Feb 14 2025 This Week in Cardiology

This Week in Cardiology

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4.9 • 876 Ratings

🗓️ 14 February 2025

⏱️ 27 minutes

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Summary

Silent cerebral embolism after LAAC, AI in ECG rhythm analysis, anti-thrombotic strategies in patients with AF and CAD, and subclinical AF are the topics John Mandrola, MD, covers in today’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. Silent Cerebral Embolism after LAAC

JAHA Case Series https://www.ahajournals.org/doi/10.1161/JAHA.124.037968
JACC https://doi.org/10.1016/j.jacc.2018.12.039

II. AI Transforming Rhythm Monitor Reading

Johnson and colleagues RCT https://www.nature.com/articles/s41591-025-03516-x

III. Anticoagulation Alone or OAC plus antiplatelets in patients with CAD and AF

Rashedi and colleagues Meta-analysis https://doi.org/10.1016/j.jacc.2024.12.030
AQUATIC https://clinicaltrials.gov/study/NCT04217447

IV. DOAC for Subclinical AF – A Subgroup Analysis of ARTESIA

Anticoagulation Uncertainty in Embolic Stroke of Undetermined Source https://www.medscape.com/viewarticle/anticoagulation-uncertainty-embolic-stroke-undetermined-2024a1000h5e

Lancet Neurology Subgroup Analysis of ARTESIA 10.1016/S1474-4422(24)00475-7
ARTESIA https://www.nejm.org/doi/full/10.1056/NEJMoa2310234
NOAH https://www.nejm.org/doi/full/10.1056/NEJMoa2303062
RE-SPECT ESUS https://www.nejm.org/doi/full/10.1056/NEJMoa1813959
NAVIGATE ESUS https://www.nejm.org/doi/full/10.1056/NEJMoa1802686

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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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Transcript

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0:00.0	You're listening to This Week in Cardiology from the heart.org, Medscape Cardiology.
0:05.7	This podcast is intended for health care professionals only.
0:08.8	Any views expressed are the presenters own and do not necessarily reflect the views of WebMD or Medscape.
0:15.8	Hi, everyone.
0:17.1	This is John Mandrola from the Heart.org, Medscape Cardiology.
0:21.4	And this is this week in cardiology for February 14th, 2025.
0:27.2	This week, silent cerebral embolism after left atrial appendage closure,
0:33.1	artificial intelligence helping out an ECG rhythm analysis,
0:39.9	antithrombotic strategies in patients with AF and coronary disease, and more on the difficult decision of subclinical AFIB.
0:48.3	First topic is silent cerebral embolism after left atrial appendage closure.
0:53.6	The Journal of the American Heart Association
0:56.0	has published a case series of 75 patients who had left atrial appendage closure
1:01.0	and then had follow-up MRI scans as well as neurocognitive testing.
1:06.0	The study comes from a group in Nanjing, China.
1:10.0	Now this was a pretty simple study looking at pre-and-post MRI studies,
1:14.8	as well as neurocognitive testing within the first year after an implant in the left atrial appendage.
1:22.2	A cool aspect of the study is that patients had lots of MRIs at each post-procedure visit at 45 days,
1:29.3	three months, six months, and one year. Now, as background, I should say out that either all
1:34.9	or most left-sided, that is, arterial procedures, can leave these, quote, white spots on the
1:41.4	brain. The Chinese team calls them silent cerebral embolism.
1:47.4	Now, one interesting thing about the baseline characteristics of their series is that, unlike
1:51.5	in the U.S., the average age of the patients who had left atrial appendage closure in this study
	...

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