Dec 12 2025 This Week in Cardiology
This Week in Cardiology
Medscape Podcasts
4.9 • 963 Ratings
🗓️ 12 December 2025
⏱️ 28 minutes
🧾️ Download transcript
Summary
An elegant study in post-TAVI atrioventricular block, a PSA for my structural colleagues, revascularization in women, and a CTO PCI 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 AV Block After TAVR
Heart Blocks During vs After TAVR Show Distinct Patterns
https://www.medscape.com/viewarticle/heart-blocks-during-vs-after-tavr-show-distinct-patterns-2025a1000ypp
- Mechanisms Underlying Alterations in Cardiac Conduction After TAVR https://jamanetwork.com/journals/jamacardiology/fullarticle/2842748
II Related PSA Announcement to My Structural Colleagues
III Revascularization Strategies in Women with Severe Chronic CAD
Women With Chronic Severe CAD Fare Better With CABG vs PCI
https://www.medscape.com/viewarticle/women-chronic-severe-cad-fare-better-cabg-vs-pci-2025a1000ygd
- PCI vs CABG in Women With Chronic CAD https://doi.org/10.1093/eurheartj/ehaf806
- PCI vs CABG - Meta-Analysis of 4 RCTs https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(21)02334-5/abstract
- CABG vs Drug-Eluting Stent Implantation for CAD - Meta-Analysis https://www.jacc.org/doi/10.1016/j.jcin.2016.10.008
- RECHARGE trial https://therechargetrial.com/
IV A CTO PCI RCT – But don't get your hopes up
- Early vs Late-Staged PCI After Subintimal Tracking and Re-entry for CTO https://doi.org/10.1016/j.jacc.2025.09.1598
- DECISION CTO trial https://pubmed.ncbi.nlm.nih.gov/30813758/
- National Inpatient Sample Database PCI CTO Associated With Higher Mortality https://pubmed.ncbi.nlm.nih.gov/37356643/
V Mandrola's Top 10 Stories
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Transcript
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| 0:00.0 | You're listening to This Week in Cardiology from the heart.org, Medscape Cardiology. |
| 0:05.4 | This podcast is intended for healthcare professionals only. |
| 0:08.5 | Any views expressed are the presenters own and do not necessarily reflect the views of WebMD or Medscape. |
| 0:14.0 | Hi everyone, this is John Mandrola from the Heart.org Medscape Cardiology, and this is this week in cardiology for December 12th, |
| 0:23.7 | 2025. This week, an elegant study in post-Tavvy AV block, a public service announcement for my |
| 0:33.9 | structural heart colleagues, revascularization in females with severe coronary disease, a CTO PCI trial, and a top 10 review. |
| 0:47.0 | All right, I want to start with a very elegant study on heartblock during and after Tavi and how it shows distinct patterns. |
| 0:57.0 | This group at the Beth Israel Deaconess Medical Center in Boston have published a remarkable |
| 1:01.5 | study from their hospital regarding the mystery of AV Block after Tavar. |
| 1:07.3 | Now before I tell you about this classical study of EP mechanisms, what else would you expect |
| 1:12.9 | from the institution of the late Mark Josephson, I should set out the problem of AV Block after |
| 1:18.4 | Tavi. |
| 1:19.8 | The problem is one of anatomy, namely the conduction system sits in close proximity to the landing |
| 1:25.0 | area of the transcatheter aortic valve implant. |
| 1:28.9 | Simply stated, if you squish important parts of the conduction system, you can impede |
| 1:34.2 | AV conduction, think of scissors in an electric cord. Now, the other main issue with AV block |
| 1:40.1 | is one of extremes. No one wants to have a perfectly good aortic valve implant with cure of the aortic |
| 1:47.3 | stenosis to result in a late death from delayed AV block. Now there's no mystery when AV block occurs and |
| 1:54.1 | persist after the procedure. This patient needs pacing simply because there are not enough heartbeats. |
| 2:00.0 | It's easy. |
| 2:13.6 | The main issues arise because transient AV block can occur during the procedure, or PR prolongation can occur post-procure, or bundle-branch block can occur post-procedure. |
| 2:18.9 | All of these findings indicate some degree of injury to the conduction system, |
... |
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