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This Week in Cardiology

Jan 09 2026 This Week in Cardiology

This Week in Cardiology

Medscape Podcasts

Science, Medicine, Health & Fitness

4.9 • 963 Ratings

🗓️ 9 January 2026

⏱️ 28 minutes

🔗️ Recording | iTunes | RSS

🧾️ Download transcript

Summary

The limits of knowing coronary artery disease anatomy, fish oil and AF risk, a new drug for PSVT, and maybe I was wrong about a drug for AF conversion (the RAFF4 trial). These 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 Prediction of CAD is hard — even if you have anatomy

  • CCTA in Prediction of First Coronary Events https://jamanetwork.com/journals/jama/fullarticle/2841255

II Fish Oil and AF (and as a bonus we learn again about analytic flexibility)

  • Are Fish Oils on the Hook for AF Risk?

https://www.medscape.com/viewarticle/995290

  • Omega-3 and Fish Oil Use With Risk of AF  https://www.ahajournals.org/doi/full/10.1161/JAHA.125.043031
  • Effect of Long-Term Marine Omega-3 Fatty Acids on the Risk of AF https://www.ahajournals.org/doi/10.1161/CIRCULATIONAHA.121.055654
  • RESPECT-EPA Trial https://www.ahajournals.org/doi/10.1161/CIRCULATIONAHA.123.065520
  • Association Between Omega-3 Fatty Acids and AF: Meta Analysis https://link.springer.com/article/10.1007/s10557-021-07204-z
  • Fish Oil Supplements and Risk of AF https://academic.oup.com/eurjpc/article/29/14/1911/6679610
  • Editorial: Fish Oil Supplements and AF Risk https://www.ahajournals.org/doi/10.1161/CIRCULATIONAHA.121.057464

III A New Drug for PSVT

  • FDA Approval https://www.fda.gov/drugs/news-events-human-drugs/fda-approves-drug-type-abnormally-fast-heart-rhythm
  • RAPID trial https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(23)00776-6/fulltext

IV AF Conversion with Vernakalant

  • RAFF4 Trial https://www.bmj.com/content/391/bmj-2025-085632.long
  • Editorial: Rapid Cardioversion for Acute AF https://www.bmj.com/content/391/bmj.r2264

VI A Quick Note on HFpEF

Med Op-Ed: Avalanche Survival, HFpEF Skepticism, and More

https://www.medscape.com/viewarticle/med-op-ed-avalanche-survival-hfpef-skepticism-and-more-2026a1000012

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 news@medscape.net

Transcript

Click on a timestamp to play from that location

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.

0:14.9

Hi, everyone.

0:16.0

This is John Mandrola from the heart.org medscape cardiology.

0:19.5

And this is this week in cardiology for January 9th 2026.

0:25.5

Today I'll talk about the limits of knowing your coronary artery anatomy, fish oil, and atrial fibrillation risk,

0:33.5

a new drug for PSVT, and maybe I was wrong about a drug for AFIB conversion, the RAF4 trial.

0:42.4

First, I say welcome back everybody. Happy New Year. I hope you had a nice holiday. It's warm and rainy here in Kentucky,

0:50.3

and as it goes in the winter here, we go from very warm days to bitter cold in a matter of hours.

0:56.4

This week was nice, but next week we have proper winter.

1:00.8

All right, first topic is the prediction of coronary disease is hard, even if you know the anatomy.

1:06.9

On the last podcast of 2025, I covered a single center study looking back at 465 patients who had had a first MI and the author sought out to determine how well risk scores would have predicted that event.

1:21.8

The main take home from their observations was that it was pretty hard.

1:26.7

Most patients who had had an MI came from

1:29.7

low-risk categories. The authors sort of called it the MI paradox, wherein these pulled cohort

1:36.8

equations or risk scores fall short. They wrote something like, even though low-risk individuals

1:43.2

have a small percentage chance of having an MI,

1:46.8

there are so many more people in the low-risk category that they contribute a large absolute number of heart attacks.

1:54.2

And as the authors note, that the large denominator of low-risk asymptomatic individuals means that even a small percentage of events in this group

2:02.9

results in a considerable absolute number of MIs. Now you would think that knowledge of corner

2:10.1

anatomy such as the number of diseased vessels or the presence of non-calcified plaque,

...

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