Oct 31 2025 This Week in Cardiology

The FDA approval of TAVR for asymptomatic AS, digital health, subcutaneous vs transvenous ICD, and cryptogenic stroke in young adults are 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  FDA announces approval for TAVR in pts with asymptomatic AS Edwards Press Release https://www.edwards.com/newsroom/news/2025-05-01-edwards-tavr-receives-fda-approval-for-patients-with-asymptomatic-severe-aortic-stenosis Transcatheter Aortic-Valve Replacement for Asymptomatic Severe Aortic Stenosis (EARLY TAVR) https://www.nejm.org/doi/full/10.1056/NEJMoa2405880 EARLY TAVR: A Positive Trial That Fails to Inform Clinical Decisions https://www.medscape.com/viewarticle/early-tavr-positive-trial-fails-inform-clinical-decisions-2024a1000kec Asymptomatic Aortic Stenosis: 'Time to Act' or Not So Fast? https://www.medscape.com/viewarticle/asymptomatic-aortic-stenosis-time-act-or-not-so-fast-2025a10005o9 II PPG that Can Distinguish source of Tachycardia Machine-learning guided differentiation between photoplethysmography waveforms of supraventricular and ventricular origin https://doi.org/10.1016/j.cmpb.2025.108798 III PRAETORIAN -XL trial Device-related Complications in Transvenous Versus Subcutaneous Defibrillator Therapy During Long-term Follow-up: the PRAETORIAN-XL Trial https://www.ahajournals.org/doi/abs/10.1161/CIRCULATIONAHA.125.074576 Subcutaneous or Transvenous Defibrillator Therapy (PRAETORIAN trial) https://www.nejm.org/doi/full/10.1056/NEJMoa1915932 Subcutaneous or Transvenous Defibrillator Therapy Letter to Editor https://www.nejm.org/doi/full/10.1056/NEJMc2034917 The PRAETORIAN Trial: Guarded Approach to Subcutaneous ICD Best https://www.medscape.com/viewarticle/937156 IV Stroke in Young People Burden of Modifiable Risk Factors in Young-Onset Cryptogenic Ischemic Stroke by High-Risk Patent Foramen Ovale https://www.ahajournals.org/doi/10.1161/STROKEAHA.124.049855 Migraine: A Key Factor in Young Adults With Unexplained Stroke https://www.medscape.com/viewarticle/migraine-key-factor-young-adults-unexplained-stroke-2025a10009jj U.S. stroke rate declining in adults 75 and older, yet rising in adults 49 and younger ASA statement https://newsroom.heart.org/news/u-s-stroke-rate-declining-in-adults-75-and-older-yet-rising-in-adults-49-and-younger Increasing stroke in the young https://doi.org/10.1016/j.ajpc.2020.100085 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

2 Touko 202529min

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

25 Huhti 202527min

The FAME 3 trial 5-year results, TAVR at 5 years, pacers after TAVR, and mavacamten not a wonder drug 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 FAME 3 at Five Years Stents as Good as Surgery for Triple-Vessel Disease https://www.medscape.com/viewarticle/noninvasive-stents-good-surgery-triple-vessel-disease-2025a10007l4 Main trial NEJM https://www.nejm.org/doi/full/10.1056/NEJMoa2112299 Circulation 3-years https://www.ahajournals.org/doi/10.1161/CIRCULATIONAHA.123.065770 5-year results Lancet 10.1016/S0140-6736(25)00505-7 https://linkinghub.elsevier.com/retrieve/pii/S0140673625005057 II TAVR in Low-Risk Patients at 5 years 5-Year TAVR, Surgery Outcomes Similar in Low-Risk Patients https://www.medscape.com/viewarticle/5-year-tavr-surgery-outcomes-similar-low-risk-patients-2025a10007zl EVOLUT Low-Risk 5 years https://www.jacc.org/doi/10.1016/j.jacc.2025.03.004 EVOLUT Editorial – We're Halfway There https://www.jacc.org/doi/10.1016/j.jacc.2025.03.428 PARTNER 3 Low-Risk https://www.nejm.org/doi/full/10.1056/NEJMoa2307447 NOTION at 5 years https://www.ahajournals.org/doi/10.1161/CIRCULATIONAHA.118.036606 III The Matter of Pacemakers After TAVI JACC IV Study Badertscher https://www.jacc.org/doi/10.1016/j.jcin.2025.03.028 Assessing the quality of reporting of harms in randomized controlled trials published in high impact cardiovascular journals IV Mavacamten Looks to Have Specific Indications EXPLORER HCM 10.1016/S0140-6736(20)31792-X External Link VALOR HCM https://jamanetwork.com/journals/jamacardiology/fullarticle/2809050 BMS Press Release https://news.bms.com/news/details/2025/Bristol-Myers-Squibb-Provides-Update-on-Phase-3-ODYSSEY-HCM-Trial/ FINAL THOUGHTS PRAGUE 25 https://bmjopen.bmj.com/content/12/6/e056522 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

