Chemical cardioversion in the ED, HF monitoring, weight loss in AF, and surgical LAA excision are the topics John Mandrola, MD, discusses in this week's podcast.

This podcast is intended for healthcare professionals only.

To read a partial transcript or to comment, visit:

https://www.medscape.com/twic

I Chemical Cardioversion of AF in the ED: The FLECA-ED Trial

• FLECA-ED Rationale paper https://pmc.ncbi.nlm.nih.gov/articles/PMC10299428/
• FLECA-ED ESC Slides https://esc365.escardio.org/presentation/321209
• Review on Flecainide Use Despite CAST https://doi.org/10.1016/j.hrthm.2025.08.034
• RACE 7 ACWAS Trial https://www.nejm.org/doi/full/10.1056/NEJMoa1900353

II Heart Failure Monitoring – The ALLEVIATE-HF Trial

• ALLEVIATE-HF Trial https://doi.org/10.1016/j.jacc.2026.03.075
• CHAMPION Trial https://doi.org/10.1016/S0140-6736(11)60101-3
• GUIDE HF Trial https://doi.org/10.1016/S0140-6736(21)01754-2
• ALLEVIATE-HF Editorial: Alerts Are Not Treatment https://doi.org/10.1016/j.jacc.2026.04.014

• Steve Stiles Medscape report on CHAMPION https://www.medscape.com/viewarticle/755189

III A Negative Weight Loss Study in AF

• LOSE-AF Trial https://jamanetwork.com/journals/jama/fullarticle/2849335

IV Surgical LAA Excision

• OPINION Trial https://doi.org/10.1093/eurheartj/ehaf674
• LAAOS 3 trial https://www.nejm.org/doi/full/10.1056/NEJMoa2101897

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A life-long treatment for high LDL, a VESALIUS subanalysis, tirzepatide beats semaglutide again, arrhythmia burden in cardiac amyloidosis, and a lipid guideline rebuttal are the topics John Mandrola, MD, discusses in this week's podcast.

This podcast is intended for healthcare professionals only. To read a partial transcript or to comment, visit:

https://www.medscape.com/twic

I Permanent Lipid Lowering therapy

• Verve 102 Therapy for FH https://www.nejm.org/doi/full/10.1056/NEJMoa2601283

II Vesalius Substudy on PCSK9i Use in Patients With Previous PCI

• VESALIUS Subgroup Analysis https://www.ahajournals.org/doi/10.1161/CIRCULATIONAHA.126.080616
• VESALIUS Study - NEJM https://www.nejm.org/doi/full/10.1056/NEJMoa2514428

III Tirzepatide looking to be best again

• SURPASS-EARLY Trial https://www.acpjournals.org/doi/10.7326/ANNALS-25-05602
• SURMOUNT-5 Trial https://www.nejm.org/doi/abs/10.1056/NEJMoa2416394

IV Arrhythmias in Cardiac Amyloidosis

Loop Recorders Reveal Arrhythmias in Cardiac Amyloidosis https://www.medscape.com/viewarticle/loop-recorders-reveal-arrhythmias-cardiac-amyloidosis-2026a1000gq9

• EXCALIBUR Study https://www.jacc.org/doi/10.1016/j.jacc.2026.04.030

V Lipid Guidelines

· In Defense of the 2026 Dyslipidemia Guideline https://www.medscape.com/viewarticle/defense-2026-dyslipidemia-guideline-2026a1000hd0

• Lipid Guidelines: Four Major Concerns https://www.medscape.com/viewarticle/lipid-guidelines-four-major-concerns-2026a1000fim

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The Bob Harrington Show with the Stephen and Suzanne Weiss Dean of Weill Cornell Medicine, Robert A. Harrington, MD. https://www.medscape.com/author/bob-harrington

Questions or feedback, please contact news@medscape.net

Three more digoxin trials, yet another GLP-1 drug on the horizon, vagal nerve stimulation, trial inside baseball, and more on lipid guidelines are the topics John Mandrola, MD, discusses in this week's podcast.

This podcast is intended for healthcare professionals only.

To read a partial transcript or to comment, visit:

https://www.medscape.com/twic

I More About Low-dose Digoxin in HF — The DECISION Trial(s)

• DECISION Trial https://www.nature.com/articles/s41591-026-04406-6
• Digitalis Glycosides in HF — JAMA Meta-Analysis https://jamanetwork.com/journals/jama/fullarticle/2848972
• DIGIT-HF Trial https://www.nejm.org/doi/10.1056/NEJMoa2415471
• RADIANCE Trial (1993) https://www.nejm.org/doi/full/10.1056/NEJM199307013290101
• DECISION Withdrawal Study https://doi.org/10.1093/eurheartj/ehag385
• Digoxin Discontinuation vs Continuation in Chronic HF https://doi.org/10.1016/j.amjcard.2007.02.099

II Yet another GLP-1 Drug Announced this Week

Lillly News Release on Retatrutide https://investor.lilly.com/news-releases/news-release-details/lillys-triple-agonist-retatrutide-delivered-powerful-weight-loss

III A Big Story in HF Science – Vagal Nerve Stimulation in HFrEF

• ANTHEM HFrEF trial https://doi.org/10.1016/j.jacc.2026.03.040
• Editorials

An Unfinished ANTHEM https://doi.org/10.1016/j.jacc.2026.04.033

When Trials Stop Prematurely https://doi.org/10.1016/j.jacc.2026.03.039

IV Lipid Guideline News

Lipid Guidelines: Four Major Concerns

https://www.medscape.com/viewarticle/lipid-guidelines-four-major-concerns-2026a1000fim

• Editorial: Time to Move Beyond the Statin Nocebo Effect https://www.jacc.org/doi/10.1016/j.jacc.2026.04.002
• Correspondence: SAMSON N-of-1 Trial of Statin, Placebo, or No Treatment https://www.nejm.org/doi/full/10.1056/NEJMc2031173

You may also like:

The Bob Harrington Show with the Stephen and Suzanne Weiss Dean of Weill Cornell Medicine, Robert A. Harrington, MD. https://www.medscape.com/author/bob-harrington

Questions or feedback, please contact news@medscape.net