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Medscape

This podcast delivers Dr. John Mandrola’s summary and perspective on top news of the week that cardiologists can’t miss. This podcast is intended for US health professionals only.

This Week in Cardiology

Another knock against the antiplatelet/anticoagulant combo, polypills in HF, the physical exam of the future, and the problem of underpowered trials that even Bayesian analyses cannot rescue 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
 
 Trends Study • 
https://www.heartrhythmjournal.com/article/S1547-5271(11)00496-6/fulltext 
II Another knock against the Antiplatelet/Anticoagulation combination
 
“Antiplatelet Plus Oral Anticoagulant Lowers Stroke, Raises Bleeding Risk” https://www.medscape.com/viewarticle/antiplatelet-plus-oral-anticoagulant-lowers-stroke-raises-2025a1000re0
 
 ATIS-NVAF Trial • 
https://jamanetwork.com/journals/jamaneurology/fullarticle/2839511 AQUATIC trial • 
https://www.nejm.org/doi/abs/10.1056/NEJMoa2507532 
III Polypill for HFrEF
 
 A Multilevel Polypill for Patients With HFrEF • 
https://www.jacc.org/doi/10.1016/j.jacadv.2025.102195 
IV The Physical Exam of the Future
 
 Point-of-Care Ultrasound • 
https://doi.org/10.1016/j.jchf.2025.102707 
V More on Underpowered Trials – GA vs Moderate Sedation in IV stroke
 
 SEGA Trial • 
https://jamanetwork.com/journals/jamaneurology/fullarticle/2839838 Bayesian Analyses of CV Trials • 
https://doi.org/10.1016/j.cjca.2021.03.014 
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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
 
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Oct 17 2025 This Week in Cardiology

GLP-1 use in HFrEF, left atrial posterior wall isolation during AF ablation, peri-device leaks for LAAO, new findings in post-cardiac surgery AF, and imaging before AF ablation 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
 
HYPERION trial https://www.nejm.org/doi/10.1056/NEJMoa2508170
 
ZENITH trial https://www.nejm.org/doi/full/10.1056/NEJMoa2415160
 
II GLP1 Use in HFrEF
 
Effects of GLP-1s in Patients With HFrEF https://doi.org/10.1016/j.jchf.2025.102573
 
FIGHT Study https://jamanetwork.com/journals/jama/fullarticle/2540402
 
FIGHT Study Post-hoc Analysis https://dom-pubs.pericles-prod.literatumonline.com/doi/10.1111/dom.14862
 
Substudy of EXSCEL Trial https://www.ahajournals.org/doi/10.1161/CIRCULATIONAHA.119.041659
 
III LA Posterior Wall Isolation Saga
 
Failure of PW Wall Isolation by PFA with Epicardial Mapping https://doi.org/10.1016/j.jacep.2025.08.017
 
IV Peridevice Leaks After LAAO
 
IMPRESSION LAAC Study https://doi.org/10.1016/j.jacep.2025.08.014
 
V Post Cardiac Surgery AF
 
Monitoring of New-Onset AF After CABG https://jamanetwork.com/journals/jama/fullarticle/2839710
 
PACES trial https://clinicaltrials.gov/study/NCT04045665
 
VI TEE vs ICE Before AF ablation
 
ICE vs TEE Study https://jamanetwork.com/journals/jamacardiology/fullarticle/2839370
 
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
 
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Oct 10 2025 This Week in Cardiology

Two great stories of translation science leading to beneficial drugs in terrible diseases of the heart and the Sisyphean task of predicting the need for pacing after TAVI 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 Sotatercept
 
 HYPERION Trial https://www.nejm.org/doi/10.1056/NEJMoa2508170 ZENITH Trial https://www.nejm.org/doi/full/10.1056/NEJMoa2415160 Evidence report on treatment for PAH https://icer.org/news-insights/press-releases/icer-publishes-final-evidence-report-on-treatment-for-pulmonary-arterial-hypertension/ PAH Sotatercept Editorial https://www.nejm.org/doi/full/10.1056/NEJMe2503944 
II Acoramidis and ATTR Cardiomyopathy
 
