Trials and Fibrillations with Dr John Mandrola

 
 
  • ESC 2020 EAST-AFNET 4 Favors Rhythm Control, but It's Complicated Electrophysiologist John Mandrola, MD, cautions against oversimplifying the results of EAST-AFNET 4 to mean use more anti-arrhythmic drugs or do more ablation.
  • ESC 2020 Digoxin Stuns in RATE-AF Trial A drug with a bad rap in the U.S. outperforms usual practice in patients with permanent AF. Are the results convincing enough to persuade a slow-medicine practitioner like John Mandrola, MD?
  • ESC 2020 Mandrola Previews the Virtual ESC 2020 Trials on SGLT2 inhibitors, rhythm control in AF, and a few drugs he’s never heard of are among John Mandrola’s picks from the upcoming European Society of Cardiology Congress.
  • LAAO vs DOAC: PRAGUE-17 Falls Short A comparison of left atrial appendage closure and direct oral anticoagulants for stroke prevention in atrial fibrillation exposes the holes in noninferiority trial design, writes John Mandrola, MD.
  • Let's Not Move at a Rapid Clip to Repair the Forgotten Valve Before we expand percutaneous repair of the forgotten valve with the CE-marked TriClip or off-label use of MitraClip, don't forget about the randomized trial, cautions John Mandrola, MD.
  • Some Data May Be Worse Than No Data in the COVID Era Over-reaching conclusions from an observational study of anticoagulation in COVID-19 can do more harm than good in our pursuit for scientific truth, argues John Mandrola, MD.
  • ACC 2020 What If There Is a Virtual ACC and Nobody Cares? It seems tone-deaf to discuss science-that-can-wait while colleagues across the world fight this challenge, writes John Mandrola, MD, of the upcoming virtual American College of Cardiology Scientific Sessions.
  • Mandrola's Top 10 Cardiology Stories of 2019 It's probably no surprise that ISCHEMIA and the EXCEL controversy make John Mandrola's annual list for 2019. He also found good news in heart failure and has words of caution for TAVR expansion.
  • AHA 2019 Signal of Harm From Impella Has an Easy Answer Two independent observational studies find worse outcomes with the Impella device compared with intra-aortic balloon pump. The time for a randomized controlled trial is now, says John Mandrola, MD.
  • AHA 2019 The ISCHEMIA Trial -- Cardiology Changes Today The AHA late-breaking trial comparing an invasive vs medical strategy for patients with stable ischemic disease validates Nobel prize-winning medical conservative Bernard Lown, writes John Mandrola, MD.
  • Mandrola Previews 2019 AHA and the ISCHEMIA Trial All eyes will be on ISCHEMIA in Philadelphia, but a study on asymptomatic aortic stenosis as well as trials in heart failure and cardiogenic shock also piqued Dr John Mandrola's interest.
  • PCI vs CABG in Left Main Disease -- The Surgeons Are Right A claim of equivalence for stents vs surgery in patients with left main coronary artery disease was called into question at EACTS. John Mandrola, MD, takes a closer look at the EXCEL trial controversy.
  • Atrial Fibrillation Ablation: Two Concerning Trends A trend toward more AF ablation and more aggressive procedures in the US concerns this electrophysiologist.
  • ESC 2019 Will DAPA-HF Turn the Tide on Heart Failure? The term gamechanger is overused but may be appropriate for the DAPA-HF trial on the SGLT2 inhibitor dapagliflozin in patients with heart failure and reduced ejection fraction. Medical conservative John Mandrola, MD, was impressed.
  • ESC 2019 When Guideline Authors Dismiss Important Studies Why does a guideline document on chronic coronary disease exclude the landmark ORBITA trial? Perhaps it's an existential tension, suggests John Mandrola, MD.
  • ESC 2019 PARAGON-HF: Heart Failure With Preserved EF Proves a Tough Foe Given the few effective therapies for HFpEF, should a new expensive drug be adopted on the basis of a borderline clinical trial result? John Mandrola, MD, weighs in.
  • ESC 2019 Mandrola Previews ESC 2019 Read what John Mandrola, MD, is looking forward to in Paris. Despite some advance spoilers, there will be plenty to pique the interest of the average cardiologist.
  • In Defense of Digoxin -- No, It's Not a Killer Drug The much-maligned cardiac glycoside has been skewered by weak observational data, according to a clever analysis of the DIG trial.
  • Is Cardiology Overly Enamored of New Unproven Therapies? A review of many cases where study data reversed a common medical practice highlights the need to be slow to embrace unproven therapies and faster to de-adopt ineffective ones, says John Mandrola, MD.
  • Just Say No to the ICD in Patients With Kidney Disease Little evidence supports the use of ICDs in patients with kidney disease. A bold new study in patients on dialysis suggests that the devices should be avoided. John Mandrola, MD, weighs in.