This Week in Cardiology

An AHA Recap: SELECT, ORBITA2, and ARTESIA are the trials John Mandrola, MD, reviews 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 American Heart Association 2023 on theHeart.org | Medscape Cardiology https://www.medscape.com/viewcollection/37277 I. SELECT Trial Semaglutide 'A New Pathway' to CVD Risk Reduction: SELECT https://www.medscape.com/viewarticle/998373 Positive Results From SELECT Begins a New Era in Cardiology https://www.medscape.com/viewarticle/998217 Is It Time for Cardiologists to Treat Obesity? https://www.medscape.com/viewarticle/998391 - SELECT trial https://www.nejm.org/doi/full/10.1056/NEJMoa2307563 - SUSTAIN 6 https://www.nejm.org/doi/full/10.1056/nejmoa1607141 II. ORBITA 2 Angioplasty Finally Proven Beneficial in Stable Angina: ORBITA-2 https://www.medscape.com/s/viewarticle/998375 ORBITA-2 Saves Interventional Cardiology and Challenges Current Guidance https://www.medscape.com/viewarticle/998213 PCI, the Antianginal 'Pill': ORBITA-2 in Detail https://www.medscape.com/viewarticle/997777 - ORBITA-2; NEJM https://www.nejm.org/doi/full/10.1056/NEJMoa2310610 - ORBITA 1 https://doi.org/10.1016/S0140-6736(17)32714-9 III. ARTESIA Apixaban Cuts Stroke but Ups Bleeding in Subclinical AF: ARTESIA https://www.medscape.com/viewarticle/998379 Sadly, ARTESIA Doesn't Answer a Common Question in Cardiology https://www.medscape.com/viewarticle/998215 - NOAH https://www.nejm.org/doi/full/10.1056/NEJMoa2303062 - ARTESIA https://www.nejm.org/doi/10.1056/NEJMoa2310234 - AVERROES https://www.nejm.org/doi/full/10.1056/NEJMoa1007432 - McIntyre Meta-analysis https://www.ahajournals.org/doi/10.1161/CIRCULATIONAHA.123.067512 - TRENDS https://www.ahajournals.org/doi/10.1161/circep.109.849638 - ASSERT https://doi.org/10.1093/eurheartj/ehx042 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

Renal denervation, a potential deadly decision in the ED, GLP-1 agonists, and an AHA preview 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. Renal Denervation FDA OKs Paradise Renal Denervation System for Hypertension https://www.medscape.com/viewarticle/998237 - Company Press Release https://www.recormedical.com/recor-medical-and-otsuka-medical-devices-announce-first-fda-approved-renal-denervation-system-for-the-treatment-of-hypertension/ - Six-month Meta-analysis of RDN Studies https://www.ahajournals.org/doi/abs/10.1161/CIRCULATIONAHA.123.066941 - March This Week in Cardiology with RDN Discussion https://www.medscape.com/viewarticle/989014 II. Potential Deadly Decisions in the ED Even One Night in the ED Raises Risk for Death https://www.medscape.com/viewarticle/998080 - JAMA Internal Medicine Study III. Tirzepatide Approval FDA Approves Tirzepatide for Treating Obesity https://www.medscape.com/viewarticle/998225 - SURMOUNT 2 https://doi.org/10.1016/S0140-6736(23)01200-X - SURMOUNT 1 https://www.nejm.org/doi/full/10.1056/NEJMoa2206038 IV. AHA Preview Mandrola's Top Trials to Look for at AHA 2023 https://www.medscape.com/viewarticle/998123 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

Tricuspid regurgitation therapy, two more left atrial appendage trials, and reflections on being too soft on medical science 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. Tricuspid Regurgitation Trilogy TAVR Safe, Effective in Aortic Regurgitation https://www.medscape.com/viewarticle/997782 The TRILUMINATE Transcatheter Tricuspid Repair Trial: Positive but No Benefit? https://www.medscape.com/viewarticle/989105 Transcatheter Tricuspid Valve Repair Effective, Safe for Regurgitation: TRILUMINATE https://www.medscape.com/s/viewarticle/989103 - TRILUMINATE NEJM https://www.nejm.org/doi/full/10.1056/NEJMoa2300525 II. LAA Occlusion Different Strengths for LAA Closure Devices? https://www.medscape.com/viewarticle/962893 - Swiss Apero – Original paper https://www.ahajournals.org/doi/10.1161/CIRCULATIONAHA.121.057859 - Swiss Apero – One-year https://www.ahajournals.org/doi/10.1161/CIRCULATIONAHA.123.067599 Peri-device Leaks After Watchman https://pubmed.ncbi.nlm.nih.gov/35902169/ TAVR With Left Atrial Appendage Occlusion Non-inferior to TAVR Plus Medical Therapy https://www.medscape.com/viewarticle/997725 - WATCH TAVR Trial https://www.ahajournals.org/doi/10.1161/CIRCULATIONAHA.123.067312 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