 ATTRIBUTE-CM Trial https://www.nejm.org/doi/full/10.1056/NEJMoa2305434?logout=true ATTRIBUTE-CM Analysis - Substudy https://www.jacc.org/doi/10.1016/j.jacc.2025.09.013 Tafamadis Trial https://www.nejm.org/doi/full/10.1056/NEJMoa1805689 
III Pacing After TAVI
 
 Prophylactic pacemaker after TAVI https://www.jacc.org/doi/10.1016/j.jacep.2025.07.028 PROMOTE study https://doi.org/10.1016/j.hrthm.2024.12.019 Evaluation of ESC criteria on RBBB patients undergoing TAVI https://doi.org/10.1016/j.hrthm.2024.11.030 Editorial on Heart Rhythm journal papers https://www.heartrhythmjournal.com/article/S1547-5271(25)00114-6/abstract 
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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

Oct 03 2025 This Week in Cardiology

A bold trial in valvular heart disease, a CV prevention trial whose message is humility, VTE dogma challenged, more news on oral GLP-1 agonists, and a few public service announcements 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 DOUBLE-CHOICE: Minimalist Approach to TAVI May Be as Good as Standard of Care https://www.medscape.com/viewarticle/double-choice-minimalist-approach-tavi-may-be-good-standard-2025a1000pp7
 
 Patient & Physician Perspectives on CV Risk https://www.ahajournals.org/doi/10.1161/CIRCOUTCOMES.124.011837 
II KP Vaccinate Trial
 
 KP Vaccinate Trial https://evidence.nejm.org/doi/full/10.1056/EVIDoa2500208 IAMI trial https://www.ahajournals.org/doi/10.1161/CIRCULATIONAHA.121.057042 Increasing Flu Vaccinations in Patients With Chronic Disease https://jamanetwork.com/journals/jama/fullarticle/2824956 MI FREEE Trial https://www.nejm.org/doi/full/10.1056/NEJMsa1107913 
III Hi PRO Trial
 
 Apixaban for Extended Treatment of VTE https://www.nejm.org/doi/full/10.1056/NEJMoa2509426 Recurrent VTE in Patients with Provoked VTE https://jamanetwork.com/journals/jamainternalmedicine/fullarticle/226140 
IV Oral GLP-1 Agonists
 
 ATTAIN 1 Trial https://www.nejm.org/doi/full/10.1056/NEJMoa2511774 
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Sep 26 2025 This Week in Cardiology

More trials at ESC, including PARACHUTE HF, DAPA ACT HF-TIMI 68, AMALFI, and a super-interesting modeling study of when to start oral anticoagulants in AF, 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 PARACHUTE HF
 
First Evidence of Treatment Benefit in Chagas Heart Failure
 
 https://www.medscape.com/viewarticle/first-evidence-treatment-benefit-chagas-heart-failure-2025a1000oem
 
 PARACHUTE-HF https://www.jacc.org/doi/10.1016/j.jchf.2024.05.021 
II SGLT2i Early Initiation — DAPA ACT HF-TIMI 68 Trial
 
Trial Data Support In-Hospital Initiation of SGLT2 Inhibitors for Heart Failure https://www.medscape.com/viewarticle/trial-data-support-hospital-initiation-sglt2-inhibitors-2025a1000o5q
 
 DAPA ACT HF-TIMI 68 
 https://www.ahajournals.org/doi/abs/10.1161/CIRCULATIONAHA.125.076575
 
III AMALFI Trial of AF Screening
 
Remote ECG Screening Ups Atrial Fibrillation Detection ‘Modestly’ https://www.medscape.com/viewarticle/remote-ecg-screening-ups-atrial-fibrillation-detection-2025a1000myx
 
 AMALFI Trial https://jamanetwork.com/journals/jama/article-abstract/2838482 STROKESTOP Trial https://www.thelancet.com/article/S0140-6736(21)01637-8/fulltext LOOP Trial 10.1016/S0140-6736(21)01698-6 External Link 
IV Finding that Sweet Spot of Stroke Risk Threshold for Starting DOAC therapy
 
 Stroke Risk Threshold for non-Vitamin K Antagonist OAC in AF • 
https://www.ahajournals.org/doi/10.1161/CIRCOUTCOMES.125.012090 Variations in Rates of Stroke Across Patients With AF • 
https://www.ahajournals.org/doi/10.1161/circulationaha.116.024057 
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Questions or feedback, please contact news@medscape.net

Sep 19 2025 This Week in Cardiology

More from ESC including: Valvular HD guidelines, a new drug class for HTN, myosin inhibition in HCM, vericiguat, and digoxin are the topic discussed by John Mandrola, MD.
 
