This Week in Cardiology

Listener feedback, CRT vs CSP, important clues on the ECG, beta-blocker interruption after myocardial infarction, novel approaches to LDL-C lowering, and ICD decisions in cardiac sarcoidosis 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 II CRT vs CSP – CONSYST-CRT • Trial JACC EP https://doi.org/10.1016/j.jacep.2025.03.024 III The Important QRS • Kewcharoen et al https://www.ahajournals.org/doi/10.1161/CIRCEP.125.013809 IV ABYSS Trial of BB Interruption after MI Continues to be Mis-interpreted • ABYSS Main https://www.nejm.org/doi/full/10.1056/NEJMoa2404204 • ABYSS substudy https://doi.org/10.1093/eurheartj/ehaf170 • REDUCE AMI https://www.nejm.org/doi/full/10.1056/NEJMoa2401479 V Oral PCSK9i and the PURSUIT Trial • Koren et al https://www.jacc.org/doi/10.1016/j.jacc.2025.03.499 • Editorial https://doi.org/10.1016/j.jacc.2025.03.518 • Is Lifelong LDL-C Lowering Within Reach? The heart-1 Gene-Editing Trial https://www.medscape.com/viewarticle/998162 • Heart-1 Gene Therapy Trial Pauses Enrollment https://www.medscape.com/viewarticle/998162 • EHJ coverage VERVE https://academic.oup.com/ehjcvp/article/10/2/87/7455877 VI Cardiac Sarcoidosis and Risk of VT • EHJ paper Mathijssen et al https://doi.org/10.1093/eurheartj/ehaf338 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 sports “disqualification,” big digoxin news, Brugada syndrome, another positive finerenone study, and unblinded transcatheter 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 Listener Feedback * JACC EP Paper https://www.jacc.org/doi/10.1016/j.jacep.2025.03.013 II Digoxin News * DIGIT HF Baseline Characteristics paper https://doi.org/10.1002/ejhf.3679 * DIGIT HF Rationale paper https://pmc.ncbi.nlm.nih.gov/articles/PMC6607489/ * Dig trial https://www.nejm.org/doi/full/10.1056/NEJM199702203360801 * DECISION trial https://onlinelibrary.wiley.com/doi/full/10.1002/ejhf.3428 * Ziff et al BMJ meta-analysis https://www.bmj.com/content/351/bmj.h4451 III Brugada Syndrome * Gomes et al https://doi.org/10.1093/europace/euaf091 IV Another Finerenone Substudy Published * FINEARTS-HF trial substudy, Bhatt, A et al https://doi.org/10.1016/j.cardfail.2025.05.006 * FINEARTS HF Main paper https://www.nejm.org/doi/full/10.1056/NEJMoa2407107 * TOPCAT https://www.nejm.org/doi/full/10.1056/NEJMoa1313731 * TOPCAT regional variation Circ paper https://www.ahajournals.org/doi/10.1161/circulationaha.114.013255 V Another Opinion on Unblinded Transcatheter Intervention Trials * Kaul https://eurointervention.pcronline.com/article/unblinded-trials-of-transcatheter-interventions-with-subjective-endpoints-what-are-the-implications 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 BedMed trial of nighttime BP meds, SURMOUNT-5, Troponin URL, gene tests in patients with no disease, and guideline-directed medical therapy for HF 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 Timing of BP Meds – The BedMed RCT * MAPEC https://doi.org/10.3109/07420528.2010.510230 * Hygia https://doi.org/10.1093/eurheartj/ehz754 * Turgeon et al https://www.ahajournals.org/doi/10.1161/HYPERTENSIONAHA.121.16501 * TIME trial https://doi.org/10.1016/S0140-6736(22)01786-X * BedMed https://jamanetwork.com/journals/jama/fullarticle/2833860 * Time Antihypertensives Taken Doesn't Matter: New Trials https://www.medscape.com/viewarticle/time-antihypertensives-taken-doesnt-matter-new-trials-2024a1000g3z * Timing of BP Dosing Doesn't Matter: BedMed and BedMed-Frail https://www.medscape.com/viewarticle/timing-blood-pressure-dosing-doesnt-matter-again-bedmed-and-2024a1000fz2 * Timing of Blood Pressure Meds Doesn’t Affect Outcomes: BedMed in Print https://www.medscape.com/viewarticle/timing-blood-pressure-meds-doesnt-affect-outcomes-bedmed-2025a1000cdm II Tirzepatide vs Semaglutide * SURMOUNT 5 https://www.nejm.org/doi/full/10.1056/NEJMoa2416394 III Age-specific Troponins * Coyle and McEvoy https://doi.org/10.1093/eurheartj/ehaf308 * Mandrola/Foy JAMA-IM https://jamanetwork.com/journals/jamainternalmedicine/fullarticle/2777967 IV Return to Play for Gene Positive Phenotype Negative athletes * Martinez et al https://doi.org/10.1016/j.jacep.2025.03.013 V Rapid Titration of GDMT in HF STRONG HF: More Beats Less After Discharge for Heart Failure https://www.medscape.com/viewarticle/983698 * JACC-HF Substudy https://doi.org/10.1016/j.jchf.2025.02.020 * STRONG HF https://doi.org/10.1016/S0140-6736(22)02076-1 * AVID https://www.nejm.org/doi/full/10.1056/NEJMoa013474 * EAST https://www.nejm.org/doi/full/10.1056/NEJMoa013474 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 controversial KETO-CTA study, tough decisions in subclinical AF, and another potentially huge benefit for GLP-1 agonist drugs 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 The KETO-CTA Study * JACC Advances Paper: https://www.jacc.org/doi/10.1016/j.jacadv.2025.101686 * Meta-analysis https://doi.org/10.1016/j.ajcnut.2024.01.009 II Subclinical AF – Anticoagulate or Not? Anticoagulation in Subclinical AF May Offer Little Benefit https://www.medscape.com/viewarticle/anticoagulation-subclinical-af-may-offer-little-benefit-2025a1000b31 Treat AFib ‘Diagnosed’ by Smartwatch https://www.medscape.com/viewarticle/treat-afib-diagnosed-smartwatch-2025a1000avp * JAMA NO paper https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2833437 * NOAH https://www.nejm.org/doi/full/10.1056/NEJMoa2303062 * ARTESIA https://www.nejm.org/doi/full/10.1056/NEJMoa2310234 * McIntyre meta-analysis https://www.ahajournals.org/doi/10.1161/CIRCULATIONAHA.123.067512 * Singer et al https://pmc.ncbi.nlm.nih.gov/articles/PMC2777526/ * Stroke paper https://www.ahajournals.org/doi/full/10.1161/STROKEAHA.123.045843 * American Journal of Medicine paper https://pubmed.ncbi.nlm.nih.gov/38331136/ III GLP1a for Treatment of Fatty Liver Disease * ESSENCE trial https://www.nejm.org/doi/10.1056/NEJMoa2413258 Features * CABG Still Superior to Stents Despite FAME 3 Endpoint Swap https://www.medscape.com/viewarticle/cabg-still-superior-stents-despite-fame-3-endpoint-swap-2025a1000ao5 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 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