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Hi everyone. This is John Mandrola from the Heart.org Medscape Cardiology, and this is this week in cardiology for March 13th,

2026. This week, some listener feedback, beta blocker use in non-obstructive hypertrophic cardiomyopathy,

a head-to-head, epixaband versus riveroxiban RCT, a observational study of Deltayazam versus Metoprolol when combined with

direct acting oral anticoagulants, and accuracy of smartwatches for atrial fibrillation.

First, some feedback. Dr. Daniel McIntyre writes to me from Sydney, Australia, about my coverage of the

Empatic trial, which tested guideline direct to medical therapy and patients who had heart failure

and advanced cancer. Not surprising was that medical therapy had no effect on a primary

hierarchical endpoint that I actually loved, and I want to repeat. This was a combination of,

one, days alive and able to wash oneself, two, ability to walk four meters, and three, a patient

reported global assessment of just well-being. I highlighted the study because you would not

believe how many very ill patients, not only with cancer,

but other conditions like dementia, COPD, nstadrenal disease, frailty, who, instead of prescriptions

for cheeseburgers and ice cream, get four drug therapy for heartfire. Dr. McIntyre read the study

carefully and noted that most patients in this study with heartfire

actually had Hep-Path, and only one of the selected medicines has the backing of an RCT, and that's

Epigliflosen. But I would note that Saccubitral Val-Sartan came close in Hepf. But McIntyre writes that this is important because in this

population, his approach has been to prioritize diureasis for symptom relief over RAS inhibition.

It was a shame to see, he said, no patients randomized to MRI or even ferocide.

He notes that only 40% of patients in both arms were on these

...