This Week in Cardiology

Listener feedback, the ZEUS trial fails, a fascinating statin trial, more on GLP-1 drugs, and radiation safety in the EP lab 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 ZEUS Fails

Rethinking Inflammation and ASCVD: Four Lessons From the ZEUS Trial

https://www.medscape.com/viewarticle/rethinking-inflammation-and-ascvd-four-lessons-zeus-trial-2026a1000rlm

• ZEUS Trial https://doi.org/10.1001/jamacardio.2025.4491

II Statins and the Elderly

• SAGA/SITE trial 10.1016/j.lanhl.2026.100884 External Link

III GLP-1 and CV Risk

• SURMOUNT-1 Trial https://www.nejm.org/doi/10.1056/NEJMoa2206038
• SURMOUNT-1 Post Hoc Analysis https://www.jacc.org/doi/10.1016/j.jacc.2026.04.044
• Reframing GLP-1s as Cardiometabolic Health Drugs: Editorial https://www.jacc.org/doi/10.1016/j.jacc.2026.06.039

IV Radiation Exposure to the Uterus in the EP Lab

• Occupational Radiation Safety in EP During Pregnancy https://www.ahajournals.org/doi/epub/10.1161/CIRCULATIONAHA.126.080556
• Survey: Working in Cath Lab During Pregnancy https://www.surveymonkey.com/share/d5c1edf7-6d99-49d4-a9fa-e9168f63ab55

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Another failure of LA posterior wall isolation, first-line AF ablation, a revelation on EAST-AFNET 4 trial, an LAAC meta-analysis, and preventing AKI post-cardiac surgery 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:

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I Listener Feedback

• DAPT-MVD Trial https://www.nejm.org/doi/full/10.1056/NEJMoa2517588

II Another Failure of Posterior Wall Isolation

• CORNERSTONE-AF Trial https://doi.org/10.1093/eurheartj/ehag486
• CAPLA Trial https://jamanetwork.com/journals/jama/fullarticle/2800186
• PVIOTAL IDE Trial 10.1016/j.hrthm.2025.08.018 External Link

III First Line AF ablation – One new study and a discovery about a second one

• Catheter Ablation vs AAD for First-line Treatment of AF 10.1016/j.hrthm.2025.07.061 External Link

• EAST-AFNET 4 Trial https://www.nejm.org/doi/full/10.1056/NEJMoa2019422
• Cardiology Trials Substack https://cardiologytrials.substack.com/p/summary-and-discussion-of-east-afnet

IV Left Atrial Appendage Closure Meta-analysis

• Long-Term Efficacy and Safety of LAAC vs OAC -- Meta-analysis https://academic.oup.com/europace/article/28/7/euag159/8739567

V Prevention of AKI after Cardiac Surgery: MERCURI-2

• MERCURI-2 Study https://jamanetwork.com/journals/jama/fullarticle/2852324

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The first oral PCSK9 inhibitor, another study finding safe MRI scanning in patients with nonconditional CIEDs, the PFA-SHAM trial, and the curious case of orthopedic injuries in cardiology 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:

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I Enlicitide Approved

First Oral PCSK9 Inhibitor Welcomed for Potential Primary Care Impact https://www.medscape.com/viewarticle/first-oral-pcsk9-inhibitor-welcomed-potential-primary-care-2026a1000own

• Dr Gregory Katz Substack https://gregorykatz.substack.com/p/are-we-sure-mercks-new-cholesterol
• CORALreef Lipids Trial https://www.nejm.org/doi/full/10.1056/NEJMoa2511002
• CORALreef HeFH Trial https://jamanetwork.com/journals/jama/fullarticle/2841258
• CORALreef Outcomes Trial https://clinicaltrials.gov/study/NCT06008756

II MRI Scans in Non-conditional CIEDs

Specialized Nurse Practitioners Safely Manage MRI in Patients With Cardiac Implantable Devices https://www.medscape.com/viewarticle/specialized-nurse-practitioners-safely-manage-mri-patients-2026a1000ozt

• Nurse Practitioner-Led CIED Monitoring During MRI 10.1016/j.hroo.2026.04.031 External Link
• MRI in Nonconditional Pacemakers and ICDs https://academic.oup.com/europace/article/22/2/288/5717383
• Heart Rhythm Society Consensus Document 10.1016/j.hrthm.2017.04.025 External Link

