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1w ago
Expert CommentaryTop JournalCirculation Highlight
Level 2: RCT
Pulsed Field Ablation Versus Sham to Treat Atrial Fibrillation: The PFA-SHAM Randomized Clinical Trial
Pulsed field ablation cuts 6-month atrial tachyarrhythmia recurrence by ~92% versus sham.
Implication
PFA markedly outperforms sham for AF recurrence and QoL; confirms ablation benefit beyond placebo in symptomatic patients.
Circulation
Charles University
6w ago
Trending on XFeatured in PodcastTop JournalNEJM Highlight
Level 2: RCT
Pulsed Field Ablation as Initial Therapy for Persistent Atrial Fibrillation
Initial PFA cuts composite treatment failure ~54% vs. antiarrhythmic drugs in persistent AF.
Implication
Supports first-line PFA over AADs in persistent AF; challenges guidelines mandating drug trial first and extends paroxysmal AF evidence.
“These findings have implications for clinical practice, for guidelines, and for insurance coverage because “there’s a lot of people that are dissuading us from doing persistents because it’s lower yield,” Tung said.”
— TCTMDView source
New England Journal of Medicine
Johns Hopkins University
1w ago
Expert CommentaryTop JournalCirculation Highlight
Level 1: Clinical Guideline
Role of Physical Activity in Obesity Treatment and Cardiometabolic Health: A Scientific Statement From the American Heart Association
Implication
Prescribe physical activity for cardiometabolic gains irrespective of weight loss; extends evidence for multimodal obesity management.
Circulation
1w ago
Expert CommentaryTop JournalESC Press Release Highlight
Level 1: Clinical Guideline
Women's heart centres: a clinical consensus statement of the European Association of Cardiovascular Imaging (EACVI), the European Association of Percutaneous Cardiovascular Interventions (EAPCI), the Heart Failure Association (HFA), and the Association for Acute CardioVascular Care (ACVC) of the ESC
Implication
Supports women's heart centre implementation to reduce sex-based care gaps; extends consensus on specialized pathways and training.
European Heart Journal
Harvard University
4w ago
Trending on XExpert CommentaryTop JournalCirculation Highlight
Level 2: RCT
Angiotensin Receptor Neprilysin Inhibitor in Heart Failure with Preserved Ejection Fraction and Secondary Mitral Regurgitation: the PRAISE-MR Randomized Trial
Sacubitril/valsartan improves exercise mPAP/CO slope by ~0.93 mmHg/L/min versus SOC in HFpEF with AFMR.
Implication
Supports sacubitril/valsartan over SOC in HF with adverse exercise hemodynamics; extends prior ARNI trials to this invasive endpoint.
“The PRAISE-MR trial is the first prospectively randomized trial to demonstrate that sacubitril/valsartan significantly improves exercise hemodynamics, functional capacity, and quality of life in patients with HFpEF and AFMR. These findings underscore that the phenotypic heterogeneity of HFpEF nec...”
— ACC Journal ScanView source
Circulation
Vrije Universiteit Brussel
1w ago
Trending on XTop JournalACC Journal Scan Highlight
Level 1: Meta-Analysis
Adverse Effects and Treatment Discontinuation of Blood Pressure–Lowering Drugs and Combinations
CCBs increase adverse event discontinuations ~43% versus placebo while ARB monotherapy reduces them.
Implication
CCBs raise and ARBs lower adverse-event discontinuations versus placebo; extends class-specific tolerability data to inform initial antihypertensive selection.
“Results from the study by Wang, et al., can help inform clinicians' selection of antihypertensive therapies for patients initiating medications for hypertension, particularly when comorbidities, such as the presence of diabetes with microvascular disease, do not warrant a specific therapy.”
— ACC Journal ScanView source
JAMA
University of Oxford
6w agoOpen Access
Top JournalCirculation Highlight
Level 2: RCT
Subcutaneous Defibrillator Implantation With or Without Defibrillation Test: The Primary Results of the Randomized PRAETORIAN-DFT Trial
PRAETORIAN score-guided omission of defibrillation testing is non-inferior to routine testing for failed first shocks.
Implication
Supports PRAETORIAN-guided omission of routine DFT in S-ICD patients; confirms non-inferior efficacy and reduced procedural risk.
“The risk-benefit ratio of routinely performing DT seems to favor not doing routine testing.”
— Raul WeissView source
Circulation
University College London
5d ago
Top Journal
Level 1: Meta-Analysis
Finerenone Across Cardiovascular-Kidney-Metabolic Syndrome Stages
Finerenone reduced cardiovascular and kidney events across CKM stages and increased CKM syndrome regression (11.4% vs 7.4%; aOR 1.66; 95% CI 1.30-2.13; P<.001) compared with placebo.
Implication
Supports finerenone across CKM stages in T2D-CKD; extends prior RCTs to include syndrome regression.
“Importantly, participants who experience new-onset AFib/AFL were at a substantially higher subsequent risk of adverse cardiovascular and kidney outcomes than were those who remained free of AFib/AFL during follow-up. These findings highlight the role of finerenone in reducing the risk of new-onset AFib/AFL, mitigating downstream complications, and ultimately improving outcomes in patients across the CKM spectrum.”
— Dr. Maria A. PabonView source
JAMA Cardiology
University of Michigan
4w ago
Expert CommentaryTop JournalACC Journal Scan Highlight
Level 3: Cohort Study
Predictors of Long-Term Outcomes in Hypertrophic Cardiomyopathy
CMR LGE% predicts ~86% higher adverse event risk in HCM, alongside NT-proBNP.
Implication
LV scar burden by LGE may refine HCM risk stratification; this observational link extends prior markers but leaves open prospective validation before guiding therapy.
“This is an important next step to do a better job of identifying HCM patients at high risk," he said. "This adds to presently used risk markers derived from the patient's and their family's prior history.”
— ACC Journal ScanView source
JAMA
University of Michigan
4w agoOpen Access
Featured in PodcastTop JournalACC Journal Scan Highlight
Level 2: RCT
Blinded withdrawal of randomized treatment with low-dose digoxin or placebo in patients with heart failure: the DECISION trial
Withdrawing low-dose digoxin increases CV death or worsening HF events ~637% vs placebo.
Implication
Caution against digoxin withdrawal in stable HF; confirms ongoing benefit of continued therapy.
“Discontinuation of long-term low-dose digoxin is associated with clinical deterioration of patients with chronic [HF] and a [LVEF] <50%. These findings warrant caution when stopping low-dose digoxin.”
— ACC Journal ScanView source
European Heart Journal
University of Amsterdam