18 Huhti 202523min

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

11 Huhti 202527min

Trials from the 2025 American College of Cardiology scientific sessions, including the WARRIOR, PROTECT TAVI, DAPATAVI, and SOUL are reviewed 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 Thank you Comments II WARRIOR Women's IschemiA TRial to Reduce Events In Non-ObstRuctive CAD Keep Fighting INOCA After Neutral WARRIOR Trial https://www.medscape.com/viewarticle/keep-fighting-inoca-after-neutral-warrior-trial-2025a10007uf III Cerebral Embolic Protection in TAVI PROTECT TAVI https://www.nejm.org/doi/full/10.1056/NEJMoa2415120 PROTECTED TAVR https://www.nejm.org/doi/full/10.1056/NEJMoa2204961 Instrumental Variables in Randomized Trials https://evidence.nejm.org/doi/10.1056/EVIDctw2400204 IV DAPATAVI SGLT2 Inhibitors Progressing to New Standard After TAVI https://www.medscape.com/viewarticle/sglt2-inhibitors-progressing-new-standard-after-tavi-2025a100081y Dapagliflozin in Patients Undergoing Transcatheter Aortic-Valve Implantation https://www.nejm.org/doi/full/10.1056/NEJMoa2500366 V SOUL Study of Oral Semaglutide and CV outcomes in Diabetes Oral GLP-1 Receptor Agonist Reduces CV Risk https://www.medscape.com/viewarticle/oral-glp-1-receptor-antagonist-reduces-cv-risk-2025a10007kr Oral Semaglutide and Cardiovascular Outcomes in High-Risk Type 2 Diabetes https://www.nejm.org/doi/full/10.1056/NEJMoa2501006 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

4 Huhti 202526min

Stopping oral anticoagulation after AF ablation, the core problem with paradoxes like the smoker's paradox, chronic total occlusion PCI, and an ACC/EHRA preview 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 Oral Anticoagulation after Successful AF Ablation Iwawakie et al https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2831851 OCEAN protocol paper https://doi.org/10.1016/j.ahj.2017.12.007 II Smoker's Paradox Presch et al https://www.jacc.org/doi/10.1016/j.jcin.2024.12.028 Gupta et al https://doi.org/10.1161/JAHA.116.003370 III CTO PCI Main sub-analysis paper Bangalore et al https://doi.org/10.1016/j.jacc.2025.01.029 DECISION CTO https://www.ahajournals.org/doi/10.1161/CIRCULATIONAHA.118.031313 Main EURO CTO trial https://doi.org/10.1093/eurheartj/ehy220 3-year MACE of EURO CTO https://eurointervention.pcronline.com/article/three-year-outcomes-of-eurocto-a-randomized-multicentre-trial-comparing-revascularization-and-optimal-medical-therapy-for-chronic-total-coronary-occlusions EXPLORE https://www.jacc.org/doi/abs/10.1016/j.jacc.2016.07.744 ISCHEMIA CTO https://www.clinicaltrials.gov/study/NCT03563417 IV ACC and EHRA Preview Mandrola's 5 Trials to Look for at the 2025 American College of Cardiology Scientific Sessions https://www.medscape.com/viewarticle/mandrolas-5-trials-look-2025-american-college-cardiology-2025a10006zu 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

28 Maalis 202528min

A large trial in cardiac pacing finally published, PVCs and cardiomyopathy, cannabis, CV risk and the danger of observational studies, and the tale of two disparate statin trials 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 BioPace Trial Trial manuscript https://doi.org/10.1093/europace/euaf029 II Another Belief Challenged in EP this week—PVCs and CM ' UC Paper https://doi.org/10.1016/j.jacep.2025.01.004 JACC Review https://doi.org/10.1016/j.jacc.2024.03.416 Lee et al https://heart.bmj.com/content/105/18/1408 III Cannabis and CV Risk Cannabis and MACE in JACC Advances: https://www.jacc.org/doi/10.1016/j.jacadv.2025.101698 Zeraatkar –Grilling the data https://doi.org/10.1016/j.jclinepi.2024.111278 PLOS-1 10.1371/journal.pone.0199705 IV Cardio-oncology Jacc Onc Substdy https://www.jacc.org/doi/10.1016/j.jaccao.2024.11.008 Editorial https://www.jacc.org/doi/10.1016/j.jaccao.2025.01.006 STOP CA JAMA 2023 https://jamanetwork.com/journals/jama/fullarticle/2807988 PREVENT https://evidence.nejm.org/doi/10.1056/EVIDoa2200097 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

21 Maalis 202528min

Listener feedback, resistant hypertension, K-binders for MRA use in heart failure, nutritional epidemiology, and a positive study for vitamin D 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 Califf editorial https://www.jacc.org/doi/10.1016/j.jaccas.2020.01.003 II Resistant HTN Positive Topline Results for Lorundrostat in Hypertension https://www.medscape.com/viewarticle/positive-topline-results-lorundrostat-hypertension-2025a100062e III K-Binding REALIZE K Trial https://doi.org/10.1016/j.jacc.2024.11.014 Packer Editorial https://doi.org/10.1016/j.jacc.2025.01.011 Diamond Trial EHJ https://doi.org/10.1093/eurheartj/ehac401 REALIZE K Commentary https://www.medscape.com/viewarticle/realize-k-new-potassium-binder-help-keep-spiro-board-2024a1000m2c IV Butter vs Plant-based Oils and Mortality JAMA-IM Study https://jamanetwork.com/journals/jamainternalmedicine/fullarticle/2831265 Is Red Meat Healthy? Multiverse Analysis Has Lessons Beyond Meat https://www.medscape.com/viewarticle/red-meat-healthy-multiverse-analysis-has-lessons-beyond-meat-2024a10008qv Cookbook Review https://doi.org/10.3945/ajcn.112.047142 V Vitamin D Impact Factor https://www.medscape.com/viewarticle/rare-win-vitamin-d-this-time-ms-2025a10005ul D-Lay trial https://jamanetwork.com/journals/jama/fullarticle/2831270 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

14 Maalis 202528min