III PFA-SHAM trial

• PFA-SHAM Trial https://www.ahajournals.org/doi/10.1161/CIRCULATIONAHA.126.079484
• SHAM-PVI Trial https://jamanetwork.com/journals/jama/fullarticle/2823283

IV Orthopedic Injuries in Cardiology

What Will It Take to Make Fluoroscopy Labs Safer?

https://www.medscape.com/viewarticle/what-will-it-take-make-fluoroscopy-labs-safer-2026a1000ox6

• Expert Consensus Statement on Enhanced Radiation Protection https://www.jacc.org/doi/10.1016/j.jcin.2026.06.011
• 'Shed the Lead' and the Injuries. Should Cath Labs Go Lead-Free? https://www.medscape.com/viewarticle/shed-lead-and-injuries-should-cath-labs-go-lead-free-2024a1000hnb
• Health Hazards of Working in the Interventional Laboratory https://doi.org/10.1016/j.jacc.2014.11.056

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DAPT back in the news, a practice-changing trial in VTE therapy, new knowledge in sudden cardiac death, heart failure definitions updated, and a dumb decision by NICE in the UK are the topics discussed by John Mandrola, MD, in this week's podcast.

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I Antiplatelet Therapy After Stenting

• DAPT-MVD Trial https://www.nejm.org/doi/full/10.1056/NEJMoa2517588
• HOST-EXAM Trial at 2 years https://pubmed.ncbi.nlm.nih.gov/34010616/
• HOST-EXAM Trial at 10 years 10.1016/S0140-6736(26)00422-8 External Link
• Nick Kurzen on X https://x.com/ncurzen/status/2077676739463922151

II Aspirin Proves Its Mettle After Hip and Knee Replacement

• EPCAT III Trial https://www.nejm.org/doi/full/10.1056/NEJMoa2603649
• CRISTAL Trial https://jamanetwork.com/journals/jama/fullarticle/2795528

III New (and old) Knowledge in Sudden Cardiac Death

• Sudden Cardiac Death and its Relation to Cardiac Disease at Autopsy https://doi.org/10.1016/j.jacc.2026.01.029
• Sudden Cardiac Death Due to MI With Obstructive and Nonobstructive Coronary Arteries https://doi.org/10.1016/j.jacc.2026.01.030
• Frequency of Sudden Cardiac Death and Profiles of Risk https://www.ajconline.org/article/S0002-9149(97)00477-3/fulltext

IV Heart Failure Diagnosis

• AHA/ACC/ESC/WHF Expert Consensus Document http://jacc.org/doi/10.1016/j.jacc.2026.05.036

V NICE Makes a Dumb Decision

• NICE Recommends New Nonsteroidal MRA for Heart Failure

https://www.medscape.com/viewarticle/nice-recommends-new-nonsteroidal-mra-heart-failure-2026a1000nzv

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Listener feedback on ICE vs TEE in AF ablation, fractional flow reserve without a wire or catheter, more bad news for ticagrelor, the POLY-HF trial, and oxygen targets after cardiac arrest 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:

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I Listener Feedback

Oct 10, 2025 This Week in Cardiology Podcast

https://www.medscape.com/viewarticle/1002990

• ICE vs TEE in Atrial Fibrillation Ablation https://jamanetwork.com/journals/jamacardiology/fullarticle/2839370

II FFR Without the Wire – Angiography-Derived FFR to Guide PCI

• ALL-RISE Trial https://www.nejm.org/doi/full/10.1056/NEJMoa2600949
• FAST III Trial https://www.nejm.org/doi/full/10.1056/NEJMoa2601841
• FAVOR III Trial 10.1016/S0140-6736(24)02175-5 External Link
• FAME 2 Trial https://www.nejm.org/doi/full/10.1056/NEJMoa1205361
• Venk Murthy on X https://x.com/venkmurthy/status/2074849421452329456?s=20

III More Bad News for Ticagrelor

Jul 11, 2025 This Week in Cardiology Podcast https://www.medscape.com/viewarticle/1002704

• Prasugel, Ticagrelor, or Clopidogrel After PCI https://jamanetwork.com/journals/jamacardiology/fullarticle/2849614

IV The Polypill in Heart Failure

• POLY-HF trial https://www.nature.com/articles/s41591-026-04504-5

V Oxygen Targets After Cardiac Arrest

• LOGICAL Trial https://www.nejm.org/doi/full/10.1056/NEJMoa2513814
• ICU-ROX Trial https://link.springer.com/article/10.1007/s00134-020-06196-y
• Secondary Analysis of the PILOT Trial https://journal.chestnet.org/article/S0012-3692(25)00553-7/fulltext
• Oxygen Targets in Comatose Survivors of Cardiac Arrest https://www.nejm.org/doi/10.1056/NEJMoa2208686