More on the Million Hearts RCT, ENRICH AF, TAVI vs SAVR, the Partner 3 and Evolut-low-risk trials, and myocardial viability 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. Listener Feedback Million Hearts CMS 'Million Hearts' CVD Risk Reduction Model Works https://www.medscape.com/viewarticle/997551 - RCT JAMA - https://jamanetwork.com/journals/jama/fullarticle/2810696 AC in ICH - ENRICH AF Oral Anticoagulation in ICH Patients With AF: New Data https://www.medscape.com/viewarticle/997547 - Lancet Neurology Meta-analysis https://doi.org/10.1016/S1474-4422(23)00315-0 - ENRICH AF letter https://doi.org/10.1016/S0140-6736(23)02025-1 II. TAVI vs SAVR Low-Risk TAVR Studies: Divergent Long-Term Results https://www.medscape.com/viewarticle/997784 - Partner 3 Main Results - Partner 3 – Five Year - Original EVOLUT -LR https://www.nejm.org/doi/10.1056/NEJMoa1816885 - EVOLUT 3-year https://doi.org/10.1016/j.jacc.2023.02.017 - EVOLUT -LR 4-year https://doi.org/10.1016/j.jacc.2023.09.813 III. Myocardial Viability Viability-Guided PCI Doubted in Stable Severe CAD: REVIVED-BCIS2 https://www.medscape.com/viewarticle/989101 - Revived BCIS – Original paper https://www.nejm.org/doi/10.1056/NEJMoa2206606 - JAMA Cardiology Viability paper https://jamanetwork.com/journals/jamacardiology/fullarticle/2810727 - STICH Viability Paper - https://www.nejm.org/doi/full/10.1056/NEJMoa1100358 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

Listener feedback, oral anticoagulation in patients with ICH, an example of statistical significance but not clinical significance, and statins and diabetes 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 October 13, 2023 This Week in Cardiology Podcast https://www.medscape.com/viewarticle/997281 - European Heart Journal: IVI for PCI https://doi.org/10.1093/eurheartj/ehad430 - Elgendy Meta-analysis of Imaging in PCI: https://www.ahajournals.org/doi/10.1161/CIRCINTERVENTIONS.116.003700 - ULTIMATE: https://www.jacc.org/doi/10.1016/j.jacc.2018.09.013 - ILUMEIN IV: https://www.nejm.org/doi/full/10.1056/NEJMoa2305861 - OCTOBER: https://www.nejm.org/doi/full/10.1056/NEJMoa2307770 - Main STEP-HFpEF paper - Letter to the Editor on Lack of Obesity Paradox https://doi.org/10.1016/j.amjcard.2019.04.037 II. Anticoagulation in ICH Oral Anticoagulation in ICH Patients With AF: New Data https://www.medscape.com/viewarticle/997547 - Lancet Neuro Meta-analysis https://doi.org/10.1016/S1474-4422(23)00315-0 - ENRICH AF letter https://doi.org/10.1016/S0140-6736(23)02025-1 III. Million Hearts CMS 'Million Hearts' CVD Risk Reduction Model Works https://www.medscape.com/viewarticle/997551 - RCT JAMA IV. Statin Choice and Diabetes April 7, 2023 This Week in Cardiology Podcast https://www.medscape.com/viewarticle/990542 - LODESTAR Main Study - LODESTAR Substudy 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

