This Week in Cardiology

May 01 2026 This Week in Cardiology

Time to quadruple therapy, the disappointing AVANT GUARD trial, PFA risks, the TREAT-PVC trial, and NSTEMI care in the frail elderly 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 Time to Quadruple Therapy in HFrEF * Time to Quadruple Therapy After Diagnosis of HFrEF https://jamanetwork.com/journals/jamacardiology/fullarticle/2846899 II AVANT GUARD PFA Bests Meds as First-Line Treatment for Persistent AF in Randomized Trial https://www.medscape.com/viewarticle/pulsed-field-ablation-bests-meds-first-line-treatment-2026a1000dsm Pulsed Field Ablation of AF Disappoints in Setup for Success: AVANT GUARD https://www.medscape.com/viewarticle/pulsed-field-ablation-af-disappoints-setup-success-avant-2026a1000ddt * AVANT GUARD Trial https://www.nejm.org/doi/full/10.1056/NEJMoa2600929 * Persistent AF: Meta-analysis of Invasive Strategies 10.1016/j.ijcard.2018.11.127 External Link III Speaking of Scary News on PFA – The TIFFANY Study * Abstract - The TIFFANY Study https://www.heartrhythmjournal.com/article/S1547-5271(26)01747-9/fulltext * Delayed Myocardial Ischemia and Malignant Arrhythmias After PFA https://www.ahajournals.org/doi/10.1161/CIRCULATIONAHA.125.077983 * Alberto Alfie Comment https://x.com/ALFIEEP1/status/2050029151315189774?s=20 IV TREAT PVC Trial * TREAT-PVC Trial https://doi.org/10.1016/j.jacep.2026.01.011 * TREAT-AF Study 2020 https://doi.org/10.1016/j.jacep.2019.11.008 V NSTEMI In Frail Older Patients * SENIOR-RITA Trial https://www.nejm.org/doi/10.1056/NEJMoa2407791 * Subanalysis of Senior RITA Trial https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2847995 * Timing of Invasive Strategy in Patients With Non-ST-Elevation Acute Coronary Syndrome -- Meta-analysis https://doi.org/10.1016/S0140-6736(17)31490-3 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

Apr 24 2026 This Week in Cardiology

PCSK9 inhibitors in high-risk diabetes without ASCVD, the CAAN-AF trial, conduction system pacing vs biventricular pacing, PFA and stroke, and therapeutic fashion infects expert consensus 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 VESALIUS-CV * VESALIUS-CV Trial https://www.nejm.org/doi/full/10.1056/NEJMoa2514428 * JAMA Substudy https://jamanetwork.com/journals/jama/fullarticle/2847162 II How Best to Maximize CRT Benefit in Patients with AF * CAAN-AF Trial https://academic.oup.com/eurheartj/advance-article/doi/10.1093/eurheartj/ehag206/8654625?searchresult=1 * Role of AV Node Ablation: Meta-analysis of Observational Studies https://www.jacc.org/doi/10.1016/j.jacc.2011.10.891 III Stroke Rates in PFA vs Thermal Ablation * Comparative Safety of RF versus PFA for AF in a High-Volume US Medical Center https://esc365.escardio.org/Ehra-congress/sessions/18281 IV Five New CSP Studies Presented and Published * HeartSync-LBBP Trial https://jamanetwork.com/journals/jamacardiology/fullarticle/2845803 * PhysioSync-HF Trial https://jamanetwork.com/journals/jamacardiology/fullarticle/2845802 * LEFT-BUNDLE-CRT Trial https://doi.org/10.1093/eurheartj/ehag225 * Long-Term Follow-up of His-Alternative I Trial https://www.jacc.org/doi/10.1016/j.jacep.2026.02.016 * LECART Trial https://esc365.escardio.org/Ehra-congress/sessions/17140 V New EP Training Document Published * Advanced Training Statement on Clinical Cardiac Electrophysiology https://www.jacc.org/doi/10.1016/j.jacc.2026.01.074 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

Apr 17 2026 This Week in Cardiology

SPIRIT-HF, another spironolactone trial in HFpEF; the ESSENCE imaging study of the drug olezarsen; the SirPAD trial in peripheral artery disease; and ultrasound-guided femoral venous access 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 ACC: SPIRIT-HF Trial * FINEARTS-HF Trial https://www.nejm.org/doi/full/10.1056/NEJMoa2407107 * TOPCAT Trial https://www.nejm.org/doi/full/10.1056/NEJMoa1313731 * TOPCAT Americas Trial https://www.ahajournals.org/doi/10.1161/circulationaha.114.013255 II A New Class of Lipid Lowering Drug Has a Dubious Debut At ACC * ESSENCE-TIMI 73b Imaging Study https://www.ahajournals.org/doi/10.1161/CIRCULATIONAHA.126.080012 * ESSENCE-TIMI 73b Trial https://www.nejm.org/doi/full/10.1056/NEJMoa2507227 * IMPROVE IT Trial https://www.nejm.org/doi/full/10.1056/NEJMoa1410489 III Drug-Coated Balloons Looked Quite Good in PAD interventions Sirolimus-Coated Balloon Reduces Amputation Risk in Peripheral Artery Disease https://www.medscape.com/viewarticle/sirolimus-coated-balloon-reduces-amputation-risk-peripheral-2026a1000a83 * SirPAD trial https://www.nejm.org/doi/full/10.1056/NEJMoa2600360 IV Another Vascular Story from the European Heart Rhythm Association * ULYSSES Trial https://doi.org/10.1093/eurheartj/ehag291 * ULTRA-FAST Trial https://doi.org/10.1093/europace/eux175 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

