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Pulsed Field Ablation Versus Sham to Treat Atrial Fibrillation: The PFA-SHAM Randomized Clinical Trial
PFA markedly outperforms sham for AF recurrence and QoL; confirms ablation benefit beyond placebo in symptomatic patients.
“It provides strong evidence of efficacy of the active treatment and evidence against it just being a placebo effect. And it treats both the doctor and the patient. It treats us by reducing the detected amount of atrial fibrillation that we see with, importantly, a loop recorder in all of these patients. And also it treats the patient because there was subjective improvement in the AFEQT score and the HADS score.”

Prescribe physical activity for cardiometabolic gains irrespective of weight loss; extends evidence for multimodal obesity management.

Scientific statement examines risk assessment for improving cardiovascular disease prevention strategies.

Angiotensin Receptor Neprilysin Inhibitor in Heart Failure with Preserved Ejection Fraction and Secondary Mitral Regurgitation: the PRAISE-MR Randomized Trial
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...”

May enhance CV endpoint consistency in oncology trials; leaves open effects on outcomes or regulatory decisions pending validation.

Supports women's heart centre implementation to reduce sex-based care gaps; extends consensus on specialized pathways and training.

Lifestyle-Induced Visceral Fat Loss as a Key Target for Durable Cardiometabolic Health: MRI-Assessed 5- and 10-Year Follow-Up After 2 Clinical Trials
Visceral fat loss may inform diabetes prevention targets; hypothesis-generating and requires randomized confirmation.
“Repeated participation in a lifestyle program for weight loss, even after a perceived 'failure,' may lead to significant health benefits over the years, especially in reducing dangerous abdominal fat.”

Low-Dose Rivaroxaban and Cardiovascular Events in Advanced Kidney Disease
Does not support low-dose rivaroxaban for cardiovascular prevention in advanced CKD; confirms lack of efficacy with increased major bleeding.
“TRACK sets the direction for the questions that must be asked next, particularly regarding which patients are most likely to benefit (e.g., those with established cardiovascular disease) and whether alternative oral anticoagulation strategies may prove more effective or safer in selected CKD popu...”

Finerenone Across Cardiovascular-Kidney-Metabolic Syndrome Stages
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.”

Precardioversion Heart Rhythm Monitoring Using Smartphone Photoplethysmography
Reduces same-day cancellations and resource waste in AF cardioversion; extends smartphone photoplethysmography evidence to preprocedural monitoring.
