May 02, 2025 This Week in Cardiology
This Week in Cardiology
Medscape Podcasts
4.9 • 876 Ratings
🗓️ 2 May 2025
⏱️ 30 minutes
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Summary
The FDA approval of TAVR for asymptomatic AS, digital health, subcutaneous vs transvenous ICD, and cryptogenic stroke in young adults are discussed by John Mandrola, MD.
This podcast is intended for healthcare professionals only.
To read a partial transcript or to comment, visit:
https://www.medscape.com/twic
I FDA announces approval for TAVR in pts with asymptomatic AS
- Edwards Press Release https://www.edwards.com/newsroom/news/2025-05-01-edwards-tavr-receives-fda-approval-for-patients-with-asymptomatic-severe-aortic-stenosis
- Transcatheter Aortic-Valve Replacement for Asymptomatic Severe Aortic Stenosis (EARLY TAVR) https://www.nejm.org/doi/full/10.1056/NEJMoa2405880
- EARLY TAVR: A Positive Trial That Fails to Inform Clinical Decisions https://www.medscape.com/viewarticle/early-tavr-positive-trial-fails-inform-clinical-decisions-2024a1000kec
- Asymptomatic Aortic Stenosis: 'Time to Act' or Not So Fast? https://www.medscape.com/viewarticle/asymptomatic-aortic-stenosis-time-act-or-not-so-fast-2025a10005o9
II PPG that Can Distinguish source of Tachycardia
- Machine-learning guided differentiation between photoplethysmography waveforms of supraventricular and ventricular origin https://doi.org/10.1016/j.cmpb.2025.108798
III PRAETORIAN -XL trial
- Device-related Complications in Transvenous Versus Subcutaneous Defibrillator Therapy During Long-term Follow-up: the PRAETORIAN-XL Trial https://www.ahajournals.org/doi/abs/10.1161/CIRCULATIONAHA.125.074576
- Subcutaneous or Transvenous Defibrillator Therapy (PRAETORIAN trial) https://www.nejm.org/doi/full/10.1056/NEJMoa1915932
- Subcutaneous or Transvenous Defibrillator Therapy Letter to Editor https://www.nejm.org/doi/full/10.1056/NEJMc2034917
- The PRAETORIAN Trial: Guarded Approach to Subcutaneous ICD Best https://www.medscape.com/viewarticle/937156
IV Stroke in Young People
- Burden of Modifiable Risk Factors in Young-Onset Cryptogenic Ischemic Stroke by High-Risk Patent Foramen Ovale https://www.ahajournals.org/doi/10.1161/STROKEAHA.124.049855
- Migraine: A Key Factor in Young Adults With Unexplained Stroke https://www.medscape.com/viewarticle/migraine-key-factor-young-adults-unexplained-stroke-2025a10009jj
- U.S. stroke rate declining in adults 75 and older, yet rising in adults 49 and younger ASA statement https://newsroom.heart.org/news/u-s-stroke-rate-declining-in-adults-75-and-older-yet-rising-in-adults-49-and-younger
- Increasing stroke in the young https://doi.org/10.1016/j.ajpc.2020.100085
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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. |
| 0:05.8 | This podcast is intended for health care professionals only. |
| 0:08.9 | Any views expressed are the presenters own and do not necessarily reflect the views of WebMD or Medscape. |
| 0:14.7 | Hi, everyone. |
| 0:16.1 | This is John Mandrola from the heart.org medscape cardiology. |
| 0:20.7 | And this is this week in cardiology for May 2nd, |
| 0:24.3 | 2025. This week, I'm talking FDA approves taver in patients with asymptomatic aortic stenosis, |
| 0:33.4 | a digital health topic, sub QICD versus transvenous ICD, and stroke in young adults. |
| 0:41.2 | Edwards' life sciences, the maker of Taver valves, announced that the FDA has given approval |
| 0:47.1 | for Taver in patients with asymptomatic aeronexidosis. |
| 0:52.1 | FDA has based disapproval on the early Taver trial, which I think is one of the most |
| 0:57.9 | biased studies I've reviewed in the last two years. Only the option trial outdoes early Taver for bias. |
| 1:05.5 | I worry that this FDA approval will lead to a serious increase in Taver procedures in patients who, A, could wait, |
| 1:12.1 | and B, might be better off with surgical aortic valve replacement. I will do a brief recap on |
| 1:18.1 | early Taver because it's instructive on how trials can be designed in such a biased way that they |
| 1:23.7 | guarantee a positive outcome. I wrote about this trial in November of 2024. |
| 1:29.8 | Early Taver compared two strategies in patients with severe but asymptomatic aortic stenosis. |
| 1:36.4 | Taver right away or clinical surveillance. Of course, the trial was unblinded. Patients knew their |
| 1:43.1 | treatment assignment, so patients in the control arm or clinical surveillance |
| 1:46.8 | arm knew they had severe valvular heart disease and did not get any treatment. |
| 1:53.1 | They had classic subtraction anxiety, like the medical treatment arm in fame too, which was PCI |
| 1:58.8 | versus medical treatment. |
... |
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