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Listener feedback on valvular heart disease, statins and frailty, left atrial posterior wall ablation fails again, interpreting medical tests and AI ECG reading 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:

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I Listener Feedback

• PREVUE-VALVE Study https://www.jacc.org/doi/10.1016/j.jacc.2026.02.5137

II Statins and Frailty

Statin Initiation Tied to Lower Frailty Risk in Older Adults https://www.medscape.com/viewarticle/statin-initiation-tied-lower-frailty-risk-older-adults-2026a1000lec

• Statins and Survival Free of Incident Frailty https://doi.org/10.1093/eurheartj/ehag451

III LA Posterior Wall Isolation Fails Again

• CORNERSTONE Trial https://doi.org/10.1093/eurheartj/ehag486
• CAPLA Trial https://jamanetwork.com/journals/jama/fullarticle/2800186

IV Does the Display of Test Results Improve Clinical Decisions?

• Interval Likelihood Ratios for Clinical Decsion-Making https://evidence.nejm.org/doi/full/10.1056/EVIDoa2500249
• Making Sense of Health Statistics https://journals.sagepub.com/doi/full/10.1111/j.1539-6053.2008.00033.x

V AI and the ECG and Saving Doctors

• Case Report — AI-Enhanced Diagnostics https://www.nature.com/articles/s41591-026-04454-y
• The New York Times article https://www.nytimes.com/2026/06/22/health/artificial-intelligence-heart-damage.html

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Listener feedback, more long-term data on the TAVR/SAVR question, population prevalence of valvular heart disease in the US, and a CMS proposal to expand TAVR coverage are the topics John Mandrola, MD, discusses in this week's podcast.

This podcast is intended for healthcare professionals only.

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I Listener Feedback

• ICD Trends and Outcomes: 15-Year Analysis https://doi.org/10.1093/europace/euag110
• MADIT-RIT https://www.nejm.org/doi/full/10.1056/NEJMoa1211107

II More Long Term Data on TAVR vs SAVR

• PARTNER 2 Trial https://www.jacc.org/doi/10.1016/j.jacc.2026.03.169
• 10-Year Outcomes of SAPIEN 3 TAVR or SAVR in Intermediate-Risk Patients https://doi.org/10.1016/j.jacc.2026.03.170
• TAVR at a Decade: Editorial https://doi.org/10.1016/j.jacc.2026.04.042
• EVOLUT Trial https://www.jacc.org/doi/10.1016/j.jacc.2026.02.5063
• Updated 5-year Outcomes of TAVR vs SAVR in AS https://heart.bmj.com/content/early/2026/02/11/heartjnl-2025-327092
• NOTION Trial https://doi.org/10.1093/eurheartj/ehae043
• PARTNER 3 Trial https://www.nejm.org/doi/full/10.1056/NEJMoa2509766
• NOTION 2 Trial https://academic.oup.com/eurheartj/article/45/37/3804/7673297
• TAVR vs SAVR Editorial : https://academic.oup.com/eurheartj/advance-article-abstract/doi/10.1093/eurheartj/ehag407/8708044

III The PREVUE-VALVE Study

• PREVUE-VALVE Study https://www.jacc.org/doi/10.1016/j.jacc.2026.02.5137

IV CMS has Proposed New Coverage for TAVR

• CMS Proposal Document https://www.cms.gov/medicare-coverage-database/view/ncacal-decision-memo.aspx?proposed=Y&ncaId=321

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Listener feedback, transcatheter tricuspid valve replacement, a new metabolic disease called CKM, the ARISE-FLUIDS Trial, the BIHCA trial, and temporal trends in ICD therapies are the topics John Mandrola, MD, discusses in this week's podcast.

This podcast is intended for healthcare professionals only.

