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Hi, everyone.

This is John Mandrola from the heart.org medscape cardiology, and is this week in cardiology for january 23rd 2026 this week i'll discuss the value of procedural

volume for taver and mitral valve trans catheter edge to edge repair ventricular arrhythmia and older

athletes and the goldilocks time horizon for predicting and modifying

cardiovascular risk. The first thing to say is that Louisville, Kentucky, my home, faces a snow

apocalypse this weekend. They say it might be the biggest storm in the last 50 years to hit

this area. And of course, we live in the southern part of

the United States, and we are not used to snow here. So it could be interesting. The second thing to say

is I have two listener feedbacks today. Dr. Jan Kleberger from Zurich writes about my coverage

of the withdrawal AF trial last week, where patients

with a-fib-related left-intricular dysfunction were treated, and then the ejection fraction recovered,

and then these patients were subsequently randomized to medication withdrawal or medication

continuation. And withdrawal A.F was a really neat study because it had a

crossover. Kleberg writes that a nuance that he would like to emphasize is terminology and

underlying assumptions. He says that the concept of lone atrial fib remains controversial

is no longer supported by contemporary guidelines, largely because of the absence

of detected disease, often reflects incomplete phenotyping rather than a distinct clinical entity.

Closely related, he goes on, to say, the notion of a specific AF-mediated cardiomyopathy

is still hypothetical. While AF burden, TACCardia, and rhythm

...