This podcast is intended for healthcare professionals only.
 
To read a partial transcript or to comment, visit:
 
https://www.medscape.com/twic
 
I New European Valvular Heart Disease Guidelines
 
 • 2025 ESC/EACTS Guidelines for the management of valvular heart disease https://doi.org/10.1093/eurheartj/ehaf194
 • Debate: Does Asymptomatic Aortic Stenosis Warrant Early Intervention? https://exp.medscape.com/debates/does-asymptomatic-aortic-stenosis-warrant-early-intervention/
 • Surgical Ablation of Atrial Fibrillation during Mitral-Valve Surgery https://www.nejm.org/doi/full/10.1056/NEJMoa1500528
 • Surgical ablation of atrial fibrillation: a systematic review and meta-analysis https://doi.org/10.1093/europace/eux336
 
II New Drug for Resistant HTN
 
 • Baxdrostat: A 'Game Changer' for Hypertension? https://www.medscape.com/viewarticle/baxdrostat-game-changer-hypertension-2025a1000mz7
 • Efficacy and Safety of Baxdrostat in Uncontrolled and Resistant Hypertension https://www.nejm.org/doi/full/10.1056/NEJMoa2507109
 • Lorundrostat Efficacy and Safety in Patients with Uncontrolled Hypertension https://www.nejm.org/doi/10.1056/NEJMoa2501440
 
III HCM News at ESC
 
 • New Trials Clarify Role of Myosin Inhibitors for Hypertrophic Cardiomyopathy https://www.medscape.com/viewarticle/new-trials-clarify-role-myosin-inhibitors-hypertrophic-2025a1000myv
 • MAPLE HCM https://www.nejm.org/doi/full/10.1056/NEJMoa2504654
 • SEQUOIA HCM https://www.nejm.org/doi/10.1056/NEJMoa2401424
 • ODYSSEY HCM https://www.nejm.org/doi/full/10.1056/NEJMoa2505927
 
IV Vericiguat at ESC
 
 • New Data Said to Support Vericiguat as Standard Therapy for Heart Failurehttps://www.medscape.com/viewarticle/new-data-said-support-vericiguat-standard-therapy-heart-2025a1000mz9
 • VICTOR https://doi.org/10.1016/S0140-6736(25)01665-4
 • VICTORIA https://www.nejm.org/doi/full/10.1056/NEJMoa1915928
 • An individual participant data analysis of the VICTORIA and VICTOR trials https://doi.org/10.1016/S0140-6736(25)01682-4
 
V More on Digoxin
 
 • RATE AF substudy https://doi.org/10.1002/ejhf.70022
 • Main RATE-AF trial https://jamanetwork.com/journals/jama/fullarticle/2774407
 • Efficacy of β blockers in patients with heart failure plus atrial fibrillation: an individual-patient data meta-analysis https://doi.org/10.1016/S0140-6736(14)61373-8
 
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Questions or feedback, please contact news@medscape.net

Sep 12 2025 This Week in Cardiology

The big beta-blocker story from ESC, dual pathway therapy with aspirin and OAC, stopping OAC after successful AF ablation, and DANCAVAS II trial are the topics John Mandrola, MD, discusses on 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
 
This Week in Cardiology Podcast – August 29 https://www.medscape.com/viewarticle/1002877
 
II The Big Beta-blocker Story from ESC
 
Beta-Blockers Post-MI: A Clear Clinical Message https://www.medscape.com/viewarticle/beta-blockers-post-mi-clear-clinical-message-2025a1000mz0
 
