This Week in Cardiology

Listener feedback shines light on cardiac sarcoidosis and emerging awareness of bystander CPR. Experts discuss the phrase 'less is more' in post-stent antiplatelet therapy for better outcomes. Lipoprotein(a) is explored as a significant factor in cardiovascular risk. The complexities of managing atrial fibrillation in patients with heart failure are dissected, emphasizing the need for collaboration with specialists. Engaging insights prompt healthcare professionals to rethink patient care strategies.

Listener feedback, CRT vs CSP, important clues on the ECG, beta-blocker interruption after myocardial infarction, novel approaches to LDL-C lowering, and ICD decisions in cardiac sarcoidosis 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 II CRT vs CSP – CONSYST-CRT • Trial JACC EP https://doi.org/10.1016/j.jacep.2025.03.024 III The Important QRS • Kewcharoen et al https://www.ahajournals.org/doi/10.1161/CIRCEP.125.013809 IV ABYSS Trial of BB Interruption after MI Continues to be Mis-interpreted • ABYSS Main https://www.nejm.org/doi/full/10.1056/NEJMoa2404204 • ABYSS substudy https://doi.org/10.1093/eurheartj/ehaf170 • REDUCE AMI https://www.nejm.org/doi/full/10.1056/NEJMoa2401479 V Oral PCSK9i and the PURSUIT Trial • Koren et al https://www.jacc.org/doi/10.1016/j.jacc.2025.03.499 • Editorial https://doi.org/10.1016/j.jacc.2025.03.518 • Is Lifelong LDL-C Lowering Within Reach? The heart-1 Gene-Editing Trial https://www.medscape.com/viewarticle/998162 • Heart-1 Gene Therapy Trial Pauses Enrollment https://www.medscape.com/viewarticle/998162 • EHJ coverage VERVE https://academic.oup.com/ehjcvp/article/10/2/87/7455877 VI Cardiac Sarcoidosis and Risk of VT • EHJ paper Mathijssen et al https://doi.org/10.1093/eurheartj/ehaf338 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

Listener feedback kicks off discussions about sports disqualification linked to genetic heart disease. Exciting updates on digoxin's role in heart failure and the implications of Brugada syndrome add depth. The show dives into innovative treatments like finerenone, weighing its efficacy against traditional options. A sharp critique of trial methodologies highlights the importance of sham controls in enhancing research validity. Overall, a blend of cutting-edge research and practical insights for healthcare professionals makes for a compelling listen!

Explore groundbreaking findings on blood pressure medication timing, revealing that when you take them may not matter as much as once thought. Discover the competitive edge of tirzepatide over semaglutide in promoting weight loss and improving cardiometabolic health. Delve into age-specific troponin reference limits, particularly relevant for older patients. Plus, learn about genetic factors in athletes and the rapid titration benefits for heart failure treatments, highlighted by recent clinical trials.

The podcast dives into the controversial KETO-CTA study, exploring its impact on cholesterol and plaque progression. It examines subclinical atrial fibrillation and the questions surrounding the need for anticoagulation treatment. Additionally, there’s an exciting discussion on the ESSENCE trial, highlighting the potential benefits of GLP-1 agonists for fatty liver disease, suggesting significant implications for cardiology. The balance between lifestyle changes and treatment strategies for cardiovascular care is also scrutinized, inviting a thoughtful dialogue.

The FDA's recent approval of TAVR for asymptomatic aortic stenosis raises questions about trial biases and the necessity of immediate intervention. Innovative diagnostic tools, including machine learning methods to differentiate tachycardia types, are explored for their potential to enhance cardiac care. Additionally, discussions on the implications of the PRAETORIAN-XL trial highlight concerns around methodologies in device therapy, shedding light on how these factors could alter patient outcomes.

AI and ECGs, novel ways to treat hypertension, combined lipid-lowering therapy after myocardial infarction, PFA and silent stroke, a move toward accountability in AF ablation, and pacing issues in TTVR 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 Help with ECGs in the ED AI Shows Promise for Rapid NSTEMI Diagnosis https://www.medscape.com/viewarticle/ai-shows-promise-rapid-nstemi-diagnosis-2025a10009pw Buscher et al https://doi.org/10.1093/eurheartj/ehaf254 II A Novel way to Treat HTN A Pacemaker to Control BP Gets FDA Breakthrough Designation https://www.medscape.com/viewarticle/pacemaker-control-bp-gets-fda-breakthrough-designation-2025a10009t3 JAHA paper https://www.ahajournals.org/doi/10.1161/JAHA.120.020492 Backbeat https://clinicaltrials.gov/study/NCT06059638 III Type of PFA may matter for Silent Cerebral Lesions Paper https://www.ahajournals.org/doi/10.1161/CIRCEP.125.013719 IV Accountability coming to US AF ablation Heart Rhythm Society Releases a Document on Establishing Centers of Excellence for AF ablation -- Press Release https://www.hrsonline.org/news/new-white-paper-on-atrial-fibrillation-centers-of-excellence/ V Pacing in Patients with Undergoing Transcatheter Tricuspid Valve Replacement Paper https://doi.org/10.1016/j.hrthm.2025.02.004 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

This week, the discussion centers on the significant findings from the FAME 3 trial, showing stents can be as effective as surgery for triple-vessel disease. TAVR outcomes in low-risk patients are explored, revealing similar results to traditional surgery. The implications of pacemaker use after TAVR also come into play. Additionally, mavacamten's limitations for treating hypertrophic cardiomyopathy are analyzed, prompting a deeper look into the evolving landscape of cardiac treatments.

The TAP-IT, STRIDE, FreshUP, and SINGLE SHOT CHAMPION trials 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 TAP IT TAP IT trial https://www.ahajournals.org/doi/10.1161/CIRCULATIONAHA.124.073521 II STRIDE LANCET Ref 10.1016/S0140-6736(25)00509-4 SUMMIT HF https://www.nejm.org/doi/full/10.1056/NEJMoa2410027 III FRESH UP No Need to Restrict Fluids in Stable Heart Failure https://www.medscape.com/viewarticle/no-need-restrict-fluids-stable-heart-failure-2025a10008bu Nature (Trial) https://www.nature.com/articles/s41591-025-03628-4 SODIUM HF https://pubmed.ncbi.nlm.nih.gov/35381194/ IV PFA for AF ablation SINGLE SHOT CHAMPION https://www.nejm.org/doi/full/10.1056/NEJMoa2502280 ADVENT https://www.nejm.org/doi/full/10.1056/NEJMoa2307291 Foy et al https://pmc.ncbi.nlm.nih.gov/articles/PMC11852674/ MANIFEST REDO Study https://doi.org/10.1093/europace/euaf012 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

Discover cutting-edge insights from recent clinical trials presented at the 2025 ACC. Hear about the WARRIOR trial's impact on non-obstructive coronary artery disease, and explore findings from PROTECT TAVI regarding cerebral embolic protection. Dive into DAPATAVI, where SGLT2 inhibitors emerge as potential new standards following TAVI. Plus, learn how oral semaglutide is shifting the landscape of diabetes management and its effects on cardiovascular outcomes!