With Maria Tereza Sampaio de Sousa Lira, Federal University of Pernambuco - Brazil and Anja Zupan Meznar, University Medical Centre Ljubljana - Slovenia.

This episode will discuss when conduction system pacing (CSP) may be the appropriate pacing strategy for heart failure patients, particularly those with pacing-induced dyssynchrony or suspected pacing-induced cardiomyopathy (PICM).

Key talking points include:

• Clinical clues and diagnostic approach to PICM

• Differentiating PICM from other causes of LV dysfunction

• When to consider CRT upgrade in pacemaker patients

• Insights from the BUDAPEST-CRT upgrade trial

• Advantages and limitations of CSP (His-bundle and left bundle branch pacing)

• Practical take-home message for clinicians managing HF patients with pacemaker

This 2026 HFA Cardio Talk podcast series is supported by Bayer in the form of unrestricted financial support. The discussion has not been influenced in any way by its sponsors.

With Felix Lindberg, Karolinska Institute & Karolinska University Hospital, Stockholm - Sweden, Martha Kyriakou, European University of Cyprus, Nicosia - Cyprus and Maggie Simpson, University of Edinburgh, Edinburgh - UK.

In this episode, Felix Lindberg, Martha Kyriakou, and Maggie Simpson discuss multidisciplinary care in heart failure, exploring why HF complexity and multimorbidity make coordinated, team-based management essential.

They outline the key professional roles and how they can work together to support continuity across the HF trajectory, from diagnosis and optimisation, through decompensations, and transition to advanced therapies and palliative care.

The discussion also addresses real-world gaps in implementation, and considers how the expanding roles of nurses, pharmacists, and allied professionals, alongside emerging digital tools, may shape the future of multidisciplinary HF care.

Proposed reading:

• Examining the clinical role and educational preparation of heart failure nurses across Europe. A survey of the Heart Failure Association (HFA) of the European Society of Cardiology (ESC) and the Association of Cardiovascular Nursing and Allied Professions (ACNAP) of the ESC. Hill et al. 2025. Eur J Heart Fail. DOI: 10.1002/ejhf.3519
• Multidisciplinary Care in Heart Failure Services. Sokos et al. 2023. J Card Fail. DOI: 10.1016/j.cardfail.2023.02.011
• The Core Curriculum for Cardiovascular Nurses and Allied Professionals. Neubeck et al. 2023. Eur J Cardiovasc Nurs. DOI: 10.1093/eurjcn/zvad035
• How to handle polypharmacy in heart failure. A clinical consensus statement of the Heart Failure Association of the ESC. Stolfo et al. 2025. Eur J Heart Fail. DOI: 10.1002/ejhf.3642
• Pharmacist- and Nurse-Led Medical Optimization in Heart Failure: A Systematic Review and Meta-Analysis. Zheng et al. 2023. J Card Fail. DOI: 10.1016/j.cardfail.2023.03.01
• Nurse-led diuretic titration via a point-of-care urinary sodium sensor in patients with acute decompensated heart failure (EASY-HF): A single-centre, randomized, open-label study. Meekers et al. 2024. Eur J Heart Fail. DOI: 10.1002/ejhf.3429
• Heart failure disease management: a systematic review of effectiveness in heart failure with preserved ejection fraction. Kalogirou et al. 2020. ESC Heart Fail. DOI: 10.1002/ehf2.12559
• What Are Effective Program Characteristics of Self-Management Interventions in Patients With Heart Failure? An Individual Patient Data Meta-analysis. Jonkman et al. 2016. J Card Fail. DOI: 10.1016/j.cardfail.2016.06.422
• Comparative effectiveness of transitional care services in patients discharged from the hospital with heart failure: a systematic review and network meta-analysis. Van Spall et al. 2017. Eur J Heart Fail. DOI: 10.1002/ejhf.765

This 2025 HFA Cardio Talk podcast series is supported by Bayer AG in the form of an unrestricted financial support. The discussion has not been influenced in any way by its sponsor.

With Sotiria Liori, Attikon University Hospital, National and Kapodistrian University of Athens - Greece and Julie De Backer, Ghent University Hospital - Belgium.

In this episode, Sotiria Liori and Julie De Backer discuss heart failure in adult congenital heart disease patients — covering how congenital lesions and prior repairs shape epidemiology and mechanisms (ventricular remodeling, valvular and conduit dysfunction, arrhythmias), as well as clinical assessment with imaging, biomarkers, and hemodynamics. They outline management with guideline-directed therapy, rhythm considerations, indications for advanced therapies (MCS and transplant), and pregnancy counseling. The episode also highlights multidisciplinary care models and key evidence gaps.

