This Week in Cardiology

The moderate aortic stenosis TAVR trial, blinded withdrawal in the DECISION digoxin trial, CTO-PCI vs no CTO-PCI 10-year results, and the P4 trial 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/twicI PROGRESS Trial PROGRESS Trial https://www.nejm.org/doi/full/10.1056/NEJMoa2607326PROGRESS Trial Editorial https://www.nejm.org/doi/full/10.1056/NEJMe2613400Genereux Classification https://academic.oup.com/eurheartj/article/38/45/3351/4002776II Withdrawing Digoxin in the DECISION trial DECISION Trial Substudy https://academic.oup.com/eurheartj/article/47/38/5545/8674856DECISION Trial - Main Trial https://www.nature.com/articles/s41591-026-04406-6Efficacy and Safety of Digitalis Glycosides in HF: Meta-analysis https://jamanetwork.com/journals/jama/fullarticle/2848972RADIANCE trial https://www.nejm.org/doi/full/10.1056/NEJM199307013290101PROVED trial https://www.jacc.org/doi/10.1016/0735-1097(93)90403-NIII DECISION CTO Trial at 10 Years DECISION-CTO Trial 10-Year Outcomes 10.1016/j.jacc.2026.10.068DECISION-CTO Main paper https://doi.org/10.1161/CIRCULATIONAHA.118.031313EURO-CTO trial https://eurointervention.pcronline.com/article/three-year-outcomes-of-eurocto-a-randomized-multicentre-trial-comparing-revascularization-and-optimal-medical-therapy-for-chronic-total-coronary-occlusionsCOMET-CTO trial https://pmc.ncbi.nlm.nih.gov/articles/PMC9868942/EXPLORE Trial https://www.ahajournals.org/doi/10.1161/JAHA.123.033556ORBITA-CTO trial https://www.jacc.org/doi/10.1016/j.jacc.2026.03.027IV The P4 Trial Coronary CT Angiography Cuts Procedural Time Relative to IVUS-Guided PCI https://www.medscape.com/viewarticle/coronary-ct-angiography-cuts-procedural-time-relative-ivus-2026a1001684P4 Trial https://www.nejm.org/doi/full/10.1056/NEJMoa2610771The 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] Hosted by Simplecast, an AdsWizz company. See pcm.adswizz.com for information about our collection and use of personal data for advertising.

The ASPIRED syncope RCT, two studies in coronary artery calcium scoring, and the LEAP-Block trial of CSP vs RV pacing 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/twicI Syncope ASPIRED Trial https://www.nejm.org/doi/full/10.1056/NEJMoa2605812REMOSYNCED Trial https://clinicaltrials.gov/study/NCT05066347II TWO CAC Studies Atherosclerosis in Young Adults and Risk of Mortality Over 30 Years https://jamanetwork.com/journals/jamacardiology/fullarticle/2855732Predictive Utility of CAC Score Added to PREVENT Score https://jamanetwork.com/journals/jama/fullarticle/2853347III Conduction System Pacing vs Standard RV Pacing for AV block LEAP-Block Trial https://jamanetwork.com/journals/jama/fullarticle/2855975Meta-analysis: CSP vs RV Pacing in Preserved or Mildly Reduced EF https://doi.org/10.1016/j.cjca.2026.04.009You 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] Hosted by Simplecast, an AdsWizz company. See pcm.adswizz.com for information about our collection and use of personal data for advertising.

