Feb 28 2025 This Week in Cardiology

This Week in Cardiology

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Cardiology, Science, Medicalpractice, Electrophysiologist, Medscape, Internalmedicine, Medicaldecisionmaking, Expertcommentary, Eartrhythmdisorder, Health, Perspective, Medicine, Healthnews, Medicalexpert, Endoflifecare, Clinicaltrials, Health & Fitness

4.9 • 876 Ratings

🗓️ 28 February 2025

⏱️ 31 minutes

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Summary

The treatment of asymptomatic aortic stenosis, the move to composite endpoints in trials, IFR vs FFR and high-frequency low tidal volume ventilation for AF ablation are the topics John Mandrola, MD, discusses 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 Aortic valve intervention for Asymptomatic AS

Lindman editorial https://jamanetwork.com/journals/jamacardiology/fullarticle/2829881
Trends https://pmc.ncbi.nlm.nih.gov/articles/PMC11308430/
Podcast EARLY TAVR Nov 8, 2024 This Week in Cardiology Podcast https://www.medscape.com/viewarticle/1001865
Faith Healing and Subtraction Anxiety https://www.ahajournals.org/doi/10.1161/circoutcomes.118.004665
Early TAVR trial https://www.nejm.org/doi/10.1056/NEJMoa2405880
EVOLVED https://jamanetwork.com/journals/jama/fullarticle/2825540
AVATAR https://www.ahajournals.org/doi/10.1161/CIRCULATIONAHA.121.057639

II Trial Endpoints

Shepshelovich https://jamanetwork.com/journals/jamainternalmedicine/fullarticle/2830023
Brown meta-analysis https://jamanetwork.com/journals/jamainternalmedicine/fullarticle/2785560

III IFR vs FFR—a debate b/w RCTs and observational data

5-year DEFINE https://jamanetwork.com/journals/jamacardiology/fullarticle/2824470
5-year SwedeHeart IFR https://doi.org/10.1016/j.jacc.2021.12.030
Eftekhari meta-analysis https://doi.org/10.1093/eurheartj/ehad582
Gotberg SWEDEHEART Registry https://doi.org/10.1016/j.jcin.2024.12.003
Editorial of SWEDEHEART-Registry https://doi.org/10.1016/j.jcin.2024.12.014

IV High-frequency low-tidal-volume ventilation for AF ablation

Osorio et al https://doi.org/10.1016/j.hrthm.2024.07.094

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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.
0:15.5	Hi, everyone.
0:16.8	This is John Mandrola from the Heart.org Medscape Cardiology, and this is this week in cardiology for February 28th, 2025.
0:26.6	This week, the debate over operating on asymptomatic patients with aortic stenosis, the move to composite endpoints in cardiac trials, IFR versus FFR, and high-frequency, low-tidal volume
0:41.1	ventilation for AF ablation.
0:44.0	First is the major topic of aortic valve intervention for patients with asymptomatic aortic
0:50.5	stenosis.
0:52.3	Gemalcarniology has published a widely circulated editorial this week from three liters in the field of aortic stenosis. Gemma cardiology is published a widely circulated editorial this week from three
0:56.2	leaders in the field of aortic stenosis therapy. The second author was Eugene Brunwald himself.
1:02.8	The title of their opinion piece was Aortic Val Replacement for Asymptomatic, Severe Aortic Stenosis.
1:09.0	The Time Has Come. Now, from that title, you can gather that they are advocating severe aortic stenosis, the time has come.
1:11.6	Now, from that title, you can gather that they are advocating for treating patients with
1:16.6	asymptomatic AS.
1:18.6	And this would be a big change because for my entire career, we have recommended AV interventions
1:24.6	when patients with severe AS become symptomatic.
1:28.3	The triad of symptoms of AS, as you know, include angina,
1:32.3	fainting, and heart failure symptoms like dysmium exertion.
1:36.3	The three Kupinian leaders' argument cited three RCTs,
1:41.3	comparing either surgical AVR or trans-c catheter aortic valve replacement taver or either
1:47.9	versus clinical surveillance. Now before I tell you why I disagree with their opinion on changing
	...

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