendation Raises Concerns https://www.medscape.com/viewarticle/966819 - Surgical Groups Push Back Against New Revascularization Guidelines https://www.medscape.com/viewarticle/966153 - Effect of coronary artery bypass graft surgery on survival: overview of 10-year results from randomised trials by the Coronary Artery Bypass Graft Surgery Trialists Collaboration https://doi.org/10.1016/S0140-6736(94)91963-1 - Ten-Year Follow-Up Survival of the Medicine, Angioplasty, or Surgery Study (MASS II) https://www.ahajournals.org/doi/10.1161/CIRCULATIONAHA.109.911669 - What constitutes an appropriate empirical trial of antianginal therapy in patients with stable angina before referral for revascularisation? https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(21)02045-6/fulltext - Initial Invasive or Conservative Strategy for Stable Coronary Disease https://www.nejm.org/doi/full/10.1056/nejmoa1915922 You may also like: Medscape editor-in-chief Eric Topol, MD, and master storyteller and clinician Abraham Verghese, MD, on Medicine and the Machine https://www.medscape.com/features/public/machine The Bob Harrington Show with Stanford University Chair of Medicine, Robert A. Harrington, MD. https://www.medscape.com/author/bob-harrington Questions or feedback, please contact news@medscape.net

Xeno-transplantation, weight loss drugs, DOAC coverage, vitamin D, LAAC and frailty, and recalled LVADs are the topics John Mandrola, MD, discusses in this week’s podcast. To read a partial transcript or to comment, visit: https://www.medscape.com/twic I – Xenotransplantation - Pig Heart Successfully Transplanted to Man https://www.medscape.com/viewarticle/966367 - What Does a Pig-to-Human Heart Transplant Mean for Medicine? https://www.medscape.com/viewarticle/966488 II – Weight Loss Drugs - Wegovy Tops Sibling Saxenda for Weight Loss https://www.medscape.com/viewarticle/966376 - Effect of Weekly Subcutaneous Semaglutide vs Daily Liraglutide on Body Weight in Adults With Overweight or Obesity Without Diabetes https://jamanetwork.com/journals/jama/article-abstract/2787907 III – DOAC Coverage - CVS Caremark Formulary Change Freezes Out Apixaban https://www.medscape.com/viewarticle/966588 IV – Vitamin D - More Vitamin D Not Better for Reducing Cancer or CVD Incidence https://www.medscape.com/viewarticle/966333 - The D-Health Trial: a randomised controlled trial of the effect of vitamin D on mortality https://doi.org/10.1016/S2213-8587(21)00345-4 - Vitamin D supplementation and prevention of cardiovascular disease and cancer in the Finnish Vitamin D Trial—a randomized controlled trial https://doi.org/10.1093/ajcn/nqab419 - Association between vitamin D supplementation and mortality: systematic review and meta-analysis https://www.bmj.com/content/366/bmj.l4673 V – LAAC and Frailty - Frailty in patients undergoing percutaneous left atrial appendage closure https://doi.org/10.1016/j.hrthm.2022.01.007 - Net Clinical Benefit of Left Atrial Appendage Closure Versus Warfarin in Patients With Atrial Fibrillation: A Pooled Analysis of the Randomized PROTECT-AF and PREVAIL Studies https://pubmed.ncbi.nlm.nih.gov/31752643/ VI – LVAD recall - A High-Risk Medical Device Didn't Meet Federal Standards. The Government Paid Millions for More. https://www.medscape.com/viewarticle/966255 You may also like: Medscape editor-in-chief Eric Topol, MD, and master storyteller and clinician Abraham Verghese, MD, on Medicine and the Machine https://www.medscape.com/features/public/machine The Bob Harrington Show with Stanford University Chair of Medicine, Robert A. Harrington, MD. https://www.medscape.com/author/bob-harrington Questions or feedback, please contact news@medscape.net This podcast is intended for US health professionals only.