Listener feedback on the nonobstructive HCM trials, AI-enhanced visits, timing of non-culprit PCI in STEMI, new tricuspid valve intervention, and EP at a crossroads 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/twicI Listener Feedback  Koelemen meta-analysis https://www.medrxiv.org/content/10.64898/2026.09.08.26362195v1.full.pdf  Improving SCD Risk Stratification in HCM https://pmc.ncbi.nlm.nih.gov/articles/PMC11026183/II More on Nonobstructive HCM  Communication on Post-Hoc Analysis of ODYSSEY (mavacamten)  Mavacamten in Nonobstructive HCM 10.1016/j.jacc.2025.12.092III Complete vs Staged PCI in STEMI With Multivessel Disease   Immediate vs Staged CR in Multivessel Disease and STEMI: Meta-Analysis https://doi.org/10.1016/j.jcin.2026.07.033  Timing of Nonculprit PCI for STEMI and Multivessel Disease: Editorial https://doi.org/10.1016/j.jcin.2026.08.009  COMPLETE Trial https://www.nejm.org/doi/full/10.1056/NEJMoa1907775  FLOWER MI Trial https://www.nejm.org/doi/full/10.1056/NEJMoa2104650  FRAME AMI Trial https://doi.org/10.1093/eurheartj/ehac763  iMODERN Trial https://www.nejm.org/doi/full/10.1056/NEJMoa2512918  COCUA Trial https://doi.org/10.1016/j.ahj.2023.01.020  MULTISTARS Trial https://www.nejm.org/doi/full/10.1056/NEJMoa2307823  OPTION STEMI Trial 10.1016/S0140-6736(25)01529-6 External Link  CULPRIT SHOCK Trial https://www.nejm.org/doi/full/10.1056/NEJMoa1710261  BioVasc Trial Substudy https://eurointervention.pcronline.com/article/immediate-versus-staged-complete-revascularisation-in-patients-presenting-with-stemi-and-multivessel-disease  Main BioVasc Trial 10.1016/S0140-6736(23)00351-3 External Link  FULL REVASC Trial https://www.nejm.org/doi/full/10.1056/NEJMoa2314149IV A Call to Action for Electrophysiologists   Twenty Years at the Crossroads 10.1016/j.jacep.2026.09.023  EP at a Crossroads - Josephson 2007 https://doi.org/10.1016/j.hrthm.2006.12.045  EP at a Crossroads: A Revisit - Josephson 2016 https://doi.org/10.1016/j.hrthm.2016.07.024V FDA Approves Another Tricuspid Valve Repair System  Press release https://www.edwards.com/newsroom/news/2026-10-21-fda-approval-of-edwards-lifesciences--pascal-preci  TRIC I HF Trial https://www.nejm.org/doi/full/10.1056/NEJMoa2606934  CLASP II TR Trial https://pubmed.ncbi.nlm.nih.gov/42855029/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]  Hosted by Simplecast, an AdsWizz company. See pcm.adswizz.com for information about our collection and use of personal data for advertising.

Some promising studies in amyloidosis, aficamten in nonobstructive HCM, costs of the microaxial flow pump in cardiogenic shock, and more on the VESALIUS trial of evolocumab 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/twicI Light Chain Amyloidosis – A Potentially Helpful DrugAnselamimab Does Not Reduce Light-Chain Amyloidosis Deathshttps://www.medscape.com/viewarticle/anselamimab-does-not-reduce-light-chain-amyloidosis-deaths-2026a1000z79II Aficamten in Nonobstructive HCM: The ACACIA trialIII Microaxial Flow Pump Cost Analysis of Danger ShockIV More on Evolocumab at ESC: Vesalius Trial SubstudiesThe Bob Harrington Show with the Stephen and Suzanne Weiss Dean of Weill Cornell Medicine, Robert A. Harrington, MD. https://www.medscape.com/author/bob-harringtonQuestions or feedback, please contact [email protected]://www.medscape.com/viewarticle/1003092 Hosted by Simplecast, an AdsWizz company. See pcm.adswizz.com for information about our collection and use of personal data for advertising.

Listener feedback on POET II, sham control trials in atrial fibrillation, ICDs in HCM, and agenda laundering 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/twicI Listener FeedbackPOET II Response-Tailored or Standard-Duration ABX for Infectious EndocarditisPOET I Trial https://www.nejm.org/doi/10.1056/NEJMoa1808312POET II Trial https://www.nejm.org/doi/full/10.1056/NEJMoa2607887II PVI-SHAM-AF trial Back in the NewsGAP-AF Trial https://www.ahajournals.org/doi/10.1161/circep.115.003337PVI-SHAM-AF Trial 10.1016/S0140-6736(26)01558-8 External LinkWhy Sham Studies Are a Sham in 2026 10.1016/j.hrthm.2026.09.056 External LinkThe Indispensable Role of Sham Controls in Evaluating Interventional Therapies 10.1016/j.hrthm.2026.10.001 External LinkIII ICDs in HCMI CDs for the Prevention of SCD in High-Risk Patients with HCM https://www.ahajournals.org/doi/10.1161/CIRCULATIONAHA.125.078597ICDs in HCM: Editorial https://www.ahajournals.org/doi/10.1161/CIRCULATIONAHA.126.079687IV Agenda LaunderingHow Commercial “Agenda Laundering” Shapes Critical Care https://www.bmj.com/content/395/bmj-2026-100963The Bob Harrington Show with the Stephen and Suzanne Weiss Dean of Weill Cornell Medicine, Robert A. Harrington, MD. https://www.medscape.com/author/bob-harringtonQuestions or feedback, please contact [email protected] Hosted by Simplecast, an AdsWizz company. See pcm.adswizz.com for information about our collection and use of personal data for advertising.

