This Week in Cardiology

Explore the latest concerns surrounding cardiac device recalls and the need for improved MI classification. Discover how listener feedback shapes the conversation on PFA technology risks. Hear about critical findings on how arm positioning can dramatically skew blood pressure readings and the implications for patient care. This insightful discussion highlights the importance of accurate measurements to prevent misdiagnosis and enhance treatment strategies.

Delve into the latest breakthroughs in cardiology, such as LGE pre-ICDs and pulse field ablation for atrial fibrillation. Discover the complexities of data sharing in medical research and how it can impact findings. The discussions reveal the importance of rigorous criteria for patient assessments and examine new procedures like endovascular ablation of the greater splanchnic nerve for managing HFpEF. Additionally, learn about the EuroCTO trial results and the evolving landscape of chronic total coronary occlusion interventions.

Dr. John Mandrola, a cardiologist with a wealth of knowledge, dives into crucial topics like the flawed concept of surgical clearance in cardiology, emphasizing the importance of understanding surgical risks. He critiques current preoperative practices and advocates for advanced imaging over traditional tests. The discussion also explores the underuse of guideline-directed medical therapy in heart failure patients. Additionally, Dr. Mandrola highlights how patient preferences significantly influence treatment decisions, underscoring the need for personalized approaches in cardiology.

John Mandrola, MD, a seasoned cardiologist, and Sripal Bangalore, a cardiac research expert, delve into some urgent issues in cardiology. They discuss the implications of FDA Class I device recalls and the troubling disparities in preventive care access for marginalized patients. The duo also tackles the risks of prematurely stopping clinical trials and the impact of potassium management on post-surgery outcomes. Plus, listeners are updated on the positive results of the SHAM-PVI trial for AF ablation, revealing its intriguing effects.

More from ESC: the SCOFF trial and fasting before cardiac cath, MATTERHORN, humbling data with AI, plus a reflection on the work of being a patient are the topics John Mandrola, MD, covers 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. Fasting Before Cardiac Procedures The SCOFF Trial https://doi.org/10.1093/eurheartj/ehae573 II. MV repair for Functional MR Large Trials Support Mitral Valve Repair in Heart Failure MATTERHORN https://www.nejm.org/doi/full/10.1056/NEJMoa2408739 III. AI in Medicine Rapidx AI Project https://healthtranslationsa.org.au/project/rapid-x-ai/ PROTEUS Trial Rationale paper https://pubmed.ncbi.nlm.nih.gov/37192698/ IV. Time Toxicity Time Toxicity https://link.springer.com/article/10.1007/s00520-024-08844-1 Thread X https://x.com/EnriqueSoto8/status/1833587144256065859 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

In this engaging discussion, John Mandrola, MD, a cardiology expert, dives into recent groundbreaking clinical trials. He shares insights on the ABYSS trial, questioning the role of beta-blockers post-myocardial infarction. The conversation also touches on the SHAM-PVI trial for AFib ablation and its implications for practice. Mandrola highlights the FINEARTS HF trial, emphasizing the benefits of finerenone for heart failure with preserved ejection fraction. This episode is a treasure trove of valuable information for healthcare professionals!

Dr. John Mandrola, a prominent cardiologist, shares insights from the European Society of Cardiology meeting. He discusses the implications of beta blockers post-myocardial infarction and introduces a promising new therapy for ATTR cardiomyopathy. Mandrola also highlights the importance of temporarily halting RAS inhibitors before non-cardiac surgery and presents encouraging developments in managing heart failure with preserved ejection fraction. The episode further examines the significance of placebo effects in cardiology trials and their influence on patient quality of life.

Suicidal ideation and GLP-1 agonists, a repeat of PARADIGM HF in Chagas CM, CASTLE HTx critical appraisal, and primary prevention of SCD in HF are the topics John Mandrola, MD, covers 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. Suicidal ideation with GLP-1 Signal of Suicidality With GLP-1 RA Semaglutide, but Experts Urge Caution https://www.medscape.com/viewarticle/signal-suicidality-glp-1-ra-semaglutide-experts-urge-caution-2024a1000fa7 Disproportionality Analysis from World Health Organization Data on Semaglutide, Liraglutide, and Suicidality Variability in Disproportionality paper https://www.frontiersin.org/journals/pharmacology/articles/10.3389/fphar.2021.668765/full II. PARACHUTE HF: Repeating the Mistakes in PARADIGM HF PARACHUTE HF https://www.jacc.org/doi/10.1016/j.jchf.2024.05.021 SOLVD https://www.nejm.org/doi/full/10.1056/NEJM199108013250501 CONSENSUS trial https://www.nejm.org/doi/full/10.1056/NEJM198706043162301 Meta-analysis of Low vs High Dose ACE/ARB https://doi.org/10.1161/CIRCHEARTFAILURE.117.003956 Meta-analysis of Sac/Val vs ARB/ACE Inhibitors https://link.springer.com/article/10.1007/s00228-024-03686-6 PARADISE MI https://www.nejm.org/doi/full/10.1056/NEJMoa2104508 III. CASTLE HTx Critical Appraisal Critical Appraisal of CASTLE HTx https://doi.org/10.1016/j.jacc.2024.06.020 CASTLE HTx https://www.nejm.org/doi/10.1056/NEJMoa2306037 CASTLE AF https://www.nejm.org/doi/full/10.1056/NEJMoa1707855 IV. More Data Suggesting Modest Benefits of the Primary Prevention ICD First and Recurrent ICD Shocks: JICE Paper from Denmark https://link.springer.com/article/10.1007/s10840-024-01873-0 HF trialists https://www.nejm.org/doi/full/10.1056/NEJMoa1609758 PROFID Trial https://profid-project.eu/ DANISH https://www.nejm.org/doi/full/10.1056/NEJMoa1608029 SCD-HeFT https://www.nejm.org/doi/full/10.1056/NEJMoa043399 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

Diuretic therapy in HFrEF, AF ablation, TACT 2 and the story of subgroups, and SGLT2 inhibitor underuse 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. Diuretic Therapy in HF Dapa vs Metolazone Trial https://doi.org/10.1093/eurheartj/ehad341 ADVOR https://www.nejm.org/doi/10.1056/NEJMoa2203094 II. Rapid Medication Titration for Acute HF ACC Decision Pathway https://www.jacc.org/doi/10.1016/j.jacc.2024.06.002 III. SGLT2 Inhibitor Use in the US Shin and Colleagues; JACC https://www.sciencedirect.com/science/article/abs/pii/S0735109724076332 Editorial https://doi.org/10.1016/j.jacc.2024.07.001 IV. AF Ablation: General Anesthesia vs Conscious Sedation Da Riis-Vestergaard and Colleagues https://doi.org/10.1093/europace/euae203 V. TACT 2 Published TACT 1 https://jamanetwork.com/journals/jama/fullarticle/1672238 TACT 1 DM https://www.ahajournals.org/doi/10.1161/CIRCOUTCOMES.113.000663 TACT 2 https://jamanetwork.com/journals/jama/fullarticle/2822472 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

John Mandrola, MD, a leading cardiologist, dives into critical cardiology topics this week. He discusses the tug-of-war between clinical prediction models and personal judgment in patient care. The conversation also covers the intricacies of CCTA quantification of atherosclerosis and its implications for cardiovascular risk. Mandrola examines the combined approach of AF ablation with LAAO, along with the efficacy of atrial shunt devices, highlighting recent studies that question their overall benefits for heart failure patients.