Three stories regarding GLP-1 agonists, imaging during PCI, and the power of sham controls in procedure trials 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. FLOW Trial Positive Novo Nordisk Stops Ozempic Kidney Trial After Early Signs of Success https://www.medscape.com/s/viewarticle/997237 - FLOW Trial – press release https://www.novonordisk.com/content/nncorp/global/en/news-and-media/news-and-ir-materials/news-details.html?id=166327 II. STEP HFpEF Semaglutide Win in HFpEF With Obesity Regardless of Ejection Fraction: STEP-HFpEF https://www.medscape.com/viewarticle/997185 The GLP-1 Agonist Semaglutide in HFpEF Cleared a Low Bar https://www.medscape.com/viewarticle/995872 - STEP HFpEF substudy - STEP HFpEF main paper III. GLP-1 Agonist Adverse Effects GLP-1 Agonists Linked to Higher Risk for Rare but Serious GI Complications https://www.medscape.com/viewarticle/997128 - GI Adverse Effects of GLP-1 Agonists https://jamanetwork.com/journals/jama/fullarticle/2810542 IV. Imaging in PCI Intravascular Imaging in PCI: Time for a Guideline Update? https://www.medscape.com/viewarticle/995677 - Intravascular imaging during percutaneous coronary intervention: temporal trends and clinical outcomes in the USA https://academic.oup.com/eurheartj/article/44/38/3845/7226277 - HEART Review of Studies of Intracoronary Imaging During PCI https://heart.bmj.com/content/107/9/755 V. The Power of Placebo (Sham) control Hopeful Insights, No Overall HFpEF Gains From Splanchnic Nerve Ablation: REBALANCE-HF https://www.medscape.com/viewarticle/997318 - Transvenous Right GSN Ablationin HFpEF https://doi.org/10.1016/j.jchf.2022.05.009 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

Coated vs uncoated ASA, a new trial in CAD, conflicts of interest, first AF in the hospital, and changing HTN scoring and CHADSVASC 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. ASA No Benefit of Enteric-Coated Aspirin vs Uncoated in CVD https://www.medscape.com/viewarticle/997119 - JAMA Cardiology: Coated vs Uncoated ASA https://jamanetwork.com/journals/jamacardiology/fullarticle/2809795 - ADAPTABLE https://www.nejm.org/doi/10.1056/NEJMoa2102137 II. RECHARGE - Revascularization Choices Among Under-Represented Groups Evaluation (The RECHARGE Program) https://www.pcori.org/research-results/2023/revascularization-choices-among-under-represented-groups-evaluation-recharge-program - Gaudino/Stone: Reconsidering Coronary Revascularization Trials III. Conflicts of Interest - Financial Conflicts of Interest in Public Comments on Medicare National Coverage Determinations of Medical Devices https://jamanetwork.com/journals/jama/fullarticle/2808721 IV. First AF in the Hospital Decoding AFib Recurrence: PCPs' Role in Personalized Care https://www.medscape.com/viewarticle/997011 - Annals of Internal Medicine: AF Recurrence https://doi.org/10.7326/M23-1411 V. Changing CHADSVASC Score - JAMA Network Open: HTN Guidelines and CHADSVASC Up-Scoring https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2809933 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

Reader feedback, leadless pacing, ABIM, SGLT2 inhibitors, peri-operative MI after cardiac surgery, and. AHA late-breakers 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. Reader Feedback Sep 22, 2023 This Week in Cardiology Podcast https://www.medscape.com/viewarticle/996694 - ODYSSEY OUTCOMES trial https://www.nejm.org/doi/full/10.1056/nejmoa1801174 - FOURIER https://www.nejm.org/doi/full/10.1056/nejmoa1615664 II. Leadless Pacing - Leadless vs Transvenous Pacemaker Study https://doi.org/10.1093/europace/euad269 III. ABIM News Heart Societies Ready to Split From ABIM Over Long-Standing MOC Disputes https://www.medscape.com/viewarticle/996747 IV. SGLT2 inhibitors Empagliflozin Gets FDA Nod for CKD Without T2D or HF https://www.medscape.com/viewarticle/996873 - EMPA-Kidney https://www.nejm.org/doi/full/10.1056/NEJMoa2204233 V. Peri-Op MI after Cardiac Surgery Cardiac Troponin Predicts Mortality Post Surgery https://www.medscape.com/viewarticle/996877 - Austrian Perioperative MI study https://doi.org/10.1016/j.jacc.2023.07.011 - Vision https://www.nejm.org/doi/10.1056/NEJMoa2000803 VI. AHA Late Breakers - Link to Late-Breakers https://professional.heart.org/en/meetings/scientific-sessions/programming/late-breaking-science#late-breaking 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 calcium, cardiac arrest survival, Factor XI drug findings, APCs and a potential new board certification in cardiology 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 Artery Calcium - CONFIRM Registry - https://doi.org/10.1016/j.jcmg.2023.03.008 - CURE -- https://www.nejm.org/doi/full/10.1056/nejmoa010746 II Cardiac Arrest Cardiac Arrest Centers No Benefit in OHCA Without STEMI https://www.medscape.com/viewarticle/995885 - Cycling coverage https://velo.outsideonline.com/road/road-racing/nathan-van-hooydonck-forced-to-end-to-racing-career-due-to-heart-condition/ - ARREST https://doi.org/10.1016/S0140-6736(23)01351-X - SCD in Athletes Bob Harrington and Manesh Patel https://www.medscape.com/viewarticle/995575 III Factor XI Trial Halted for Bleeding Reduction With Abelacimab vs Rivaroxaban in AF https://www.medscape.com/viewarticle/996587 - Press Release - https://anthostherapeutics.com/wp-content/uploads/2023/09/2023-09-18-Anthos-Press-Release-final.pdf - Abelacimab, a Factor XI Inhibitor, Prevents VTE With Low Bleeding Risk in Knee Replacement - NEJM proof-of-concept https://www.nejm.org/doi/full/10.1056/NEJMoa2105872 - OCEANIC-AF https://classic.clinicaltrials.gov/ct2/show/NCT05643573 - Will Factor XI Be the Goldilocks Anticoagulant Target? https://www.medscape.com/viewarticle/979634 IV APC Care NPs and PAs Handling Increasingly More Primary Care Visits: New Studies https://www.medscape.com/viewarticle/996709 BMJ paper -- https://www.bmj.com/content/382/bmj-2022-073933 V Possible Cardiology Board Certification Changes - Heart Societies Ready to Split From ABIM Over MOC Disputes https://www.medscape.com/viewarticle/996747 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