Listener feedback on DANISH-CRT, the POET II trial, a mechanistic study in obesity and AF, the DANCODE trial of slowing CAC progression, and more on GLP-1 drugs 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 DANISH-CRT Trial 10.1016/S0140-6736(26)01597-7 Identifying LV Posterior Wall Delay in RBBB Using Lead V8 https://doi.org/10.1016/j.jacep.2026.03.009 Using Lead V8 as a Tool to Improve Patient Selection in CRT https://doi.org/10.1093/europace/euaf194 II POET II Response-Tailored or Standard-Duration Antibiotics for Endocarditis POET I https://www.nejm.org/doi/10.1056/NEJMoa1808312 POET II https://www.nejm.org/doi/full/10.1056/NEJMoa2607887 III Obesity and AF – A Neat Study from the Team in Prague LA Remodeling and Functional Maladaptations in Obesity https://www.ahajournals.org/doi/10.1161/CIRCHEARTFAILURE.126.014509 IV Reducing CAC: The DANCODE Trial DANCODE Trial https://www.ahajournals.org/doi/10.1161/CIRCULATIONAHA.126.082363 V Two Big RCTs of New GLP-1 Drugs TRIUMPH-1 Trial https://www.nejm.org/doi/full/10.1056/NEJMoa2604169 SYNCHRONIZE-2 Trial https://www.nejm.org/doi/full/10.1056/NEJMoa2607219 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] Hosted by Simplecast, an AdsWizz company. See pcm.adswizz.com for information about our collection and use of personal data for advertising.

Listener feedback, pulmonary embolism intervention, simple vs complex in BiV pacing, exercise in AF, and TAVR for paradoxical low-flow, low-gradient aortic stenosis 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 LBBP ICD Lead LEADR LBBAP Trial https://pubmed.ncbi.nlm.nih.gov/41110529/ TRIC-I-HF trial TRIC-I-HF Trial https://www.nejm.org/doi/full/10.1056/NEJMoa2606934 Growth of Tricuspid Interventions in Germany https://www.jacc.org/doi/10.1016/j.jcin.2025.05.030 II Treatment of Acute Intermediate-High Risk PE – the PRAGUE-26 Trial PRAGUE-26 Trial https://www.nejm.org/doi/full/10.1056/NEJMoa2608012 III Targeting CS leads in CRT devices – DANISH-CRT Trial DANISH-CRT Trial 10.1016/S0140-6736(26)01597-7 IV Exercise for AF, Especially When There Is LA Disease Physical Activity and Risk of Incident AF in Atrial Cardiomyopathy https://www.jacc.org/doi/10.1016/j.jacadv.2026.102999 V Paradoxical Low-Flow, Low-Gradient AS – REBOOT-PARADOX REBOOT-PARADOX trial 10.1016/j.jacc.2026.08.017 ROTAS Trial https://heart.bmj.com/content/110/20/1223 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] Hosted by Simplecast, an AdsWizz company. See pcm.adswizz.com for information about our collection and use of personal data for advertising.

Another ESC recap, listener feedback on two trials, and a paper on GLP-1 effects on inflammation from the SELECT trial 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 Correction on PROFID Trial II Listener Feedback III Fifth Universal Definition of MI Fifth Universal Definition of MI https://doi.org/10.1093/eurheartj/ehag101 Foy/Mandrola Editorial on Troponin Use and Interpretation https://jamanetwork.com/journals/jamainternalmedicine/fullarticle/2777967 IV New ESC HF Guidelines ESC Guidelines for Management of HF https://doi.org/10.1093/eurheartj/ehag100 Sanjay Kaul on X https://x.com/kaulcsmc/status/2094959683215958158?s=20 Geographic Disparities in TOPCAT https://pmc.ncbi.nlm.nih.gov/articles/PMC5065247/ V AIR STEMI Trial AIR-STEMI Trial https://www.nejm.org/doi/full/10.1056/NEJMoa2605373 CR Strategies After MI https://www.jacc.org/doi/10.1016/j.jacc.2024.04.051 PRAMI Trial https://www.nejm.org/doi/full/10.1056/NEJMoa1305520 COMPLETE Trial https://www.nejm.org/doi/full/10.1056/NEJMoa1907775 FULL REVASC Trial https://www.nejm.org/doi/full/10.1056/NEJMoa2314149 VI GLP-1 News – A SELECT Trial Secondary Analysis Semaglutide and hsCRP in Patients with CVD and Obesity https://www.ahajournals.org/doi/10.1161/CIRCULATIONAHA.125.074482 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] Hosted by Simplecast, an AdsWizz company. See pcm.adswizz.com for information about our collection and use of personal data for advertising.

