This Week in Cardiology

Critiques of last week's comments on VT ablation and a review of EHRA presentations, including new ways to ablate atrial myocardium and pace the ventricle, 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 – VT ablation - VT Ablation After First ICD Shock Boosts Survival: PARTITA https://www.medscape.com/viewarticle/971969 - Does Timing of Ventricular Tachycardia Ablation Affect Prognosis in Patients With an Implantable Cardioverter Defibrillator? Results From the Multicenter Randomized PARTITA Trial https://www.ahajournals.org/doi/abs/10.1161/CIRCULATIONAHA.122.059598 - Substrate Ablation vs Antiarrhythmic Drug Therapy for Symptomatic Ventricular Tachycardia https://www.jacc.org/doi/10.1016/j.jacc.2022.01.050 - Ventricular Tachycardia Ablation versus Escalation of Antiarrhythmic Drugs https://www.nejm.org/doi/full/10.1056/NEJMoa1513614 II – Pulsed-Field Ablation - Pulsed Field Ablation Treats AF With Few Complications https://www.medscape.com/viewarticle/972147 - Pulsed Field Ablation for Persistent Atrial Fibrillation (PersAFOne): Hope or Hype? https://www.jacc.org/doi/10.1016/j.jacc.2020.07.032 III – High-Power Short Duration Ablation - Short, High-Power Ablation on Par With Standard AF Ablation https://www.medscape.com/viewarticle/972087 IV – LBB-Area Pacing - MELOS: LBB Area Pacing Promising for Bradyarrhythmias, HF https://www.medscape.com/viewarticle/972270 Also of interest... - Conduction System Pacing Noninferior to Biventricular Pacing for HF With Wide QRS https://www.medscape.com/viewarticle/971740 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

ACC Recap, Part 2: VT ablation, HF care, three-vessel disease, and patiromer 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 – VT ablation VT Ablation After First ICD Shock Boosts Survival: PARTITA https://www.medscape.com/viewarticle/971969 • Does Timing of Ventricular Tachycardia Ablation Affect Prognosis in Patients With an Implantable Cardioverter Defibrillator? Results From the Multicenter Randomized PARTITA Trial https://www.ahajournals.org/doi/abs/10.1161/CIRCULATIONAHA.122.059598 • Substrate Ablation vs Antiarrhythmic Drug Therapy for Symptomatic Ventricular Tachycardia https://www.jacc.org/doi/10.1016/j.jacc.2022.01.050 • Ventricular Tachycardia Ablation versus Escalation of Antiarrhythmic Drugs https://www.nejm.org/doi/full/10.1056/NEJMoa1513614 II – HF Care Alerts Improve Prescribing of HF Quadruple Therapy: PROMPT-HF https://www.medscape.com/viewarticle/972079 • Electronic Alerts to Improve Heart Failure Therapy in Outpatient Practice: A Cluster Randomized Trial https://www.jacc.org/doi/10.1016/j.jacc.2022.03.338 • Reassessing Quality Assessment — The Flawed System for Fixing a Flawed System https://www.nejm.org/doi/full/10.1056/NEJMms2200976 III – Three-Vessel Disease FAME 3 Subanalysis Adds Twist to Negative Primary Results https://www.medscape.com/viewarticle/971495 • Fractional Flow Reserve–Guided PCI as Compared with Coronary Bypass Surgery https://www.nejm.org/doi/10.1056/NEJMoa2112299 • Quality of Life After Fractional Flow Reserve-Guided PCI Compared with Coronary Bypass Surgery https://www.ahajournals.org/doi/abs/10.1161/CIRCULATIONAHA.122.060049 IV – Treating Drug Side Effects with More Drugs DIAMOND: Adding Patiromer Helps Optimize HF Meds, Foils Hyperkalemia https://www.medscape.com/viewarticle/971616 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