Reader feedback, imaging in the cath lab, AF ablation to relieve anxiety, and some possible help in hypertension 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. Reader Feedback Sep 08, 2023 This Week in Cardiology Podcast https://www.medscape.com/viewarticle/996233 First Clinical Trial of CTO Procedures Fails to Deliver https://www.medscape.com/viewarticle/877405 - DanGerShock trial https://pubmed.ncbi.nlm.nih.gov/31176289/ II. Imaging in the Cath Lab Should Intravascular Imaging Be Almost Routine in PCI? https://www.medscape.com/viewarticle/996375 - ILUMIEN IV https://www.nejm.org/doi/full/10.1056/NEJMoa2305861 - OCTOBER https://www.nejm.org/doi/full/10.1056/NEJMoa2307770 III. AF Ablation to Relieve Anxiety - REMEDIAL Trial https://jamanetwork.com/journals/jama/fullarticle/2809419 - Sohaib and Francis; Meta analysis of Symptomatic Response Effect of CRT Pacing https://pubmed.ncbi.nlm.nih.gov/24259043/ IV. HTN 'New Dawn' for Aldosterone as Drug Target in Hypertension? https://www.medscape.com/viewarticle/996316 - TARGET HTN - https://jamanetwork.com/journals/jama/fullarticle/2809625 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

ESC Recap Part 2: ECLS-SHOCK, FIRE, MULTISTARS-AMI, HEART FID, and DANPACE II are the trials 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. Cardiogenic Shock ECMO for Shock in Acute MI Won't Help, May Harm: ECLS-SHOCK https://www.medscape.com/viewarticle/995882 - ECLS-SHOCK trial https://www.nejm.org/doi/full/10.1056/NEJMoa2307227 - ECMO-CS trial https://www.ahajournals.org/doi/10.1161/CIRCULATIONAHA.122.062949 II. FIRE TRIAL FIRE a Win for Physiology-Guided MI Complete Revascularization in Older Patients https://www.medscape.com/viewarticle/995875 - FIRE Trial https://www.nejm.org/doi/full/10.1056/NEJMoa2300468 - COMPLETE Trial https://www.nejm.org/doi/full/10.1056/NEJMoa1907775 III. Immediate vs Staged Revascularization Parity for Prompt vs Staged STEMI Complete Revascularization: MULTISTARS-AMI https://www.medscape.com/viewarticle/995961 - MULTISTARS AMI trial https://www.nejm.org/doi/full/10.1056/NEJMoa2307823 - Complete Revascularization Now Compulsory? MULTISTARS-AMI and FIRE in Context https://www.medscape.com/viewarticle/995676 IV. Iron-Supplementation in Heart Failure IV Iron Shows Only Modest Benefit in HF: HEART-FID https://www.medscape.com/viewarticle/995874 - HEART-FID https://www.nejm.org/doi/full/10.1056/NEJMoa2304968 - EHJ meta-analysis of Iron Supplementation https://doi.org/10.1093/eurheartj/ehad586 V. AF Prevention with Pacing Minimizing Atrial Pacing No Benefit in Sinus Node Disease: DANPACE II https://www.medscape.com/viewarticle/996076 - DANPACE II https://doi.org/10.1093/eurheartj/ehad564 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

