Trials and Fibrillations with Dr John Mandrola

ACC 2025 Little Learned From Trials That Are Positive by Design Dapagliflozin after TAVI? Semaglutide for claudication? Two trials designed to be positive should not warrant new indications for these drugs writes John Mandrola, MD.
Commentary, April 10, 2025
ACC 2025 Mandrola’s 5 Picks for ACC 25 Trials on cerebral protection in TAVR, fluid restriction in heart failure, and risk factor management in AF are among John Mandrola’s picks from the upcoming ACC Scientific Sessions.
Commentary, March 25, 2025
Are We Inflating the Success Rate of AF Ablation? Not counting recurrent arrhythmias that occur during the 3-month blanking period after ablation for atrial fibrillation is fudging the numbers, writes electrophysiologist John Mandrola, MD.
Commentary, February 26, 2025
Do We Really Know the Stroke Risk From AF? There is growing evidence that the risk for stroke in patients with untreated AF is declining, changing the risk-benefit calculus for anticoagulation.
Commentary, February 04, 2025
Mandrola’s Top 10 Stories in 2024 Cardiologist John Mandrola reviews his top 10 stories in 2024 covering beta-blockers, GLP-1s, finerenone, Impella, pulsed field ablation, tricuspid intervention, and a potential renaming of STEMI.
Commentary, December 11, 2024
AHA 2024 Has Tirzepatide Scaled the HFpEF/Obesity SUMMIT? The GIP/GLP-1 receptor agonist reduced events in patients with HFpEF and obesity. John Mandrola questions whether it changed the disease trajectory, as the investigators claim.
Commentary, December 03, 2024
AHA 2024 4 Reasons to Question Percutaneous LAAC After AF Ablation The OPTION trial of Watchman after ablation for AF vs anticoagulation was positive. John Mandrola questions the conclusions and fears the rise in percutaneous left atrial appendage closure procedures.
Commentary, November 18, 2024
AHA 2024 The Most Worrisome Study at AHA 2024 A trial on percutaneous left atrial appendage closure combined with AF ablation vs ablation and DOACs raises concerns about a potential wave of overuse of a new combo procedure.
Commentary, November 12, 2024
TCT 2024 A Positive Trial That Fails to Inform Clinical Decisions A trial suggests that patients with asymptomatic severe aortic stenosis should undergo early transcatheter aortic valve implantation, but John Mandrola, MD, sees flaws in the study design.
Commentary, November 08, 2024
ESC 2024 AF Ablation Works…But: SHAM PVI The first sham-controlled trial of atrial fibrillation ablation with pulmonary vein isolation shows a placebo-resistant benefit, but questions remain about how it works, writes John Mandrola, MD.
Commentary, September 18, 2024
ESC 2024 Old, Frail Patients: Study More, Intervene Less? A trial of an early invasive vs conservative approach to older patients with NSTEMI brings welcome news to John Mandrola, MD.
Commentary, September 05, 2024
ESC 2024 TEER in Functional MR: Data Deluge, but No Easy Answers A third trial of transcatheter edge-to-edge repair in patients with functional mitral regurgitation doesn't make for easy patient selection writes John Mandrola, MD.
Commentary, September 01, 2024
ESC 2024 Beta-Blockers Post-MI? No for Me, Even After ABYSS The need for routine beta-blockers post-MI in contemporary practice has been questioned, but a randomized trial of stopping vs continuing suggested they still have a role. Dr John Mandrola disagrees.
Commentary, August 31, 2024
ESC 2024 Five Trials to Look For at ESC 2024 A sham trial of AF ablation, finerenone in heart failure, and transcatheter edge-to-edge repair of functional mitral regurgitation are among the trials that caught cardiologist John Mandrola's eye.
Commentary, August 26, 2024
Did Statin Decision-Making Just Get Harder? The new PREVENT risk calculator could mean far fewer US adults meet the thresholds for statins. But this cardiologist doesn't think population risk is that helpful for individual decision-making.
Commentary, August 08, 2024
Are US Electrophysiologists Too Easily Impressed? Electrophysiologists adopt new things a little too enthusiastically, writes John Mandrola, MD, of a new technique to treat atrial fibrillation.
Commentary, July 17, 2024
Is Red Meat Healthy? Multiverse Analysis Has Lessons Beyond Meat Is red meat bad for you? A multiverse analysis shows that the answer varies by analytic method. The takeaway beyond meat is that this approach should be used for most observational research.
Commentary, May 09, 2024
EMPACT-MI: Another SGLT2 Inhibitor Miss Post-MI Empagliflozin added to standard care did not improve outcomes in post-MI patients at risk for heart failure. John Mandrola, MD, sees the diminishing returns for add-on drugs as positive for patients.
Experts And Viewpoints, April 12, 2024
ACC 2024 Preventive Coronary Stents: Not There Yet The PREVENT trial on stenting stable plaques deemed vulnerable by imaging criteria suggests a benefit over medical therapy alone. John Mandrola, MD, finds it provocative but not yet ready to act on.
Commentary, April 11, 2024
ACC 2024 Beta-Blockers Post-MI Past Their Expiration Date: REDUCE-AMI REDUCE-AMI showed no benefit for routine beta-blockers post–MI in patients with normal ejection fraction. John Mandrola, MD, asks: Does evidence-based medicine need expiration dates?
Experts And Viewpoints, April 08, 2024

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