ACC Recap: John Mandrola, MD, provides part 1 of an ACC recap 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 – HTN in Pregnancy - Hypertension Control During Pregnancy Validated in Large Trial https://www.medscape.com/viewarticle/971486 - Treatment for Mild Chronic Hypertension during Pregnancy https://www.nejm.org/doi/full/10.1056/NEJMoa2201295 II – Prevention of Bleeding in Non-Cardiac Surgery - POISE-3 Backs Wider Use of Tranexamic Acid in Noncardiac Surgery https://www.medscape.com/viewarticle/971483 - Tranexamic Acid in Patients Undergoing Noncardiac Surgery https://www.nejm.org/doi/full/10.1056/NEJMoa2201171 III – HCM - VALOR-HCM: Novel Drug May Delay, Avert Invasive Therapy in OHCM https://www.medscape.com/viewarticle/971484 IV – Left Atrial Appendage Occlusion - Small Leaks After LAAO Linked to Thromboembolism, Bleeding https://www.medscape.com/viewarticle/971709 V – Low Sodium Diet for HF - Low-Sodium Diet Did Not Cut Clinical Events in Heart Failure Trial https://www.medscape.com/viewarticle/971482 - Reduction of dietary sodium to less than 100 mmol in heart failure (SODIUM-HF): an international, open-label, randomised, controlled trial https://doi.org/10.1016/S0140-6736(22)00369-5 VI – Flu Vaccine and Heart Failure - Flu Vaccines Cut Seasonal Death in Patients With Heart Failure https://www.medscape.com/viewarticle/971619 VII – New Anticoagulant? - Less Bleeding With Factor XI Inhibitor Anticoagulant? PACIFIC-AF https://www.medscape.com/viewarticle/971702 Features: - Sodium Restriction in Heart Failure: Another Dogma Felled by Randomization https://www.medscape.com/viewarticle/971697 - Percutaneous Left Atrial Appendage Occlusion: ACC Data Challenge Promise vs Reality https://www.medscape.com/viewarticle/971512 - Mavacamten in Hypertrophic Cardiomyopathy: Reasons for Both Optimism and Caution https://www.medscape.com/viewarticle/971485 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

Coronary CTA, semaglutide, coronary artery calcium, exercise, and an ACC and EHRA preview 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 – Coronary CTA Feedback - Coronary Computed Tomography Angiography vs Functional Stress Testing for Patients With Suspected Coronary Artery Disease https://jamanetwork.com/journals/jamainternalmedicine/fullarticle/2655243 II – Semaglutide - FDA Okays Semaglutide Higher Dose, 2 mg/Week, for Type 2 Diabetes https://www.medscape.com/viewarticle/971156 - Efficacy and safety of once-weekly semaglutide 2·0 mg versus 1·0 mg in patients with type 2 diabetes (SUSTAIN FORTE): a double-blind, randomised, phase 3B trial https://doi.org/10.1016/S2213-8587(21)00174-1 - Semaglutide and Cardiovascular Outcomes in Patients with Type 2 Diabetes https://www.nejm.org/doi/full/10.1056/NEJMoa1607141 - Once-Weekly Semaglutide in Adults with Overweight or Obesity https://www.nejm.org/doi/full/10.1056/NEJMoa2032183 III – CAC and SCD - Calcium Scores Predict Sudden-Death Risk in Preclinical CAD in Large Cohort Study https://www.medscape.com/viewarticle/971056 - Coronary Artery Calcium for Risk Stratification of Sudden Cardiac Death: The Coronary Artery Calcium Consortium https://www.jacc.org/doi/10.1016/j.jcmg.2022.02.011 IV – Exercise and COVID-19 - More Exercise Linked to Lower Chance of Severe COVID-19: Study https://www.medscape.com/viewarticle/949468 - Small steps, strong shield: directly measured, moderate physical activity in 65 361 adults is associated with significant protective effects from severe COVID-19 outcomes http://dx.doi.org/10.1136/bjsports-2021-105159 V – ACC Preview - Hybrid ACC.22 Resurrects the Live Scientific Session https://www.medscape.com/viewarticle/971083 - Mandrola Previews the 2022 American College of Cardiology Scientific Sessions https://www.medscape.com/viewarticle/971084 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 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