ESC Wrap-up 1: Obesity, heart failure with preserved EF and reduced EF, AF, frailty, evidence translation, and catheter 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. FRAIL AF -FRAIL-AF Study https://www.ahajournals.org/doi/10.1161/CIRCULATIONAHA.123.066485 -The Most Important Study From ESC: FRAIL-AF https://www.medscape.com/viewarticle/996063 II. STEP-HFpEF Wegovy Scores HFpEF Benefits in People With Obesity https://www.medscape.com/viewarticle/995844 GLP-1 Agonist Semaglutide in HFpEF Cleared Low Bar https://www.medscape.com/viewarticle/995872 Semaglutide’s Big Step in HFpEF With Obesity: Investigator Inteview https://www.medscape.com/viewarticle/995673 -Semaglutide in Obese Patients With HFpEF https://www.nejm.org/doi/full/10.1056/NEJMoa2306963 III. NOAH AFNET 6 Anticoagulation No Benefit in Presumed AF Detected by Cardiac Devices https://www.medscape.com/viewarticle/995861 How Much AF Warrants Anticoagulation? NOAH-AFNET 6 Provides Clues https://www.medscape.com/viewarticle/995871 -NOAH AFNET-6 – NEJM https://www.nejm.org/doi/full/10.1056/NEJMoa2303062 IV. ADVENT Pulsed Field Ablation Challenges Conventional Devices in AF https://www.medscape.com/viewarticle/995884 Pulsed Field Ablation Noninferior but Underwhelming in ADVENT https://www.medscape.com/viewarticle/995898 -PPFA vs Thermal Ablation for PAF https://www.nejm.org/doi/10.1056/NEJMoa2307291 V. BUDAPEST CRT Impact of RV Pacing in Heart Failure, CRT Benefit Shown in BUDAPEST-CRT https://www.medscape.com/viewarticle/996035 Supporting Evidence for a Common Practice: BUDAPEST CRT https://www.medscape.com/viewarticle/995880 -BUDAPEST CRT Study: European Heart Journal https://doi.org/10.1093/eurheartj/ehad591 VI. CASTLE HTx Advanced HF No Obstacle to AF Ablation Success: CASTLE-HTx https://www.medscape.com/viewarticle/995897 AF Ablation in End-Stage HF: Is CASTLE-HTx Too Good to Be True? https://www.medscape.com/viewarticle/995974 -CASTLE AF (2018) https://www.nejm.org/doi/full/10.1056/nejmoa1707855 -CASTLE HTx https://www.nejm.org/doi/full/10.1056/NEJMoa2306037 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

GLP-1 agonists in HFpEF, DOACs for subclinical AF, renal denervation, and the matter of remaining in the profession 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. Obesity and HFpEF GLP-1 Agonists in HFpEF With Obesity: Are We There Yet? https://www.medscape.com/viewarticle/993980 Wegovy Scores HFpEF Benefits in People With Obesity https://www.medscape.com/viewarticle/995844 - Semaglutide in Obese Patients With HFpEF https://www.nejm.org/doi/full/10.1056/NEJMoa2306963 - Rationale/Protocol Paper https://doi.org/10.1016/j.jchf.2023.05.010 II. DOAC for Subclinical AF - NOAH-AFNET 6 Rationale/Protocol https://doi.org/10.1016/j.ahj.2017.04.015 - NOAH-AFNET 6 Trial Results https://www.nejm.org/search?q=NOAH+AFNET III. Renal Denervation ReCor Renal Denervation System Safe, Effective: FDA Panel https://www.medscape.com/viewarticle/995741 FDA Panel Split on Efficacy of Spyral Renal Denervation https://www.medscape.com/viewarticle/995800 SPYRAL HTN-ON MED https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(22)00455-X/fulltext IV. Maintenance of Certification As MOC Debate Heats Up, Cardiology Societies Weigh In https://www.medscape.com/viewarticle/moc-debate-heated-cardiology-societies-weigh-2023a1000jju Features Mandrola's 5 Things to Look for at the Upcoming ESC 2023 https://www.medscape.com/viewarticle/995614 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