Proposed reading:

1. General Principles of Heart Failure Management in Adult Congenital Heart Disease. Tompkins R, Romfh A. Heart Failure Reviews. 2020;25(4):555-567. doi:10.1007/s10741-019-09895-x
2. Chronic Heart Failure in Congenital Heart Disease: A Scientific Statement From the American Heart Association. Stout KK, Broberg CS, Book WM, et al. Circulation. 2016;133(8):770-801. doi:10.1161/CIR.0000000000000352.
3. Relation Between New York Heart Association Functional Class and Objective Measures of Cardiopulmonary Exercise in Adults With Congenital Heart Disease. Das BB, Young ML, Niu J, et al. The American Journal of Cardiology. 2019;123(11):1868-1873. doi:10.1016/j.amjcard.2019.02.053.
4. Heart Failure and Patient-Reported Outcomes in Adults With Congenital Heart Disease from 15 Countries. Lu CW, Wang JK, Yang HL, Kovacs AH, et al; APPROACH‐IS consortium, the International Society for Adult Congenital Heart Disease (ISACHD) *.J Am Heart Assoc. 2022 May 3;11(9):e024993. doi: 10.1161/JAHA.121.024993. Epub 2022 Apr 26.
5. Pharmacological Therapy in Adult Congenital Heart Disease: Growing Need, Yet Limited Evidence. Brida M, Diller GP, Nashat H, et al. European Heart Journal. 2019;40(13):1049-1056. doi:10.1093/eurheartj/ehy480.
6. Advanced Heart Failure Therapies For Adults With Congenital Heart Disease: JACC State-of-the-Art Review. Givertz MM, DeFilippis EM, Landzberg MJ, et al. Journal of the American College of Cardiology. 2019;74(18):2295-2312.doi:10.1016/j.jacc.2019.09.004.
7. A Review of Heart Transplantation for Adults With Congenital Heart Disease. McMahon A, McNamara J, Griffin M. Journal of Cardiothoracic and Vascular Anesthesia. 2021;35(3):752-762. doi:10.1053/j.jvca.2020.07.027.
8. Heart Failure in Adult Congenital Heart Disease: From Advanced Therapies to End-of-Life Care. Crossland DS, Van De Bruaene A, Silversides CK, Hickey EJ, Roche SL. The Canadian Journal of Cardiology. 2019;35(12):1723-1739. doi:10.1016/j.cjca.2019.07.626.

This 2025 HFA Cardio Talk podcast series is supported by Bayer AG in the form of an unrestricted financial support. The discussion has not been influenced in any way by its sponsor.

With Tim Balthazar, University Hospital of Brussels - Belgium and Luca Fazzini, Papa Giovanni XXIII Hospital, Bergamo - Italy.

In this episode of HFA CardioTalk, Luca Fazzini interviews Tim Balthazar on the contemporary use of vasodilators and inotropic agents in heart failure. The conversation explores the gaps in current guidelines, the hemodynamic profile of patients suited for vasodilator therapy, and the rationale behind choosing specific inotropes in different clinical settings. Tim Balthazar further discusses the management of patients on chronic beta-blocker therapy presenting with signs of hypoperfusion and the challenges in designing randomized trials in this field. The discussion also touches on the role of inotropes in palliative care, as well as future perspectives and emerging pharmacological strategies.

This 2025 HFA Cardio Talk podcast series is supported by Bayer AG in the form of an unrestricted financial support. The discussion has not been influenced in any way by its sponsor.

With Gregorio Tersalvi, Mayo Clinic, Rochester - USA, and Faiez Zannad, University of Lorraine, Nancy - France. In this episode of HFA CardioTalk, Gregorio Tersalvi interviews Faiez Zannad on the future of trials in heart failure. Together, they explore how the landscape of heart failure trials has evolved, the major challenges in trial design today, the relevance of current and emerging outcomes, and the vision for the next decades of heart failure research. The discussion also touches on lessons learned from landmark trials and advice for young clinicians and researchers who aspire to become trialists. Recommended readings: Zannad F, Pitt B. The Future of Clinical Trials. Circulation 2024 Jun 4;149(23):1783-85. doi: 10.1161/CIRCULATIONAHA.123.066982. This 2025 HFA Cardio Talk podcast series is supported by Bayer AG in the form of an unrestricted financial support. The discussion has not been influenced in any way by its sponsor.

In this episode, we give a wrap-up of late-breaking clinical science presented at the ESC Congress 2025 in Madrid.

First, David Berg presents the DAPA ACT HF-TIMI 68 trial, reporting on dapagliflozin in patients hospitalized for acute heart failure, along with a meta-analysis of SGLT2 inhibitors in this setting.

Next, Javed Butler highlights results of the VICTOR trial, a large phase 3 study of vericiguat in chronic heart failure with reduced ejection fraction.

