This Week in Cardiology

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.
To read a partial transcript or to comment, visit:
https://www.medscape.com/twic
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:
https://www.medscape.com/twic
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:
https://www.medscape.com/twic
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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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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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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Questions or feedback, please contact news@medscape.net