ICD generator change, less is more in VT management, co-morbidity in HF, and SGLT2i after AF ablation 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. ICD Gen Change - Patients’ Perspectives Regarding Generator Exchanges of Implantable Cardioverter Defibrillators https://www.ahajournals.org/doi/10.1161/CIRCOUTCOMES.122.009827 - DEFINITE https://www.nejm.org/doi/10.1056/nejmoa033088 - SCD-HeFT https://www.nejm.org/doi/full/10.1056/nejmoa043399 - DANISH https://www.nejm.org/doi/10.1056/NEJMoa1608029 - Poole and colleagues; 11-year follow-up of SCD-HeFT https://doi.org/10.1016/j.jacc.2020.05.061 - Editorial – Howell/Stecker https://www.ahajournals.org/doi/10.1161/CIRCOUTCOMES.123.010266 II. VT Therapy Crossed Wires: Ischemia Testing and Monomorphic VT Storm https://www.medscape.com/viewarticle/995401 - Cleveland Clinic Study https://doi.org/10.1016/j.jacep.2023.04.030 III. Co-Morbidity in HF - Hospital admissions in the last year of life of patients with heart failure https://doi.org/10.1093/ehjqcco/qcad047 - Four Horsemen of Apocalypse Lecture http://www.louisvillelectures.org/imblog/2017/10/5/whw8sf0m1k0wi6lm6kvjsx4nxzzjg5 IV. SGLT2i After Ablation for AF SGLT2 Inhibitors Curb AF Post-Ablation Recurrences in Diabetes https://www.medscape.com/viewarticle/995415 - Observational Study – Abu-Qaoud et al https://www.jacc.org/doi/full/10.1016/j.jacep.2023.06.008 - Meta-analysis SGLT2i and AF https://www.ahajournals.org/doi/full/10.1161/JAHA.121.022222 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

Observational studies, another defense of digoxin, CTO-PCI, BP measurement, and a possible revolution in cardiovascular protection 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. Observational Research Yeh; Credibility in Observational Research https://www.ahajournals.org/doi/10.1161/CIRCULATIONAHA.123.064645 Hernan; Causal Language in Observational Research https://ajph.aphapublications.org/doi/full/10.2105/AJPH.2018.304337 Wang; RCT Duplicate Initiative https://jamanetwork.com/journals/jama/fullarticle/2804067 II. Defense of Digoxin Brophy; Beta Blockers, Digoxin, or Both https://doi.org/10.1016/j.cjca.2023.06.009 Dorian editorial https://doi.org/10.1016/j.cjca.2023.07.013 Ziff Digoxin Meta-analysis https://www.bmj.com/content/351/bmj.h4451.long DIG trial https://www.nejm.org/doi/full/10.1056/nejm199702203360801 Davila Analysis of DIG Trial https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6801940/ Kotecha Meta-analysis of Beta Blockers https://pubmed.ncbi.nlm.nih.gov/25193873/ RATE-AF https://jamanetwork.com/journals/jama/fullarticle/2774407 III. CTO-PCI PCI of Chronic Total Occlusions Improves Angina, Quality of Life in Trials https://www.medscape.com/viewarticle/994739 JAMA Network Open Meta-analysis IV. BP Measurement One Size Doesn’t Fit All in Blood Pressure Measurement https://www.medscape.com/viewarticle/995216 Ishigami Blood Pressure Measurement Comparison https://jamanetwork.com/journals/jamainternalmedicine/article-abstract/2807853 V. GLP-1 SELECT Trial Semaglutide Cuts Cardiovascular Events in Landmark Trial https://www.medscape.com/viewarticle/995270 SELECT Protocol Paper 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

Listener feedback re observational studies, surgeons’ dissent from recent guidelines, aspirin for primary prevention, and fish oil 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. Heart Surgeons Dissent Surgical Groups Push Back Against New Revascularization Guidelines https://www.medscape.com/viewarticle/966153 New Revascularization Guidelines: Key Points and Navigating Controversies https://www.medscape.com/viewarticle/972014 - AHA Guidelines - https://doi.org/10.1161/CIR.0000000000001168 - AATS statement 2023 https://doi.org/10.1016/j.jtcvs.2023.03.001 - Yusef and colleagues 1994 Meta-analysis - https://doi.org/10.1016/S0140-6736(94)91963-1 - 10-year SYNTAXES https://doi.org/10.1016/S0140-6736(19)31997-X - Surgeons’ argument 2021 https://doi.org/10.1016/j.athoracsur.2021.12.003 - FAME 3 https://www.nejm.org/doi/full/10.1056/NEJMoa2112299 - Gaudino Meta-analysis of Medical Therapy vs CABG https://doi.org/10.1016/j.jtcvs.2022.06.003 - NOBLE https://doi.org/10.1016/S0140-6736(19)32972-1 - EXCEL 5 years https://www.nejm.org/doi/full/10.1056/nejmoa1909406 II. ASA for Primary Prevention Daily Aspirin Challenged in Primary Stroke Prevention: ASPREE https://www.medscape.com/viewarticle/994963 - ASPREE – All-cause mortality - ASPREE (MACE and Bleeding) https://www.nejm.org/doi/full/10.1056/NEJMoa1805819 - ASPREE (disability) https://www.nejm.org/doi/full/10.1056/NEJMoa1800722 - JAMA Network Open Subanalysis https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2807630 III. Fish Oil - OMEMI Substudy https://doi.org/10.1016/j.clnu.2023.07.002 - Gencer and colleagues Meta-analysis - https://www.ahajournals.org/doi/10.1161/CIRCULATIONAHA.121.055654 - OMEMI Main Trial https://www.ahajournals.org/doi/10.1161/CIRCULATIONAHA.120.052209 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

