This Week in Cardiology

Explore the heated debate on treating asymptomatic aortic stenosis, with insights on whether early intervention is necessary. Delve into the complexities of trial design, especially the challenges of using composite endpoints. The discussion also covers the nuances between fractional flow reserve and instantaneous wave-free ratio, shedding light on their impacts in clinical settings. Additionally, listeners gain perspectives on high-frequency low tidal volume ventilation techniques for atrial fibrillation ablation, highlighting advancements in cardiovascular care.

The podcast dives into the controversial 'blanking period' following atrial fibrillation ablation, raising questions about patient impacts. It discusses the risks of periprocedural myocardial injury in non-STEMI cases and how AI can predict atrial fibrillation after ischemic strokes. The conversation also explores the evolving standards for mitral valve repair, weighing the merits of surgical versus transcatheter methods to ensure the best outcomes for patients. Engaging and informative, it’s a vital listen for healthcare professionals.

Explore the intriguing issue of silent cerebral embolism following left atrial appendage closure, highlighting its unexpected connection to cognitive decline. Discover how AI is revolutionizing ECG monitoring, improving the detection of critical arrhythmias. Dive into the debate over anticoagulation methods in patients with atrial fibrillation and chronic coronary disease, emphasizing the potential advantages of oral anticoagulation monotherapy. This fascinating discussion is packed with insights for healthcare professionals.

Sugar-sweetened beverages, the epidemiology of driving after an ICD, BP measurements, and massive EBM lesson in EVT for acute stroke are the topics John Mandrola, MD, discusses in today'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. Sugar-Sweetened Beverages Sugary Drinks Fuel Millions of Diabetes and CVD Cases https://www.medscape.com/viewarticle/sugary-drinks-fuel-millions-diabetes-and-cvd-cases-2025a10002wr Nature Medicin;e Epidemiologic Study https://www.nature.com/articles/s41591-024-03345-4 JAMA-Network Open;  Beverage Tax Observational Study https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2829505 Lancet Regional Health; Beverage Tax Philadelphia EHR 10.1016/j.lana.2024.100906 II. Driving With an ICD JACC Electrophysiology paper https://doi.org/10.1016/j.jacep.2024.12.002 Earlier HEART paper https://heart.bmj.com/content/110/24/1401 III. Blood Pressure Measurements and Simple RCTs BP Readings in Noisy Market as Good as Quiet Office? https://www.medscape.com/viewarticle/bp-readings-noisy-market-good-quiet-office-2025a10002z0 Annals of Internal Medicine Study https://www.acpjournals.org/doi/10.7326/ANNALS-24-00873 IV. A Big Shake-up in Interventional Stroke Care Endovascular Therapy Fails to Show Benefit in Distal Occlusion Stroke  https://www.medscape.com/viewarticle/endovascular-therapy-fails-show-benefit-distal-occlusion-2025a100035u ESCAPE-MeVO https://www.nejm.org/doi/full/10.1056/NEJMoa2411668 DISTAL trial https://www.nejm.org/doi/full/10.1056/NEJMoa2408954 J. Mocco Editorial https://www.nejm.org/doi/full/10.1056/NEJMe2500492 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 news@medscape.net

Another negative AF ablation trial, predicting AF after stroke, the value of RCTs, troponin testing in the ED and surgical aortic valve choice are the topics John Mandrola, MD, discusses this week. 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 Coronary Sinus Isolation for High-Burden Atrial Fibrillation: A Randomized Clinical Trial https://doi.org/10.1016/j.jacep.2024.09.017 Approaches to Catheter Ablation for Persistent Atrial Fibrillation (STAR AFII) https://www.nejm.org/doi/full/10.1056/NEJMoa1408288 Effect of Catheter Ablation With Vein of Marshall Ethanol Infusion vs Catheter Ablation Alone on Persistent Atrial Fibrillation: The VENUS Randomized Clinical Trial https://doi.org/10.1001/jama.2020.16195 Hybrid Convergent Procedure for the Treatment of Persistent and Long-Standing Persistent Atrial Fibrillation: Results of CONVERGE Clinical Trial https://www.ahajournals.org/doi/10.1161/CIRCEP.120.009288 II Post-Stroke AF monitoring Prediction of atrial fibrillation after a stroke event: a systematic review with meta-analysisMeta-analysis 10.1016/j.hrthm.2025.01.026 Dabigatran for Prevention of Stroke after Embolic Stroke of Undetermined Source https://www.nejm.org/doi/full/10.1056/NEJMoa1813959 Rivaroxaban for Stroke Prevention after Embolic Stroke of Undetermined Source (Navigate ESUS https://www.nejm.org/doi/full/10.1056/NEJMoa1802686 Apixaban to Prevent Recurrence After Cryptogenic Stroke in Patients With Atrial Cardiopathy (ARCADIA) https://jamanetwork.com/journals/jama/fullarticle/2814933 III RCTs Large simple randomized controlled trials—from drugs to medical devices: lessons from recent experience https://trialsjournal.biomedcentral.com/articles/10.1186/s13063-025-08724-x Outcomes 1 Year after Thrombus Aspiration for Myocardial Infarction (TASTE) https://www.nejm.org/doi/full/10.1056/NEJMoa1405707 IV Troponin Testing in the ED Cardiac Biomarker Testing in US Emergency Departments https://jamanetwork.com/journals/jamainternalmedicine/fullarticle/2829344 Updating Our Thinking on Troponin Use and Interpretation https://jamanetwork.com/journals/jamainternalmedicine/fullarticle/2777967 V Choice of AVR Bioprosthetic vs Mechanical Aortic Valve Replacement in Patients 40-75 Years https://doi.org/10.1016/j.jacc.2025.01.013 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 news@medscape.net

Explore the latest advancements in the management of familial hypercholesterolemia and innovative therapies for cardiac arrest. The discussion also covers groundbreaking Factor XI inhibition research and its implications. Finally, the complexities surrounding tricuspid valve interventions are examined, highlighting the need for better clinical trial methodologies to enhance treatment outcomes.

This week delves into the promising role of renal denervation and the FINEARTS trial results for finerenone in heart failure treatment. It raises questions about the effectiveness of current strategies for patients with HFpEF. The discussion also includes critical reflections on cardiovascular research, examining how marketing may sway outcomes. A significant setback in a medical device study adds to the conversation, alongside a critique of observational studies and their reliability in medical publishing.

This week's discussion tackles the significant cancer risks associated with alcohol consumption, spotlighting a new advisory from the Surgeon General. The podcast also delves into the challenges of applying GLP-1 trial findings to real-world patient care due to rigorous exclusion criteria. Insights on stress testing reveal important nuances in diagnosing coronary artery disease. To wrap up, listeners learn about a positive trend: decreasing stroke rates in atrial fibrillation patients, highlighting advancements in treatment.

Listener feedback sparks a debate over a controversial trial. The latest studies in AF ablation reveal better outcomes with PVI add-ons. Insights into the DANISH trial provide new perspectives on ICDs in non-ischemic cardiomyopathy. Additionally, eye complications related to GLP-1 agonist therapy are examined, shedding light on potential side effects. The podcast offers a mix of clinical findings and expert opinions, making it a rich resource for healthcare professionals.

Delve into the controversies surrounding ticagrelor and clopidogrel, with new research shaking up established beliefs in cardiology. Explore the debate on physician compensation and the impact of electronic health records on heart failure treatment. Discover why clopidogrel edges out aspirin even in high bleeding risk situations and unpack the nuances of holding antiplatelet medications for non-cardiac surgeries. The discussion challenges norms while shedding light on the evolving landscape of cardiovascular care.