{"id":6721,"date":"2025-05-05T15:54:03","date_gmt":"2025-05-05T12:54:03","guid":{"rendered":"https:\/\/jordan-cardiac.org\/?p=6721"},"modified":"2025-05-05T15:57:45","modified_gmt":"2025-05-05T12:57:45","slug":"highlights-from-this-week-in-cardiology-april-25-may-2-2025","status":"publish","type":"post","link":"https:\/\/jordan-cardiac.org\/en\/highlights-from-this-week-in-cardiology-april-25-may-2-2025\/","title":{"rendered":"Highlights from \u201cThis Week in Cardiology\u201d \u2013 April 25 & May 2, 2025:"},"content":{"rendered":"

Highlights from \u201cThis Week in Cardiology\u201d \u2013 April 25 & May 2, 2025:
\nSource: This Week in Cardiology, Medscape podcast :<\/p>\n

1. AI and ECG Interpretation in the Emergency Department (ED)<\/p>\n

Source: European Heart Journal, ACC 2025 late-breaker
\nDate: April 25, 2025
\n\u2022 AI model trained on 200,000 ED ECGs showed excellent performance in diagnosing NSTEMI:
\n\u2022 AUROC = 0.91 (vs clinician ECG reading = 0.65; vs troponin = 0.71).
\n\u2022 Negative predictive value: 99.92%.
\n\u2022 External validation in Germany yielded AUROC of 0.81.
\n\u2022 AI is promising for early decision-making, but troponin still outperforms AI in some contexts.
\n\u2022 Open-source and explainable model.
\n\u2022 Mandrola\u2019s comment: AI won\u2019t replace clinicians\u2014history and patient interaction remain irreplaceable.<\/p>\n

2. AVIM Pacemaker Therapy for Hypertension<\/p>\n

Source: JAHA (2021), FDA Breakthrough Designation
\nDate: April 25, 2025
\n\u2022 FDA designated Orchestra BioMed\u2019s AVIM therapy as a Breakthrough Device.
\n\u2022 AVIM modulates autonomic tone via atrioventricular delay changes.
\n\u2022 Phase 2 trial showed BP reduction of 8 mmHg.
\n\u2022 Larger BACKBEAT trial underway.
\n\u2022 Mandrola\u2019s view: Promising but early; needs safety validation.<\/p>\n

3. Early Ezetimibe After MI \u2013 SWEDEHEART Observational Study<\/p>\n

Source: JACC
\nDate: April 25, 2025
\n\u2022 Compared early, late, and no ezetimibe post-MI in >35,000 patients.
\n\u2022 MACE: 1.8 (early) vs 2.8 (late) vs 4.0 (none) per 100 pt-yrs.
\n\u2022 Adjusted HR (no ezetimibe vs early): 1.29.
\n\u2022 NNT = 53 (early vs none).
\n\u2022 Comment: Marginal benefit; shared decision-making advised. Adherence remains key.<\/p>\n

4. Pulsed Field Ablation and Silent Strokes<\/p>\n

Source: Circulation: EP
\nDate: April 25, 2025
\n\u2022 Study of 16 patients showed significant difference in MRI-detected brain lesions:
\n\u2022 J&J PFA catheter: 85% incidence, avg 13 lesions.
\n\u2022 Medtronic catheter: 22%, avg 2 lesions.
\n\u2022 Concern: Potential cognitive impact; more comparative data needed.<\/p>\n

5. AF Ablation \u2013 Heart Rhythm Society White Paper<\/p>\n

Source: Heart Rhythm (pre-release)
\nDate: April 25, 2025
\n\u2022 Calls for creation of Centers of Excellence for AF Ablation with standards for:
\n\u2022 Procedural quality, multidisciplinary teams, QI, and transparency.
\n\u2022 Mandrola\u2019s take: Long overdue\u2014calls AF ablation the \u201cWild West\u201d in the US.<\/p>\n

6. Pacing Challenges in TTVR<\/p>\n

Source: Heart Rhythm
\nDate: April 25, 2025
\n\u2022 Study of 73 TTVR patients from Emory:
\n\u2022 21 had preexisting pacemakers; 14 had leads jailed.
\n\u2022 21% of jailed lead patients had complications; 1 fatal infection.
\n\u2022 Message: Multidisciplinary planning is essential before TTVR.<\/p>\n