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I Listener Feedback

• LOSE-AF Trial https://jamanetwork.com/journals/jama/fullarticle/2849335
• ARREST-AF Trial https://jamanetwork.com/journals/jamacardiology/fullarticle/2840225
• POP-AF Trial https://doi.org/10.1093/eurheartj/ehaf689
• PRAGUE-25 Trial https://www.jacc.org/doi/10.1016/j.jacc.2025.04.042

II Transcatheter Tricuspid Valve Replacement

• TRISCEND Cost Study https://doi.org/10.1016/j.shj.2026.101049
• TRISCEND II Trial https://www.nejm.org/doi/full/10.1056/NEJMoa2401918

III More Disease Creation – the CKM Syndrome

ACC/AHA Release First-Ever Guideline for CKM Syndrome https://www.medscape.com/viewarticle/acc-aha-release-first-ever-guideline-ckm-syndrome-2026a1000jbs

• CKM Guideline in Circulation https://www.ahajournals.org/doi/10.1161/CIR.0000000000001447

IV Two Trials That Teach Important EBM Lessons

• ARISE-FLUIDS Trial https://www.nejm.org/doi/full/10.1056/NEJMoa2516225
• Dr Josh Farkas Post on X https://x.com/PulmCrit/status/2065064796270022845?s=20

V Bicarbonate for Inpatient Cardiac Arrest –The BIHCA trial

• BIHCA Trial https://jamanetwork.com/journals/jama/fullarticle/2850405

VI The Decline of VT in Heart Failure

• Trends and Outcomes in ICD Recipients: 15-Year Analysis https://doi.org/10.1093/europace/euag110
• Declining Risk of Sudden Death in HF https://www.nejm.org/doi/full/10.1056/NEJMoa1609758

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Chemical cardioversion in the ED, HF monitoring, weight loss in AF, and surgical LAA excision 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:

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I Chemical Cardioversion of AF in the ED: The FLECA-ED Trial

• FLECA-ED Rationale paper https://pmc.ncbi.nlm.nih.gov/articles/PMC10299428/
• FLECA-ED ESC Slides https://esc365.escardio.org/presentation/321209
• Review on Flecainide Use Despite CAST https://doi.org/10.1016/j.hrthm.2025.08.034
• RACE 7 ACWAS Trial https://www.nejm.org/doi/full/10.1056/NEJMoa1900353

II Heart Failure Monitoring – The ALLEVIATE-HF Trial

• ALLEVIATE-HF Trial https://doi.org/10.1016/j.jacc.2026.03.075
• CHAMPION Trial https://doi.org/10.1016/S0140-6736(11)60101-3
• GUIDE HF Trial https://doi.org/10.1016/S0140-6736(21)01754-2
• ALLEVIATE-HF Editorial: Alerts Are Not Treatment https://doi.org/10.1016/j.jacc.2026.04.014

• Steve Stiles Medscape report on CHAMPION https://www.medscape.com/viewarticle/755189

III A Negative Weight Loss Study in AF

• LOSE-AF Trial https://jamanetwork.com/journals/jama/fullarticle/2849335

IV Surgical LAA Excision

• OPINION Trial https://doi.org/10.1093/eurheartj/ehaf674
• LAAOS 3 trial https://www.nejm.org/doi/full/10.1056/NEJMoa2101897

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A life-long treatment for high LDL, a VESALIUS subanalysis, tirzepatide beats semaglutide again, arrhythmia burden in cardiac amyloidosis, and a lipid guideline rebuttal 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:

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I Permanent Lipid Lowering therapy

• Verve 102 Therapy for FH https://www.nejm.org/doi/full/10.1056/NEJMoa2601283

II Vesalius Substudy on PCSK9i Use in Patients With Previous PCI

• VESALIUS Subgroup Analysis https://www.ahajournals.org/doi/10.1161/CIRCULATIONAHA.126.080616
• VESALIUS Study - NEJM https://www.nejm.org/doi/full/10.1056/NEJMoa2514428

III Tirzepatide looking to be best again

• SURPASS-EARLY Trial https://www.acpjournals.org/doi/10.7326/ANNALS-25-05602
• SURMOUNT-5 Trial https://www.nejm.org/doi/abs/10.1056/NEJMoa2416394

IV Arrhythmias in Cardiac Amyloidosis

Loop Recorders Reveal Arrhythmias in Cardiac Amyloidosis https://www.medscape.com/viewarticle/loop-recorders-reveal-arrhythmias-cardiac-amyloidosis-2026a1000gq9

• EXCALIBUR Study https://www.jacc.org/doi/10.1016/j.jacc.2026.04.030

V Lipid Guidelines

· In Defense of the 2026 Dyslipidemia Guideline https://www.medscape.com/viewarticle/defense-2026-dyslipidemia-guideline-2026a1000hd0

• Lipid Guidelines: Four Major Concerns https://www.medscape.com/viewarticle/lipid-guidelines-four-major-concerns-2026a1000fim

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