Trials and Fibrillations with Dr John Mandrola

 
 

Trials and Fibrillations with Dr John Mandrola

  • TCT 2018 MitraClip for Secondary MR -- The Redux Two conflicting studies on the percutaneous treatment of secondary mitral regurgitation in patients with heart failure lead John Mandrola, MD, to compare and contrast as we await the tiebreaker third.
  • Beta-Blockade After MI: No Practice Should Be Set in Stone Meta-analyses suggest little benefit for beta-blockers in contemporary patients with normal ejection fraction after MI. What other dogma should be revisited in light of an evolving evidence base?
  • ESC 2018 Don't Ignore the Many Lessons of the MitraClip Failure Reflecting on the MITRA-FR trial, Dr John Mandrola says it can help us learn both specific lessons about the treatment of people with heart failure and more general lessons on the acceptance of untested therapeutics.
  • ESC 2018 Ten Things I Learned About Aspirin at ESC Two neutral trials inform an everyday clinical question: who should take aspirin for primary prevention of cardiovascular disease. John Mandrola spoke with both investigators; these are his takeaways.
  • ESC 2018 Five Reasons I Don't Believe an Imaging Test Improves Outcomes The SCOT-HEART presentation at ESC 2018 contends that CT angiography can lead to fewer events at 5 years in patients with stable chest pain. John Mandrola remains unconvinced.
  • Mandrola's ESC 2018 Preview From aspirin to VTE, John Mandrola reflects on the potpourri of relevant data for the practicing clinician at this year's European Society of Cardiology Congress.
  • Should Mandatory Screening of Young Athletes End? John Mandrola reviews the most comprehensive study to date on cardiac screening of teenage athletes and sees the futility of searching for a deadly needle in a haystack.
  • Atrial Fibrillation: What's New? Not Much An investigation of AF trials on ClinicalTrials.gov found few studies of high scientific rigor. John Mandrola, MD, ponders the implications for patient management.
  • HRS 2018 Potential Major Problem With a Common Pacing Lead A poster presentation at HRS on lead failure with a popular St Jude Medical lead echoed a case familiar to John Mandrola, MD. He wasn't the only concerned EP calling for further investigation.
  • HRS 2018 CABANA: Initial Thoughts on AF Ablation vs Drugs The long-awaited trial was the star of HRS. The neutral primary endpoint sent some electrophysiologists into despair and others into spin mode, but Dr Mandrola sees value in the incremental move of science.
  • The Case Against Thrombolytic Therapy in Stroke A New York Times article siding with neurologists in their debate with emergency medicine over the benefits of tPA in ischemic stroke prompted Dr Mandrola to take a closer look at the data.
  • Pharmacists and Barbers on the Cutting Edge of Medicine Dr Mandrola's hands-down favorite study from the 2018 American College of Cardiology meeting showed that a pharmacist-led intervention in black-owned barbershops cut hypertension in black men.
  • ACC 2018 Ten Quick Thoughts on ODYSSEY Despite a suggested mortality benefit for the PCSK9 inhibitor alirocumab, in high-risk ACS patients, a return to lipid targets may be the cost-effective lesson from this trial, argues Dr Mandrola.
  • ACC 2018 The VEST Trial Failed, and So Did the Press Release The first randomized trial on the wearable cardioverter defibrillator didn't meet its primary endpoint, yet the press release was overly positive.
  • Mandrola Previews 2018 ACC PCSK9 inhibitors, LifeVest, and his-bundle pacing are among Dr Mandrola's picks for what to look for at the 2018 American College of Cardiology Scientific Sessions.
  • Donald Trump Has Coronary Calcium: Is That Helpful to Know? A briefing on the President's health included the detail that he has a coronary artery calcium score of 133. Dr Mandrola questions whether Trump should have even had a calcium scan.
  • Nine Things to Remember About CASTLE-AF Ablation of atrial fibrillation in patients with heart failure lowered all-cause mortality in this trial, but Dr Mandrola urges electrophysiologists not to overextrapolate these impressive results.
  • Flawed Surgical Left Atrial Appendage Closure Study Oversold An observational study on surgical left atrial appendage closure prompts Dr Mandrola to bemoan the overreach of the authors and editorialist.
  • Mandrola's Top 10 Cardiology Stories of 2017 Controversy surrounding saturated fat and sham PCI make this year's list as well as a few medical reversals and the continuing opioid crisis. What topics would you add or omit?
  • Overdiagnosis Only a Matter of Time With ECG Watches An Apple Watch with an ECG reader may be fun for specific tasks, but it's fantasy to think it will improve health outcomes, according to this electrophysiologist.