Then, Andre Zimerman discusses the PhysioSync-HF trial, comparing conduction system pacing with biventricular resynchronization therapy in patients with HFrEF.

Finally, Kieran Docherty shares insights from a community-based study on the benefits of early initiation of disease-modifying therapy in suspected heart failure.

Additional information:

Topic 1:

With Gregorio Tersalvi, Mayo Clinic, Rochester, MN - USA, David Berg, Brigham and Women's Hospital, Boston - USA and Novi Yanti Sari, Siloam Hospitals Group, Jakarta - Indonesia

Results paper:

Dapagliflozin in Patients Hospitalized for Heart Failure: Primary Results of the DAPA ACT HF-TIMI 68 Randomized Clinical Trial and Meta-Analysis of Sodium-Glucose Cotransporter-2 Inhibitors in Patients Hospitalized for Heart Failure

Replay ESC Congress Hot Line: https://esc365.escardio.org/presentation/312142

Circulation. 2025 Aug 29. doi: 10.1161/CIRCULATIONAHA.125.076575.

Topic 2:

With Javed Butler, Baylor Scott & White Health, Dallas - USA and Henrike Arfsten, Medical University of Vienna, Vienna - Austria

Results papers:

Vericiguat in patients with chronic heart failure and reduced ejection fraction (VICTOR): a double-blind, placebo-controlled, randomised, phase 3 trial Lancet. 2025

Replay ESC Congress hotline: https://esc365.escardio.org/presentation/312148 doi: 10.1016/S0140-6736(25)01665-4.

Vericiguat for patients with heart failure and reduced ejection fraction across the risk spectrum: an individual participant data analysis of the VICTORIA and VICTOR trials Lancet. 2025 Aug 29:S0140-6736(25)01682-4. doi: 10.1016/S0140-6736(25)01682-4.

Topic 3:

With Andre Zimerman, Hospital Moinhos De Vento, Porto Alegre - Brazil and Floran Sahiti, University Hospital of Wurzburg, Wurzburg - Germany

Methods paper:

Conduction system pacing vs biventricular resynchronization in heart failure with reduced ejection fraction and left bundle branch block: Rationale and design of the PhysioSync-HF Trial

Am Heart J. 2025 Dec:290:38-45.

Replay ESC Congress: https://esc365.escardio.org/session/50327 doi: 10.1016/j.ahj.2025.06.002.

Topic 3:

With Kieran Docherty, University of Glasgow, Glasgow - UK and Jolie Bruno, Inserm UMR-S942, Paris - France

Results paper:

Benefit of early initiation of disease-modifying therapy in community-based patients with suspected heart failure

Eur Heart J. 2025 Aug 29:ehaf675. doi: 10.1093/eurheartj/ehaf675.

This 2025 HFA Cardio Talk podcast series is supported by Bayer AG in the form of an unrestricted financial support. The discussion has not been influenced in any way by its sponsor.

Wtih Robert Mentz, Duke University, North Carolina - USA, and Cornelia Margineanu University of Medicine and Pharmacy Carol Davila, Bucharest - Romania.

A focused discussion and an update on the latest developments in iron deficiency — a journey from definition to outcomes through available therapeutic options. Not to be missed!

This 2025 HFA Cardio Talk podcast series is supported by Bayer AG in the form of an unrestricted financial support. The discussion has not been influenced in any way by its sponsor.

With Kevin Damman, University Medical Center Groningen, Groningen - The Netherlands, Floran Sahiti, University Hospital of Wurzburg, Wurzburg - Germany, Joao Pedro Ferreira, University of Porto, Porto - Portugal, Novi Yanti Sari, Siloam Hospitals Group, Jakarta - Indonesia, Marat Fudim, Duke University Medical Center, Durham, NC - USA, Gregorio Tersalvi, Mayo Clinic, Rochester, MN - USA, Jose Luis Morales Rull, University Hospital Arnau de Vilanova, Lleida - Spain and Cornelia Margineanu, Bucharest - Romania.

In this episode, we discuss four late-breaking clinical trials presented at the Heart Failure Congress 2025 in Belgrade, Serbia.

First, Kevin Damman presents the results of FUTURE-HF, a first-in-human study evaluating the long-term safety, accuracy, and clinical utility of a novel implantable IVC sensor for remote heart failure management.

Next, Joao Pedro Ferreira highlights the key findings of SOGALDI-PEF, a crossover trial comparing SGLT2 inhibitor monotherapy versus combination therapy with an SGLT2 inhibitor and a mineralocorticoid receptor antagonist (MRA) in reducing NT-proBNP levels.