7. FDA Approval of TAVR for Asymptomatic AS \u2013 EARLY TAVR Trial<\/p>\n

Source: FDA; NEJM; Podcast Review
\nDate: May 2, 2025
\n\u2022 TAVR approved for asymptomatic severe AS based on EARLY TAVR trial.
\n\u2022 Primary endpoint driven by unplanned hospitalization (21% vs 42%).
\n\u2022 No significant difference in death or stroke.
\n\u2022 Mandrola: Strong criticism\u2014trial bias, endpoint manipulation, absence of surgical arm.<\/p>\n

8. PPG to Identify Source of Tachycardia<\/p>\n

Source: Computer Methods and Programs in Biomedicine
\nDate: May 2, 2025
\n\u2022 ML study using wristband-derived PPG distinguished VT from SVT with high accuracy.
\n\u2022 Up to 97% accurate with patient-specific adaptation.
\n\u2022 Implication: Early proof of concept; potential for consumer-grade arrhythmia monitoring.<\/p>\n

9. PRAETORIAN-XL Trial \u2013 Subcutaneous ICD<\/p>\n

Source: HRS 2025; Circulation
\nDate: May 2, 2025
\n\u2022 Extended follow-up of original PRAETORIAN trial (8 years).
\n\u2022 No significant difference in overall complications.
\n\u2022 SICD had fewer lead-related issues but higher need for pacing switches.
\n\u2022 Mandrola: Critiques design flaws, endpoint selection bias, and SICD marketing influence.<\/p>\n

10. Cryptogenic Stroke in Young Adults and Migraine<\/p>\n

Source: Stroke (Journal)
\nDate: May 2, 2025
\n\u2022 Finnish case-control study (500 patients, median age 41):
\n\u2022 With PFO: nontraditional risk factors (esp. migraine with aura) dominate (PAR 50%).
\n\u2022 Without PFO: traditional risk factors dominate (PAR 65%).
\n\u2022 Insight: Need to evaluate migraines and non-traditional factors in young strokes.<\/p>\n

11. IMPLEMENT-HF Study \u2013 Improving GDMT(Guideline-Directed Medical Therapy )in HF:<\/div>\n
<\/div>\n
Source: ACC 2025<\/div>\n
Date: May 1, 2025<\/div>\n
\u2022 AHA-led multi-site initiative (2021\u20132023, 40,000+ patients).<\/span><\/div>\n
\u2022 Quadruple GDMT at discharge rose from 5% to 45%.<\/span><\/div>\n
\u2022 SGLT2 and MRA use >70%.<\/span><\/div>\n
\u2022 No sex\/race disparities.<\/span><\/div>\n
\u2022 Success factors: Dashboards, competition, model sharing.<\/span><\/div>\n
\u2022 Takeaway: System-based nudges and institutional culture drive real-world GDMT use.<\/span><\/div>\n","protected":false},"excerpt":{"rendered":"

Highlights from \u201cThis Week in Cardiology\u201d \u2013 April 25 & May 2, 2025: Source: This Week in Cardiology, Medscape podcast : 1. AI and ECG Interpretation in the Emergency Department (ED) Source: European Heart Journal, ACC 2025 late-breaker Date: April 25, 2025 \u2022 AI model trained on 200,000 ED ECGs showed excellent performance in diagnosing […]<\/p>\n","protected":false},"author":1,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[1],"tags":[],"class_list":["post-6721","post","type-post","status-publish","format-standard","hentry","category-uncategorized"],"_links":{"self":[{"href":"https:\/\/jordan-cardiac.org\/en\/wp-json\/wp\/v2\/posts\/6721","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/jordan-cardiac.org\/en\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/jordan-cardiac.org\/en\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/jordan-cardiac.org\/en\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/jordan-cardiac.org\/en\/wp-json\/wp\/v2\/comments?post=6721"}],"version-history":[{"count":2,"href":"https:\/\/jordan-cardiac.org\/en\/wp-json\/wp\/v2\/posts\/6721\/revisions"}],"predecessor-version":[{"id":6728,"href":"https:\/\/jordan-cardiac.org\/en\/wp-json\/wp\/v2\/posts\/6721\/revisions\/6728"}],"wp:attachment":[{"href":"https:\/\/jordan-cardiac.org\/en\/wp-json\/wp\/v2\/media?parent=6721"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/jordan-cardiac.org\/en\/wp-json\/wp\/v2\/categories?post=6721"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/jordan-cardiac.org\/en\/wp-json\/wp\/v2\/tags?post=6721"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}