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Any views expressed are the presenters own and do not necessarily reflect the views of WebMD or Medscape.

Hi, everyone.

This is John Mandrola from the Heart.org Medscape Cardiology, and this is this week in cardiology for July 11th,

2025. This week, some listener feedback on approval of first generation devices, more on the

ticagular controversy, ICD longevity matters, and Prague 25, one of the most important trials of the year

in atrial fibrillation, plus some thoughts on the end of EP as a profession.

I say, welcome back. The mandrolas had a fun holiday, one memory from our Independence Day.

I sat on the back of my pickup truck with the four and six-year-old grandchildren, watching my daughter risk her fingers lighting fireworks.

The boys tingled with delight with each of the mini blast. It brought pack memories. And yes,

as a proper Kentuckian, I now have a pickup truck. Okay, first is listener feedback

regarding the PE data that I discussed on the previous episode. Cattelin Toma, who is director

of Interventional Cardiology at the University of Pittsburgh Medical Center, writes regarding

what I talked about in the lack of data in the

invasive PE field. He writes, I have been involved with PE interventions from early on and could

not agree more that we need RCTs to understand the role of interventional PE therapies

in the high intermediate risk and massive PE groups. However, until a few years ago,

the whole field of interventional EP was completely new with virtually no expertise, launching

into an RCT with the early devices and with the lack of cumulative knowledge we now have

would have led to predictable negative results.

He says, good thing we didn't send astronauts to the moon and Apollo 1 or to Mars in the current

...