This Week in Cardiology

Listener feedback, huge news in the rapidly expanding world of PFA AF Ablation, obesity, and a beautiful trial studying an AI-enhanced diagnostic tool in the office are the topics 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
Risk-Based TEE Omission in PVI 10.1016/j.hrthm.2025.04.056 External Link
II PFA News
BEAT PAROX-AF trial https://academic.oup.com/eurheartj/advance-article/doi/10.1093/eurheartj/ehaf1115/8436829
Life-Threatening Delayed Myocardial Ischemia and Malignant Arrhythmias Occurring After PFA https://www.ahajournals.org/doi/full/10.1161/CIRCULATIONAHA.125.077983
Heart Rhythm TV: Life-Threatening Delayed Myocardial Ischemia and Malignant Arrhythmias  https://www.youtube.com/watch?v=M-npoLKmRa4
MAUDE Adverse Event report https://www.accessdata.fda.gov/scripts/cdrh/cfdocs/cfmaude/detail.cfm?mdrfoi__id=23733351&pc=QZI
III Obesity trends
US State-Level Obesity Trends 1990-2022 and Forecasted to 2035 https://jamanetwork.com/journals/jama/fullarticle/2844495
IV New Tools in the Office
TRICORDER Trial https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(25)02156-7/fulltext
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 [email protected]

Listener feedback, the value of procedural volume for TAVR and MTEER, ventricular arrhythmia in older athletes, and the Goldilocks time horizon for predicting and modifying CV risk 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 Procedural Volume and Outcomes for TAVI and M-TEER
Operator Procedural Volumes and Outcomes for TAVR and MTEER https://jamanetwork.com/journals/jamacardiology/fullarticle/2843740
II Ventricular Arrhythmia in Older Male Endurance Athletes
Myocardial Fibrosis May Raise Arrhythmia Risk in Older Male Endurance Athletes
https://www.medscape.com/viewarticle/myocardial-fibrosis-may-raise-arrhythmia-risk-older-male-2026a10001y0
Timing and Relationship of VA With Exercise Patterns in Older Male Endurance Athletes https://doi.org/10.1093/eurjpc/zwag021
III Predicting Cardiac Risk and Statin Use
30-Year ASCVD Risk Among US Adults Aged 30-59 https://www.ahajournals.org/doi/10.1161/CIRCOUTCOMES.125.012348
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 [email protected]

Some great listener feedback, one of the best studies of the year in atrial fibrillation and heart failure, imaging to exclude left atrial thrombus, and a truly amazing first cardiac procedure 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
On Fish Oil and AF
Links between omega-3 fatty acids and AF https://www.ahajournals.org/doi/10.1161/CIRCULATIONAHA.121.058596
Omega-3 and risk of AF https://doi.org/10.1016/j.pcad.2024.11.003
DHA vs EPA in reducing vulnerability to AF https://www.ahajournals.org/doi/10.1161/CIRCEP.112.971515
II Withdrawal of HF Therapy  AF rhythm control
The AF is Gone, the EF Is Up. Can You Stop the HF Meds?
https://www.medscape.com/viewarticle/af-gone-ef-can-you-stop-hf-meds-2024a1000h6o
Effect of beta-blockers in patient with HF plus AF -- meta-analysis https://pubmed.ncbi.nlm.nih.gov/25193873/
TRED HF Trial 10.1016/S0140-6736(18)32484-X External Link
WITHDRAW-AF Trial https://academic.oup.com/eurheartj/article/47/2/250/8238240
III ICE or TEE Before AF Ablation
ICE vs TEE in Atrial Fibrillation Ablation https://jamanetwork.com/journals/jamacardiology/fullarticle/2839370
IV The Vector Procedure
Percutaneous Aorto-Coronary Bypass Graft: the VECTOR procedure https://www.ahajournals.org/doi/10.1161/CIRCINTERVENTIONS.125.016130
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 [email protected]

The limits of knowing coronary artery disease anatomy, fish oil and AF risk, a new drug for PSVT, and maybe I was wrong about a drug for AF conversion (the RAFF4 trial). These 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 Prediction of CAD is hard — even if you have anatomy
CCTA in Prediction of First Coronary Events https://jamanetwork.com/journals/jama/fullarticle/2841255
II Fish Oil and AF (and as a bonus we learn again about analytic flexibility)
Are Fish Oils on the Hook for AF Risk?
https://www.medscape.com/viewarticle/995290
Omega-3 and Fish Oil Use With Risk of AF  https://www.ahajournals.org/doi/full/10.1161/JAHA.125.043031
Effect of Long-Term Marine Omega-3 Fatty Acids on the Risk of AF https://www.ahajournals.org/doi/10.1161/CIRCULATIONAHA.121.055654
RESPECT-EPA Trial https://www.ahajournals.org/doi/10.1161/CIRCULATIONAHA.123.065520
Association Between Omega-3 Fatty Acids and AF: Meta Analysis https://link.springer.com/article/10.1007/s10557-021-07204-z
Fish Oil Supplements and Risk of AF https://academic.oup.com/eurjpc/article/29/14/1911/6679610
Editorial: Fish Oil Supplements and AF Risk https://www.ahajournals.org/doi/10.1161/CIRCULATIONAHA.121.057464
III A New Drug for PSVT
FDA Approval https://www.fda.gov/drugs/news-events-human-drugs/fda-approves-drug-type-abnormally-fast-heart-rhythm
RAPID trial https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(23)00776-6/fulltext
IV AF Conversion with Vernakalant
RAFF4 Trial https://www.bmj.com/content/391/bmj-2025-085632.long
Editorial: Rapid Cardioversion for Acute AF https://www.bmj.com/content/391/bmj.r2264
VI A Quick Note on HFpEF
Med Op-Ed: Avalanche Survival, HFpEF Skepticism, and More
https://www.medscape.com/viewarticle/med-op-ed-avalanche-survival-hfpef-skepticism-and-more-2026a1000012
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 [email protected]

The MI paradox of risk scores, the CELEBRATE trial of a new subcutaneous glycoprotein IIb/IIIA inhibitor (with its funny endpoint), the SURPASS CVOT trial, and the bad story of andexanet alfa 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 What do risk scores mean for individuals? Or perhaps a better question: Is a first MI preventable?
Limitations of Screening in Predicting First MI https://www.jacc.org/doi/10.1016/j.jacadv.2025.102361
Sudden Death Due to Cardiac Arrhythmias https://www.nejm.org/doi/abs/10.1056/NEJMra000650
UMC Amsterdam group (EHJ) https://academic.oup.com/eurheartj/article/46/38/3762/8181058
II CELEBRATE Trial
CELEBRATE Trial https://evidence.nejm.org/doi/full/10.1056/EVIDoa2500268
III SURPASS CVOT Trial Published
Aug 01, 2025 This Week in Cardiology Podcast
https://www.medscape.com/viewarticle/1002781
SURPASS-CVOT Trial https://www.nejm.org/doi/full/10.1056/NEJMoa2505928
REWIND Trial 10.1016/S0140-6736(19)31149-3 External Link
IV FDA Pulls Andexanet Alfa From the Market
ANNEXA 4 https://www.nejm.org/doi/10.1056/NEJMoa1814051
ANNEXA I https://www.nejm.org/doi/full/10.1056/NEJMoa2313040
Richard Buka Tweet https://x.com/richardbuka/status/2001045834050216327?s=20
V Mandrola's Top Cardiovascular Stories of 2025
https://www.medscape.com/viewarticle/mandrolas-top-10-cardiovascular-stories-2025-2025a1000yuh
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 [email protected]