Antiarrhythmic drugs in patients with CAD, observational studies, GLP-1 agonists, and the subcutaneous ICD 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. AAD in Patients with CAD - The Feasibility and Safety of Flecainide Use Among Patients With Varying Degrees of Coronary Disease https://doi.org/10.1016/j.jacep.2022.12.021 - Three Questions for Evidence-Based Cardiac Electrophysiology https://www.ahajournals.org/doi/full/10.1161/circoutcomes.110.957381 - The Cardiac Arrhythmia Suppression Trial (CAST) https://www.nejm.org/doi/full/10.1056/nejm198908103210608 II. GLP-1 Agonists Tirzepatide Powers Weight Loss in Two More Pivotal Trials https://www.medscape.com/viewarticle/994889 Semaglutide Use Surges in US Adults With Type 2 Diabetes https://www.medscape.com/viewarticle/994873 - Tirzepatide Once Weekly for the Treatment of Obesity https://www.nejm.org/doi/full/10.1056/NEJMoa2206038 - Tirzepatide once weekly for the treatment of obesity in people with type 2 diabetes (SURMOUNT-2): a double-blind, randomised, multicentre, placebo-controlled, phase 3 trial https://doi.org/10.1016/S0140-6736(23)01200-X III. S-ICD S-ICD Shows Virtues, Limits in 'Real World' Postmarket Study https://www.medscape.com/viewarticle/994851 - Postapproval Study of a Subcutaneous Implantable Cardioverter-Defibrillator System https://doi.org/10.1016/j.jacc.2023.05.034 - Subcutaneous or Transvenous Defibrillator Therapy https://www.nejm.org/doi/full/10.1056/NEJMoa1915932 - Letter to the Editor https://www.nejm.org/doi/full/10.1056/NEJMc2034917 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

Listener feedback, conduction system pacing, eating fish vs fish pills, exercise, and an RCT for diet 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. Listener Feedback Monitor HF and AHA Jun 02, 2023 This Week in Cardiology Podcast https://www.medscape.com/viewarticle/992678 - Link to the ACC Email -- https://www.acc.org/Latest-in-Cardiology/Clinical-Trials/2023/07/18/17/21/monitor-hf - Tweet From Anthony Pearson https://twitter.com/skepcard/status/1681288604990189574 II. Conduction System Pacing - Clinical Outcomes in Conduction System Pacing Compared to Right Ventricular Pacing in Bradycardia https://doi.org/10.1016/j.jacep.2022.10.016 - Hormone Therapy To Prevent Disease and Prolong Life in Postmenopausal Women https://www.acpjournals.org/doi/abs/10.7326/0003-4819-117-12-1016 III. Fish Oil Omega-3s and AF: No Added Risk From Eating Fish but High-Dose Supplement Questions Persist https://www.medscape.com/viewarticle/994559 - Omega-3 Fatty Acid Biomarkers and Incident Atrial Fibrillation https://www.jacc.org/doi/full/10.1016/j.jacc.2023.05.024 - Cardiovascular Risk Reduction with Icosapent Ethyl for Hypertriglyceridemia https://www.nejm.org/doi/full/10.1056/nejmoa1812792 - Effect of Long-Term Marine ɷ-3 Fatty Acids Supplementation on the Risk of Atrial Fibrillation in Randomized Controlled Trials of Cardiovascular Outcomes: A Systematic Review and Meta-Analysis https://www.ahajournals.org/doi/10.1161/CIRCULATIONAHA.121.055654 IV. Exercise Even Exercise by 'Weekend Warriors' Can Cut CV Risk https://www.medscape.com/viewarticle/994617 - Accelerometer-Derived “Weekend Warrior” Physical Activity and Incident Cardiovascular Disease https://jamanetwork.com/journals/jama/article-abstract/2807286 V. Diet Cognitive Benefit of Highly Touted MIND Diet Questioned https://www.medscape.com/viewarticle/994550 - Trial of the MIND Diet for Prevention of Cognitive Decline in Older Persons https://www.nejm.org/doi/full/10.1056/NEJMoa2302368 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

