Trials and Fibrillations with Dr John Mandrola

 
 

Trials and Fibrillations with Dr John Mandrola

  • Five Thoughts on the Damar Hamlin Collapse The cardiac arrest of Buffalo Bills defensive back Damar Hamlin has led to speculation about commotio cordis and more, but one electrophysiologist sees an opportunity for education on CPR and AEDs.
  • Mandrola’s Top 10 Cardiology Stories of 2022 A few dogmas felled, wins for meds, an exemplary trial, and clinical trends good and bad are covered in John Mandrola’s annual wrap up of cardiology stories for 2022.
  • AHA 2022 STRONG HF: More Beats Less After Discharge for Heart Failure Rapid uptitration of meds after hospitalization for decompensated HF was associated with a reduction in death or hospitalizations. Can health systems do the intense early management, asks John Mandrola, MD.
  • AHA 2022 Is Iron Replacement in Heart Failure Worth the Trouble? The data from IRONMAN don't persuade this cardiologist that the additional burden outpatient iron infusions would place on patients with heart failure and low iron are worth it.
  • AHA 2022 HCTZ vs Chlorthalidone -- A Win for Practicing Doctors and Science In the Diuretic Comparison Project, hydrochlorothiazide held its own compared with chlorthalidone as first-line hypertension agent despite U.S. experts' preference for the latter -- a lesson for us all, writes John Mandrola, MD.
  • Mandrola's Top 5 Picks From AHA 2022 Previewed John Mandrola, MD, previews his top 5 presentations from the upcoming American Heart Association Scientific Sessions in Chicago. They cover diuretics, iron therapy, early ablation, and CRISPR gene editing.
  • TCT 2022 Neutral Trial, Positive Spin: PROTECTED TAVR The primary endpoint was negative for a trial of embolic protection during transcatheter aortic valve replacement, yet the paper's conclusion emphasized the potential benefit.
  • ESC 2022 Judicious CVD Screening May Work in Men: DANCAVAS Comprehensive cardiac screening in men over 65 years seemed to be of benefit but the Danish setting may be key, writes John Mandrola, MD. Would U.S. screeners be as conservative with their interventions?
  • ESC 2022 PCI Fails in Stable Disease Again: REVIVED-BCIS Yet another null finding for stenting in stable patients leads this cardiologist to wonder whether the next generation of cardiologists will end the sclerotic clogged-pipe frame of treating atherosclerosis.
  • ESC 2022 Do SGLT2 Inhibitors DELIVER in All Heart Failure? The investigators of the DELIVER trial and others suggest that all patients with heart failure get SGLT2 inhibitors, but this cardiologist sees differing effects depending on ejection fraction.
  • ESC 2022 CAPLA Challenges Expert Opinion on Ablation of Persistent AF A trial presented at the European Society of Cardiology teaches that less is more in ablation for persistent AF and reminds clinicians to demand data before adopting aggressive procedures
  • ESC 2022 Mandrola Previews His Top 5 Trials From ESC 2022 Dr John Mandrola gives some insight on his choices for important trials to look for at this weekend's European Society of Cardiology Congress in Barcelona
  • Medical Necessity vs Therapeutic Fashion How will the sharp eye of history view the procedures and tests we routinely do? Could better critical appraisal sort the medically necessary from those that will eventually fall out of fashion?
  • Why I've Changed My Mind About Shared Decision-Making Shared decision-making is too often an excuse for dubious care, leading this cardiologist to have a change of heart.
  • HRS 2022 Taking Cardiac Pacing From Boring to Super-Cool Ablation has hogged the electrophysiology spotlight recently, but three presentations at the 2022 Heart Rhythm Society meeting put cardiac pacing on the comeback trail.
  • ACC 2022 Sodium Restriction in Heart Failure: Another Dogma Felled If you still think that strict sodium limits are worthwhile in patients with heart failure, the onus is on you to prove it. They have enough to deal with, writes John Mandrola, MD.
  • ACC 2022 Percutaneous Left Atrial Appendage Occlusion: Promise vs Reality The selling point of percutaneous left atrial appendage occlusion is to prevent stroke while avoiding the bleeding risk of antithrombotics. The data paint a different picture, writes John Mandrola, MD.
  • ACC 2022 Mavacamten in HCM: Reasons for Optimism and Caution The novel drug helped patients avoid septal reduction therapy in the short term and approval looks likely, but more details and longer-term safety data will be needed before broader use, writes John Mandrola, MD.
  • ACC 2022 Mandrola Previews ACC 2022 Studies on sodium restriction, fractional flow reserve, and strategies to improve patient and clinician behavior intrigue, but the best part of ACC22 is that it's largely in-person, writes John Mandrola, MD.
  • CardioMEMS Remote HF Monitoring: Resist the Spin and FOMO An expanded indication based on a dubious post hoc analysis of GUIDE-HF should not allow the CardioMEMS HF system to become the therapeutic fashion, writes John Mandrola, MD.