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 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

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 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 on SURPASS CVOT, AF ablation and the limits of meta-analyses, a Watchman alert from FDA, and oral anticoagulation choices in elderly patients are discussed by John Mandola, 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 SURPASS CVOT * This Week in Cardiology Podcast, August 1 https://www.medscape.com/viewarticle/1002781 * Mounjaro Appears More Heart Protective Than Trulicity in Trial Of Eli Lilly Diabetes Drugs https://www.medscape.com/s/viewarticle/mounjaro-proves-more-heart-protective-than-trulicity-trial-2025a1000kct II Catheter and Surgical AF ablation * Catheter and Surgical Ablation for AF: Meta-Analysis https://www.acpjournals.org/doi/10.7326/ANNALS-25-00253 III Watchman Air Embolism Alerts * Looming Pay Cut to LAAO Triggers Objection From Card Groups https://www.medscape.com/viewarticle/looming-pay-cut-laao-triggers-objection-card-groups-2025a1000l0j * FDA Alert https://www.fda.gov/medical-devices/medical-device-recalls/early-alert-watchman-access-system-issue-boston-scientific IV Switching Oral Anticoagulants in Frail Older Adults Patients * FRAIL AF Trial https://www.ahajournals.org/doi/10.1161/CIRCULATIONAHA.123.066485 * COMBINE AF Substudy https://doi.org/10.1016/j.jacc.2025.05.060 * The Most Important Study From ESC: FRAIL-AF https://www.medscape.com/viewarticle/996063 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

Exercise and CV outcomes, aldosterone modulation, AI for ECG reading, GLP-1 comparisons, end-of-life decisions, and another well-meaning policy that caused harm in veterans 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 Exercise and CV outcomes II Aldosterone Modulation in Cardio-Kidney Disease * Aldosterone and Aldosterone Modulation https://doi.org/10.1016/j.jacc.2025.06.012 * Randomized Aldactone Evaluation Study https://www.nejm.org/doi/full/10.1056/NEJM199909023411001 III AI vs MD ECG-Reading for Cath Lab Activation * Accuracy of Cath Lab Activation Decisions https://doi.org/10.1016/j.ajem.2025.07.061 IV Tirzepatide vs Dulaglutide - SURPASS CVOT Study * Eli Lilly Press Release https://investor.lilly.com/news-releases/news-release-details/lillys-mounjaro-tirzepatide-gipglp-1-dual-agonist-demonstrated * REWIND Study 10.1016/S0140-6736(19)31149-3 External Link V End-of-Life Decisions Doctors’ Own End-of-Life Choices Defy Common Medical Practice https://www.medscape.com/viewarticle/doctors-own-end-life-choices-defy-common-medical-practice-2025a1000k01 * Physicians’ Preferences for Their Own End of Life https://jme.bmj.com/content/early/2025/06/05/jme-2024-110192 * How US Doctors Die: A Cohort Study https://agsjournals.onlinelibrary.wiley.com/doi/full/10.1111/jgs.14112 VI Well-Meaning Policies That Make Sense   * The Mission Act and Cardiovascular Procedures https://jamanetwork.com/journals/jama/fullarticle/2837067 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

The VENTOUX study of endurance athletes, the 10,000 step myth was not busted, rate vs rhythm control for AF, and GLP1 drugs and observational studies 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 Endurance Athletes and Arrhythmia (again) * VENTOUX trial https://www.ahajournals.org/doi/10.1161/CIRCIMAGING.125.018470 II Daily Step Count and Health — no myths were busted. * Lancet Public Health: https://doi.org/10.1016/S2468-2667(25)00164-1 III Rate vs Rhythm Control of AF Medscape: Everyone Deserves a Shot at the American Dream: Sinus Rhythm https://www.medscape.com/viewarticle/everyone-deserves-shot-american-dream-sinus-rhythm-2025a1000jle * This Week in Cardiology, July 11, 2025 https://www.medscape.com/viewarticle/1002704 * AFFIRM trial https://www.nejm.org/doi/full/10.1056/NEJMoa021328 * AFFIRM substudy https://jamanetwork.com/journals/jamainternalmedicine/fullarticle/486560 IV GLP-1 Drugs and Observational Studies * Neurodegeneration and Stroke After Semaglutide and Tirzepatide https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2836412 * SUSTAIN-6 https://www.nejm.org/doi/full/10.1056/NEJMoa1607141 * SELECT Trial https://www.nejm.org/doi/full/10.1056/NEJMoa2307563 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