This Week in Cardiology

Three more digoxin trials, yet another GLP-1 drug on the horizon, vagal nerve stimulation, trial inside baseball, and more on lipid guidelines 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 More About Low-dose Digoxin in HF — The DECISION Trial(s)
DECISION Trial https://www.nature.com/articles/s41591-026-04406-6
Digitalis Glycosides in HF — JAMA Meta-Analysis https://jamanetwork.com/journals/jama/fullarticle/2848972
DIGIT-HF Trial https://www.nejm.org/doi/10.1056/NEJMoa2415471
RADIANCE Trial (1993) https://www.nejm.org/doi/full/10.1056/NEJM199307013290101
DECISION Withdrawal Study https://doi.org/10.1093/eurheartj/ehag385
Digoxin Discontinuation vs Continuation in Chronic HF https://doi.org/10.1016/j.amjcard.2007.02.099
II Yet another GLP-1 Drug Announced this Week
Lillly News Release on Retatrutide https://investor.lilly.com/news-releases/news-release-details/lillys-triple-agonist-retatrutide-delivered-powerful-weight-loss
III A Big Story in HF Science – Vagal Nerve Stimulation in HFrEF
ANTHEM HFrEF trial https://doi.org/10.1016/j.jacc.2026.03.040
Editorials
An Unfinished ANTHEM https://doi.org/10.1016/j.jacc.2026.04.033
When Trials Stop Prematurely https://doi.org/10.1016/j.jacc.2026.03.039
IV Lipid Guideline News
Lipid Guidelines: Four Major Concerns
https://www.medscape.com/viewarticle/lipid-guidelines-four-major-concerns-2026a1000fim
Editorial: Time to Move Beyond the Statin Nocebo Effect  https://www.jacc.org/doi/10.1016/j.jacc.2026.04.002
Correspondence: SAMSON N-of-1 Trial of Statin, Placebo, or No Treatment https://www.nejm.org/doi/full/10.1056/NEJMc2031173
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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
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Another positive digoxin trial, another classic coronary physiology study from Imperial College London (ORBITA-FIRE), news in hypertrophic cardiomyopathy, and TAVR done in the wrong patients 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 Digoxin in Rheumatic Heart Disease
Dig-RHD Trial https://jamanetwork.com/journals/jama/fullarticle/2848973
Safety and Efficacy of Digoxin: Meta-Analysis https://www.bmj.com/content/351/bmj.h4451.long
DIGIT-HF Trial https://www.nejm.org/doi/full/10.1056/NEJMoa2415471
DIG Trial https://www.nejm.org/doi/full/10.1056/NEJM199702203360801
RADIANCE Trial https://www.nejm.org/doi/full/10.1056/NEJM199307013290101
II The Physiologic Threshold for Angina
ORBITA-FIRE Trial https://www.ahajournals.org/doi/full/10.1161/CIRCULATIONAHA.125.078738
III Prediction in Hypertrophic Cardiomyopathy
Predictors of Long-Term Outcomes in HCM https://jamanetwork.com/journals/jama/fullarticle/2848800#250998713
IV TAVR Trends in Young Patients
Temporal Trends in AVR for Aortic Stenosis in Patients
Wall Street Journal article https://www.wsj.com/health/healthcare/heart-valve-tavr-surgery-aorta-1e0eda70
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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
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Listener feedback from the DanGer Shock investigators, complete vs staged revascularization, polygenic risk scores, and quality improvement failure in an RCT 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
DanGer Shock Trial https://www.nejm.org/doi/full/10.1056/NEJMoa2312572
CHIP-BCIS 3 Trial https://www.nejm.org/doi/full/10.1056/NEJMoa2515704
II Immediate Complete vs Staged Revascularization in STEMI
Meta-analysis: Timing of Complete Revasc in Patients with STEMI and Multivessel Disease https://www.ahajournals.org/doi/10.1161/CIRCINTERVENTIONS.126.016601
COMPLETE Trial https://www.nejm.org/doi/full/10.1056/NEJMoa1907775
FULL REVASC Trial https://www.nejm.org/doi/full/10.1056/NEJMoa2314149
iMODERN Trial https://www.nejm.org/doi/full/10.1056/NEJMoa2512918
III Polygenic Risk Scores for Prediction
Polygenic Risk Report in US-Based Hospitals for 8 CV Conditions  https://www.jacc.org/doi/10.1016/j.jacc.2026.03.035
IV Practice Improvement Policies Undergo the Proper Test – Randomization
Quality Improvement on Hospitalizations and Health Outcomes for People with CHD https://www.ahajournals.org/doi/10.1161/CIRCOUTCOMES.125.012904
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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
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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
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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 [email protected]