Trials and Fibrillations with Dr John Mandrola

 
 

Trials and Fibrillations with Dr John Mandrola

  • ACC 2019 Taking the Pulse of the Apple Heart Study What did we really learn from the study using a smart watch and phone app to identify atrial fibrillation? New ways to conduct research, but not much to advance practice, argues John Mandrola, MD.
  • ACC 2019 A Sobering Breakthrough in AF Care Frequent alcohol drinkers with atrial fibrillation benefitted from abstinence in a novel randomized trial, which prompts the question: Should temperance be prescribed before meds and procedures?
  • ACC 2019 Boom: TAVR Low-Risk Trials Usher in a New Era in Cardiology The results are impressive for transcatheter aortic valve replacement in low-surgical-risk patients, but longer-term data on durability will be crucial, notes John Mandrola, MD.
  • ACC 2019 Quick Thoughts on the Wrap-IT Trial An antibiotic-impregnated envelope casing for cardiac implantable devices may lower the risk for infection, but is it enough to justify the costs?
  • ACC 2019 Mandrola Previews the 2019 ACC Meeting The Apple Heart Study will hog the spotlight, but trials on TAVR in low-risk aortic stenosis are more likely to affect practice, says digital-health skeptic John Mandrola, MD. Links
  • Broken PROMISE: CTA for Suspected CAD in Patients With Diabetes A flawed post hoc analysis was critiqued on social media, but why didn't peer review catch the weaknesses, asks John Mandrola, MD.
  • Ten Thoughts on the 2019 AF Treatment Guidelines John Mandrola, MD, agrees with a lot of the updates in the new atrial fibrillation guidelines but worries that color-coded tables of recommendations oversimplify the nuances of clinical decision making.
  • Mandrola's Top 10 Cardiology Stories of 2018 From blood pressure management in the community to a study on potentially biased referees -- John Mandrola reviews his picks for the year's big stories in cardiology and medicine.
  • Treating the Individual, Not the 'Average' Patient Using SPRINT trial data, researchers calculated a score to allow clinicians to measure how close their patient matches the study participants. John Mandrola, MD, sees a means to individualize therapy.
  • AHA 2018 Think You're Immune From Bias? Think Again John Mandrola, MD, is intrigued by two studies at AHA that track the cognitive and financial biases that may influence what physicians do in practice and how they write and read research papers.
  • AHA 2018 ENCORE-VT: Noninvasive Ablation of VT Could Disrupt EP A small study suggests that ventricular arrhythmia may be treated without the need for catheters and anesthesia. John Mandrola, MD, is impressed with the findings and the investigators' lack of hyperbole.
  • AHA 2018 Pure Fish Oil Lowers CVD Risk Even If We Don’t Understand How REDUCE-IT found that high-dose purified omega-3 fish oil reduced CV events even if the drug didn’t work as expected. Evidence-based practice means we should embrace these results, says John Mandrola, MD.
  • Mandrola Previews AHA 2018 Among the highlights for the upcoming American Heart Association Scientific Sessions are studies on omega-3, inflammation, a potential EP breakthrough, and yoga. Not to mention new lipid guidelines.
  • Joint Commission Accreditation: Mission Not Accomplished If outcomes and patient experience are no better for hospitals accredited by the Joint Commission, this illustrates the need for evidence-based healthcare policy, says John Mandrola, MD.
  • TCT 2018 Clinician-Scientists: Impartiality Co-opted? Why do positive clinical trials draw applause while neutral studies are seen as disappointing? Shouldn't impartial scientists embrace all findings equally?
  • 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.