Carotid stents, the paclitaxel story now closed, inclisiran, DOAC failures, and primary vs secondary prevention 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. Carotid Stenting CMS Proposal Expanded Coverage of Carotid Stenting in CMS Draft Proposal https://www.medscape.com/viewarticle/994315 No Added Benefit From Revascularization in Low-Risk CAS https://www.medscape.com/viewarticle/992524 - Percutaneous Transluminal Angioplasty (PTA) of the Carotid Artery Concurrent with Stenting https://www.cms.gov/medicare-coverage-database/view/ncacal-decision-memo.aspx?proposed=Y&NCAId=311 - Second asymptomatic carotid surgery trial (ACST-2): a randomised comparison of carotid artery stenting versus carotid endarterectomy https://doi.org/10.1016/S0140-6736(21)01910-3 - SPACE-2 https://journals.sagepub.com/doi/10.1177/1747493019833017 - Rationale, Design, and Implementation of Intensive Risk Factor Treatment in the CREST2 Trial 10.1161/STROKEAHA.120.030730 II. Paclitaxel FDA: No Excess Mortality Risk From Paclitaxel Stents, Balloons for Peripheral Intervention https://www.medscape.com/viewarticle/994253 - FDA Statement https://www.fda.gov/medical-devices/letters-health-care-providers/update-paclitaxel-coated-devices-treat-peripheral-arterial-disease-unlikely-increase-risk-mortality?utm_medium=email&utm_source=govdelivery#_FDA_Actions III. Inclisiran FDA Expands Inclisiran Statin-Adjunct Indication to Include Primary Prevention https://www.medscape.com/viewarticle/994185 - ORION 10-11 Two Phase 3 Trials of Inclisiran in Patients with Elevated LDL Cholesterol https://www.nejm.org/doi/10.1056/NEJMoa1912387 - Effect of inclisiran on lipids in primary prevention: the ORION-11 trial https://doi.org/10.1093/eurheartj/ehac615 - Inclisiran and cardiovascular events: a patient-level analysis of phase III trials https://pubmed.ncbi.nlm.nih.gov/36331326/ IV. DOAC Failure Association of Alternative Anticoagulation Strategies and Outcomes in Patients With Ischemic Stroke While Taking a Direct Oral Anticoagulant https://doi.org/10.1212/WNL.0000000000207422 V. Primary or Secondary Prevention 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

European HTN Guidelines, vitamin D, bempedoic acid, and leadless pacing, with some critical appraisal techniques thrown in, are the topics John Mandrola, MD, tackles 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. European Hypertension Guidelines New ESH Hypertension Guidelines Aim for Simplified Message https://www.medscape.com/viewarticle/993913 - 2023 ESH Guidelines for the management of arterial hypertension The Task Force for the management of arterial hypertension of the European Society of Hypertension Endorsed by the European Renal Association (ERA) and the International Society of Hypertension (ISH) https://pubmed.ncbi.nlm.nih.gov/37345492/ II. Vitamin D CV Benefit From Vitamin-D Caps Hinted in Huge D-Health Trial https://www.medscape.com/viewarticle/993996 - Vitamin D supplementation and major cardiovascular events: D-Health randomised controlled trial https://www.bmj.com/content/381/bmj-2023-075230 - Vitamin D Supplementation and Cardiovascular Disease Risks in More Than 83 000 Individuals in 21 Randomized Clinical Trials https://jamanetwork.com/journals/jamacardiology/fullarticle/2735646 III. Bempedoic Acid 'Striking' Benefit of Lipid Lowering in Primary Prevention https://www.medscape.com/viewarticle/993666 - Bempedoic Acid for Primary Prevention of Cardiovascular Events in Statin-Intolerant Patients https://jamanetwork.com/journals/jama/fullarticle/2806646 - Bempedoic Acid for High-Risk Primary Prevention of Cardiovascular Disease https://jamanetwork.com/journals/jama/fullarticle/2806647 - Bempedoic Acid and Cardiovascular Outcomes in Statin-Intolerant Patients https://www.nejm.org/doi/full/10.1056/NEJMoa2215024 IV. Leadless Pacing FDA Approves First Leadless Dual-Chamber Pacing System https://www.medscape.com/viewarticle/994033 - A Dual-Chamber Leadless Pacemaker https://www.nejm.org/doi/full/10.1056/NEJMoa2300080 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