Apr 10 2026 This Week in Cardiology

Three imaging-guided PCI trials (two with surprising results), LDL targets, an oral PCSK9 inhibitor, and another beta-blocker withdrawal trial 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 IVUS-Guided PCI * OPTIMAL Trial https://www.nejm.org/doi/full/10.1056/NEJMoa2600440 * IVUS-CHIP Trial https://www.nejm.org/doi/full/10.1056/NEJMoa2601521 * ILUMIEN IV Trial https://www.nejm.org/doi/10.1056/NEJMoa2305861 * DKCRUSH VIII Trial https://doi.org/10.1016/j.jacc.2026.01.081 II Ez-PAVE Trial — Low vs Very Low LDL-targets Does Ez-PAVE Support 'Lower Is Better' for LDL-C? https://www.medscape.com/viewarticle/does-ez-pave-support-lower-better-ldl-c-2026a1000akx * Ez-PAVE Trial https://www.nejm.org/doi/full/10.1056/NEJMoa2600283 * 2026 ACC/AHA Lipid Guidelines https://www.ahajournals.org/doi/10.1161/CIR.0000000000001423 III CORALreef AddOn * CORALreef AddOn Trial https://www.jacc.org/doi/abs/10.1016/j.jacc.2026.03.036 * This Week in Caardiology 2-6-26 https://www.medscape.com/viewarticle/1003240 * CORALreef Lipids Trial https://www.nejm.org/doi/full/10.1056/NEJMoa2511002 IV Another Post-MI Beta-blocker Withdrawal Study: SMART-DECISION * SMART-DECISION Trial https://www.nejm.org/doi/full/10.1056/NEJMoa2601005 * ABYSS Trial https://www.nejm.org/doi/full/10.1056/NEJMoa2404204 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

Apr 03 2026 This Week in Cardiology

John Mandrola offers an ACC recap of 5 big trials—Hi-PEITHO, PROTAVI, ORBITA-CTO, CHIPS-BCIS3 and CHAMPION AF This podcast is intended for healthcare professionals only. To read a partial transcript or to comment, visit: https://www.medscape.com/twic I Catheter Based Fibrinolysis of Pulmonary Embolism –Hi PEITHO * Fibrinolysis Treatment Validated in Large Trial for Acute Intermediate-Risk PE https://www.medscape.com/viewarticle/fibrinolysis-treatment-validated-large-trial-acute-2026a10009im * Ultrasound-Facilitated, Catheter-Directed Fibrinolysis for Acute Pulmonary Embolism (HI PEITHO) https://www.nejm.org/doi/full/10.1056/NEJMoa2516567 * National Early Warning Score (NEWS) https://www.england.nhs.uk/ourwork/clinical-policy/sepsis/nationalearlywarningscore/ II PRO-TAVI trial * Deferral of percutaneous coronary intervention in patients undergoing transcatheter aortic valve implantation (PRO-TAVI) 10.1016/S0140-6736(26)00308-9 External Link * PCI in Patients Undergoing Transcatheter Aortic-Valve Implantation (Notion 3) https://www.nejm.org/doi/full/10.1056/NEJMoa2401513 III ORBITA CTO Sham vs PCI for Angina Relief * Tightly Blinded Trial Confirms PCI Reduces Angina in Obstructive Occlusion https://www.medscape.com/viewarticle/tightly-blinded-trial-confirms-pci-reduces-angina-2026a10009ob * A Randomized, Placebo-Controlled Trial of Chronic Total Occlusion Percutaneous Coronary Intervention in Stable Angina - ORBITA-CTO https://www.jacc.org/doi/10.1016/j.jacc.2026.03.027 * ORBITA 1 10.1016/S0140-6736(17)32714-9 External Link * ORBITA 2 https://www.nejm.org/doi/full/10.1056/NEJMoa2310610 * DECISION CTO https://www.ahajournals.org/doi/10.1161/CIRCULATIONAHA.118.031313 * EuroCTO https://doi.org/10.1093/eurheartj/ehy220 * IV CHIPS BCIS3 Impella Supported High-Risk PCI * Adoption Before Evidence: CHIP-BCIS3 Humbles Impella https://www.medscape.com/viewarticle/adoption-before-evidence-chip-bcis3-humbles-impella-2026a10009jh * Left Ventricular Unloading in High-Risk PCI (CHIP BCIS3) https://www.nejm.org/doi/full/10.1056/NEJMoa2515704 * Microaxial Flow Pump or Standard Care in Infarct-Related Cardiogenic Shock (DanGer Shock) https://www.nejm.org/doi/full/10.1056/NEJMoa2312572 V CHAMPION AF – Watchman vs DOAC in Patients With AF * CHAMPION-AF Trial Finds LAAC an Alternative for NOAC in Lower-Risk Patients https://www.medscape.com/viewarticle/champion-af-trial-finds-laac-alternative-noac-lower-risk-2026a10009ij * Six Reasons Why CHAMPION-AF Should Not Change Practice https://www.medscape.com/viewarticle/six-reasons-why-champion-af-should-not-change-practice-2026a10009i7 * Left Atrial Appendage Closure or Anticoagulation for Atrial Fibrillation (CHAMPION AF) https://www.nejm.org/doi/full/10.1056/NEJMoa2517213 * Left Atrial Appendage Closure or Medical Therapy in Atrial Fibrillation (CLOSURE AF) https://www.nejm.org/doi/full/10.1056/NEJMoa2513310 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