This interview features JACC Associate Editor Neha Pagidipati, MD, FACC, speaking with Maria Pabon, MD and Muthu Vaduganathan, MD about their study on finerenone’s role in reducing new-onset atrial fibrillation in patients with cardio-kidney metabolic disease. The discussion covers the methodology and findings of a pooled analysis from three major clinical trials, highlighting finerenone’s 17% risk reduction in atrial fibrillation, its potential mechanisms, and the need for greater diversity in clinical trial populations. They also touch on comparative evidence with other mineralocorticoid receptor antagonists and the broader implications for heart failure management.