A second ESC recap plus two breaking stories on the failure of an investigational Lp(a) reducing drug and a new FDA approval of an AI-ECG app are covered by John Mandrola, MD This podcast is intended for healthcare professionals only. To read a partial transcript or to comment, visit: https://www.medscape.com/twic I Lp(a) Disappointment HORIZON https://clinicaltrials.gov/study/NCT04023552 Press Release https://www.novartis.com/news/media-releases/novartis-announces-lpahorizon-phase-iii-topline-results-pelacarsen-patients-elevated-lpa-and-established-cardiovascular-disease-cvd Rationale paper https://doi.org/10.1016/j.ahj.2025.03.019 II FDA Clears AI-ECG for Acute MI Detection Accuracy of cath lab activation decisions for STEMI-equivalent and mimic ECGs: Physicians vs. AI (Queen of Hearts by PMcardio) 10.1016/j.ajem.2025.07.061 AI-Enabled ECG Analysis Improves Diagnostic Accuracy and Reduces False STEMI Activations: A Multicenter U.S. Registry https://www.jacc.org/doi/10.1016/j.jcin.2025.10.018 Queen of Hearts™ AI ECG App https://www.powerfulmedical.com/pmcardio-stemi/ III TARGET CTCA Trial Targeted Use of Computed Tomographic Coronary Angiography in Acute Chest Pain https://www.nejm.org/doi/10.1056/NEJMoa2608903 IV CorCal trial Press release https://www.escardio.org/news/press/press-releases/new-data-presented-on-the-use-of-coronary-artery-calcium-for-cardiovascular-risk-assessment/ CorCal Outcomes: A randomized trial using the pooled cohort equation or coronary artery calcium to select statin therapy in primary prevention patients. Study design and baseline characteristics https://doi.org/10.1016/j.ahj.2026.107473 V AMUNDSEN Trial LDL Cholesterol Lowering With Evolocumab Before Percutaneous Coronary Intervention for Acute Myocardial InfarctionThe AMUNDSEN Randomized Clinical Trial https://jamanetwork.com/journals/jama/fullarticle/2853274 VI TRIC-I-HF trial Tricuspid Repair Cuts Death, HF Hospitalization in Severe TR https://www.medscape.com/viewarticle/tricuspid-repair-cuts-death-hf-hospitalization-severe-tr-2026a1000wvk Tricuspid-Valve Intervention in Heart Failure https://www.nejm.org/doi/full/10.1056/NEJMoa2606934 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] Hosted by Simplecast, an AdsWizz company. See pcm.adswizz.com for information about our collection and use of personal data for advertising.

ESC recaps on the SINGLE-AF trial, CMR Guide trial, two ATTR studies, PVI-SHAM-AF, STAREE, and an observational study of ICD benefit over the past decades 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 SINGLE-AF Trial To Anticoagulate or Not in Intermediate-Risk AF: The SINGLE-AF Trial https://www.medscape.com/viewarticle/anticoagulate-or-not-intermediate-risk-af-single-af-trial-2026a1000uko SINGLE-AF https://www.nejm.org/doi/10.1056/NEJMoa2607978 II Scar as an ICD risk stratifier Is Scar on CMR an Indication for ICD? CMR Guide Leaves Doubts https://www.medscape.com/viewarticle/scar-cmr-indication-icd-cmr-guide-leaves-doubts-2026a1000ukq CMTR GUIDE Trial https://jamanetwork.com/journals/jama/fullarticle/2853395 MADIT II Trial https://www.nejm.org/doi/full/10.1056/NEJMoa013474 III Single vs Dual Therapy in ATTR-CM HELIOS-B Trial Sub-analysis https://www.sciencedirect.com/science/article/pii/S0735109726072086 HELIOS-B Sub-analysis Editorial https://www.sciencedirect.com/science/article/pii/S0735109726073766#bib8 HELIOS-B main trial https://www.nejm.org/doi/10.1056/NEJMoa2409134 CARDIO-TTRansform Trial https://www.nejm.org/doi/full/10.1056/NEJMoa2608510 IV A Stunning Result of another Sham-controlled AF ablation trial Does AF Ablation Work? That's in Question After PVI-SHAM-AF https://www.medscape.com/viewarticle/does-af-ablation-work-s-question-after-sham-pvi-af-2026a1000uli PVI-SHAM-AF Trial 10.1016/S0140-6736(26)01558-8 External Link SHAM-PVI Trial https://jamanetwork.com/journals/jama/fullarticle/2823283 PFA-Sham Trial https://www.ahajournals.org/doi/10.1161/CIRCULATIONAHA.126.079484 V Should Older Adults Take Statins: The STAREE trial. STAREE Strengthens Case for Over-the-Counter Statins https://www.medscape.com/viewarticle/staree-strengthens-case-over-counter-statins-2026a1000vrw STAREE Trial https://www.nejm.org/doi/full/10.1056/NEJMoa2607314 VII Declining ICD Benefit After MI Mortality Reduction with ICD for Prevention of SCD Post-MI https://academic.oup.com/eurheartj/advance-article/doi/10.1093/eurheartj/ehag706/8768943 CONTEMP-ICD Trial https://clinicaltrials.gov/study/NCT06543446 PROFID-EHRA Trial https://profid-project.eu/profid-ehra-trial/ 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] Hosted by Simplecast, an AdsWizz company. See pcm.adswizz.com for information about our collection and use of personal data for advertising.