 REBOOT https://www.nejm.org/doi/full/10.1056/NEJMoa2504735 BETAMI-DANBLOCK https://www.nejm.org/doi/abs/10.1056/NEJMoa2505985 REDUCE AMI https://www.nejm.org/doi/10.1056/NEJMoa2401479 CAPITAL RCT https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0199347 Post Hoc Analysis From REBOOT Trial https://eurointervention.pcronline.com/article/effect-of-beta-blocker-withholding-or-withdrawal-after-myocardial-infarction-without-reduced-ejection-fraction-on-ischaemic-events-a-post-hoc-analysis-from-the-reboot-trial Beta-Blockers After MI With Mildly Reduced Ejection Fraction https://doi.org/10.1016/S0140-6736(25)01592-2 CAPRICORN 10.1016/S0140-6736(00)04560-8 External Link BHAT https://jamanetwork.com/journals/jama/fullarticle/370103 ISIS 1 https://pubmed.ncbi.nlm.nih.gov/2873379/ 
III Aspirin and OAC Combination Clearly Dangerous
 
Aspirin Plus Oral Anticoagulants Raises Mortality, Bleeding https://www.medscape.com/viewarticle/aspirin-plus-oral-anticoagulants-raises-mortality-bleeding-2025a1000nam
 
 AQUATIC https://www.nejm.org/doi/full/10.1056/NEJMoa2507532 AFIRE https://www.nejm.org/doi/full/10.1056/NEJMoa1904143 EPIC CAD https://www.nejm.org/doi/10.1056/NEJMoa2407362 OAC-ALONE https://pubmed.ncbi.nlm.nih.gov/30586700/ 
IV Stop or Continue OAC after Successful AF Ablation
 
 ALONE-AF https://jamanetwork.com/journals/jama/fullarticle/2838294 OCEAN trial protocol https://doi.org/10.1016/j.ahj.2017.12.007 
V DANCAVAS II Trial
 
 DANCAVAS II https://doi.org/10.1093/eurheartj/ehaf704 DANCAVAS I https://www.nejm.org/doi/full/10.1056/NEJMoa2208681 
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Sep 05 2025 This Week in Cardiology

CAC 0 takes a gut punch, ICD therapies cannot be surrogates for benefit, and two important trials from ESC 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 CAC 0
 
 LDL-C and CVD Risk With CAC Score 0 https://academic.oup.com/eurheartj/advance-article/doi/10.1093/eurheartj/ehaf497/8228645 
II ICD Therapies
 
 Contemporary ICD Benefit https://www.jacc.org/doi/10.1016/j.jacep.2025.06.028 PROFID Trial https://profid-project.eu/profid-ehra-trial/ MADIT-RIT Trial https://www.nejm.org/doi/full/10.1056/NEJMoa1211107 Declining Risk of Sudden Death in HF https://www.nejm.org/doi/full/10.1056/NEJMoa1609758 
III Digit-HF
 
 DIGIT-HF Trial https://www.nejm.org/doi/full/10.1056/NEJMoa2415471 Digoxin–Mortality: Comparison in the DIG trial https://academic.oup.com/eurheartj/article/40/40/3336/5520008 
IV POTCAST
 
 POTCAST trial https://www.nejm.org/doi/full/10.1056/NEJMoa2509542 
ESC Preview
 
IV HTN Guidelines
 
 New Blood Pressure Guidelines: 4 Things I Like and 2 Concerns https://www.medscape.com/viewarticle/new-blood-pressure-guidelines-4-thing-i-and-2-concerns-2025a1000m1x 
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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

Aug 29 2025 This Week in Cardiology

John Mandrola discusses conduction system pacing vs standard pacing, withdrawing HF meds when AF is corrected and patient selection in LAAO.
 
This podcast is intended for healthcare professionals only.
 
To read a partial transcript or to comment, visit:
 
https://www.medscape.com/twic
 
I Conduction System Pacing
 
 • CSPACE trial https://doi.org/10.1016/j.jacc.2025.06.043
 • BLOCK HF trial https://www.nejm.org/doi/full/10.1056/NEJMoa1210356
 • BioPace trial https://doi.org/10.1093/europace/euaf029
 
II Withdrawing Meds After AF Corrected
 
 • WITHDRAW AF https://doi.org/10.1093/eurheartj/ehaf563
 • TRED HF https://pubmed.ncbi.nlm.nih.gov/30429050/
 