Third, Marat Fudim reports on the MUSIC-HFpEF phase 1/2a trial, which explores the safety and preliminary efficacy of a novel gene therapy using adeno-associated virus vectors in patients with HFpEF.

Finally, Jose Luis Morales Rull shares insights from PREFER-HF, a study assessing the effects of intravenous or oral iron therapy versus placebo in patients with HFpEF and iron deficiency anemia.

1. FUTURE-HF: Long-term safety, accuracy, and utility of a novel implantable IVC sensor for remote HF management - Kevin Damman, University Medical Center Groningen, Groningen, The Netherlands. Host: Floran Sahiti, University Hospital of Wurzburg, Wurzburg, Germany doi: 10.1016/j.jchf.2025.01.019.
2. SOGALDI-PEF: SOdium-Glucose cotransporter 2 inhibitor with and without an ALDosterone AntagonIst for heart failure with preserved ejection fraction – Joao Pedro Ferreira, University of Porto, Porto, Portugal. Host: Novi Yanti Sari, Siloam Hospitals Group, Jakarta (Indonesia).
3. MUSIC-HFpEF: Gene therapy in Heart Failure with Preserved Ejection Fraction – Marat Fudim, Duke University Medical Center, Durham, NC, USA. Host: Gregorio Tersalvi, Mayo Clinic, Rochester, MN, USA
4. PREFER¬-HF: Effects intravenous iron or oral iron therapy compared to placebo in HFpEF with iron deficiency anemia - Jose Luis Morales Rull, University Hospital Arnau de Vilanova, Lleida, Spain. Host: Cornelia Margineanu, Bucharest, Romania.

This 2025 HFA Cardio Talk podcast series is supported by Bayer AG in the form of an unrestricted financial support. The discussion has not been influenced in any way by its sponsor.

With Justyna Sokolska, Institute of Heart Diseases, Wroclaw Medical University, Wroclaw - Poland, and Maja Cikes, University of Zagreb School of Medicine, Head at the Unit for Heart Failure and Mechanical Circulatory Support, Department of Cardiovascular Diseases, University Hospital Center, Zagreb - Croatia.

In this episode of HFA CardioTalk, Justyna Sokolska interviews Maja Cikes on the challenges in management of long-term left ventricular assist device in patients with advanced heart failure. The discussion emphasizes the importance of selecting appropriate patients at the optimal time, examines the adverse events and highlights major ongoing clinical trials.

Recommended readings:

Aspirin and Hemocompatibility Events With a Left Ventricular Assist Device in Advanced Heart Failure: The ARIES-HM3 Randomized Clinical Trial, Mehra MR, et al. JAMA. 2023 Dec 12;330(22):2171-81

Trends and Outcomes of Left Ventricular Assist Device Therapy: JACC Focus Seminar, Varshney AS, et al. J Am Coll Cardiol 2022 Mar 22;79(11):1092-1107

Cardiac implantable electronic devices with a defibrillator component and all-cause mortality in left ventricular assist device carriers: results from the PCHF-VAD registry, Cikes M, et al. Eur J Heart Fail 2019 Sep;21(9):1129-41

A Fully Magnetically Levitated Left Ventricular Assist Device — Final Report, Mehra MR, et al. N Engl J Med 2019 Apr 25;380(17):1618-27

This 2025 HFA Cardio Talk podcast series is supported by Bayer AG in the form of an unrestricted financial support. The discussion has not been influenced in any way by its sponsor.

With Robert M.A. van der Boon, Erasmus Medical Center, Rotterdam - The Netherlands, and Anuradha Lala, Mount Sinai Fuster Heart Hospital, New York City - USA.

In this episode of HFA Cardio talk, we dive into how factors like sex, socio-economics status and ethnicity shape the way heart failure presents and progresses in different populations. We'll discuss why recognizing these differences is critical for accurate diagnosis and effective treatment and highlight practical steps clinicians can take to close the gaps in prevention and care.

Papers:

https://onlinelibrary.wiley.com/doi/10.1002/ejhf.2534

https://academic.oup.com/eurheartj/article/40/47/3859/5652224?login=true

https://www.sciencedirect.com/science/article/pii/S1071916421004322?via%3Dihub

https://www.sciencedirect.com/science/article/pii/S0002914922010074?via%3Dihub

https://www.sciencedirect.com/science/article/pii/S2468266719301082?via%3Dihub

https://journals.lww.com/co-cardiology/fulltext/2021/05000/racial_and_ethnic_disparities_in_heart_failure_.12.aspx

https://onlinelibrary.wiley.com/doi/10.1002/ehf2.14986

This 2025 HFA Cardio Talk podcast series is supported by Bayer AG in the form of an unrestricted financial support. The discussion has not been influenced in any way by its sponsor.