III Patient Selection in Left Atrial Appendage Occlusion
 
 • Long-Term Outcomes Following LAAO in Medicare Beneficiaries: Outcomes From the National Cardiovascular Data Registry https://www.ahajournals.org/doi/10.1161/JAHA.124.039780
 
ESC Preview
 
IV HTN Guidelines
 
 • New Blood Pressure Guidelines: 4 Things I Like and 2 Concerns https://www.medscape.com/viewarticle/new-blood-pressure-guidelines-4-thing-i-and-2-concerns-2025a1000m1x
 
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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

Aug 22 2025 This Week in Cardiology

Big new hypertension guidelines, ultraprocessed foods, coronary sinus reduction and evidence-based medicine, and more news on pulsed field ablation for atrial fibrillation 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 HTN Guidelines
 
 BP Meds Should Begin Promptly, New ACC/AHA Guidelines Say 
 https://www.medscape.com/viewarticle/bp-meds-should-begin-promptly-new-acc-aha-guidelines-say-2025a1000lms
 
 Guideline for Management of High Blood Pressure https://www.ahajournals.org/doi/10.1161/CIR.0000000000001356 BPROAD trial https://www.nejm.org/doi/full/10.1056/NEJMoa2412006 Trial Score Framework https://pmc.ncbi.nlm.nih.gov/articles/PMC6459598/ 
II UltraProcessed Foods
 
 AHA statement on Ultraprocessed Foods and Cardiometabolic Health • 
https://www.ahajournals.org/doi/full/10.1161/CIR.0000000000001365 
III Refractory Angina and the Coronary Sinus Reducer – A Lesson in EBM
 
 Coronary Sinus Reducer Shows Promise, With Caveats https://www.medscape.com/viewarticle/coronary-sinus-reducer-shows-promise-caveats-2025a1000l76 Coronary Sinus Reducer — Meta-analysis https://www.jacc.org/doi/10.1016/j.jcin.2025.06.012 COSIRA II Trial https://clinicaltrials.gov/study/NCT05102019 
IV Pulsed Field Ablation Still Looking Strong
 
 Management of OACs After PFA 10.1016/j.hrthm.2025.03.1952 External Link 
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Questions or feedback, please contact news@medscape.net

Aug 15 2025 This Week in Cardiology

The treatment of asymptomatic aortic stenosis, the move to composite endpoints in trials, IFR vs FFR and high-frequency low tidal volume ventilation for AF ablation 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 Aortic valve intervention for Asymptomatic AS
 
 Lindman editorial https://jamanetwork.com/journals/jamacardiology/fullarticle/2829881 Trends https://pmc.ncbi.nlm.nih.gov/articles/PMC11308430/ Podcast EARLY TAVR Nov 8, 2024 This Week in Cardiology Podcast https://www.medscape.com/viewarticle/1001865 Faith Healing and Subtraction Anxiety https://www.ahajournals.org/doi/10.1161/circoutcomes.118.004665 Early TAVR trial https://www.nejm.org/doi/10.1056/NEJMoa2405880 EVOLVED https://jamanetwork.com/journals/jama/fullarticle/2825540 AVATAR https://www.ahajournals.org/doi/10.1161/CIRCULATIONAHA.121.057639 
II Trial Endpoints
 
 Shepshelovich https://jamanetwork.com/journals/jamainternalmedicine/fullarticle/2830023 • Brown meta-analysis https://jamanetwork.com/journals/jamainternalmedicine/fullarticle/2785560
 
III IFR vs FFR—a debate b/w RCTs and observational data
 
 • 5-year DEFINE https://jamanetwork.com/journals/jamacardiology/fullarticle/2824470
 • 5-year SwedeHeart IFR https://doi.org/10.1016/j.jacc.2021.12.030
 • Eftekhari meta-analysis https://doi.org/10.1093/eurheartj/ehad582
 • Gotberg SWEDEHEART Registry https://doi.org/10.1016/j.jcin.2024.12.003
 • Editorial of SWEDEHEART-Registry https://doi.org/10.1016/j.jcin.2024.12.014
 
IV High-frequency low-tidal-volume ventilation for AF ablation
 
 • Osorio et al https://doi.org/10.1016/j.hrthm.2024.07.094
 
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Feb 28 2025 This Week in Cardiology

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