Time to quadruple therapy, the disappointing AVANT GUARD trial, PFA risks, the TREAT-PVC trial, and NSTEMI care in the frail elderly 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 Time to Quadruple Therapy in HFrEF

• Time to Quadruple Therapy After Diagnosis of HFrEF https://jamanetwork.com/journals/jamacardiology/fullarticle/2846899

II AVANT GUARD

PFA Bests Meds as First-Line Treatment for Persistent AF in Randomized Trial https://www.medscape.com/viewarticle/pulsed-field-ablation-bests-meds-first-line-treatment-2026a1000dsm

Pulsed Field Ablation of AF Disappoints in Setup for Success: AVANT GUARD https://www.medscape.com/viewarticle/pulsed-field-ablation-af-disappoints-setup-success-avant-2026a1000ddt

• AVANT GUARD Trial https://www.nejm.org/doi/full/10.1056/NEJMoa2600929
• Persistent AF: Meta-analysis of Invasive Strategies 10.1016/j.ijcard.2018.11.127 External Link

III Speaking of Scary News on PFA – The TIFFANY Study

• Abstract - The TIFFANY Study https://www.heartrhythmjournal.com/article/S1547-5271(26)01747-9/fulltext

• Delayed Myocardial Ischemia and Malignant Arrhythmias After PFA https://www.ahajournals.org/doi/10.1161/CIRCULATIONAHA.125.077983
• Alberto Alfie Comment https://x.com/ALFIEEP1/status/2050029151315189774?s=20

IV TREAT PVC Trial

• TREAT-PVC Trial https://doi.org/10.1016/j.jacep.2026.01.011
• TREAT-AF Study 2020 https://doi.org/10.1016/j.jacep.2019.11.008

V NSTEMI In Frail Older Patients

• SENIOR-RITA Trial https://www.nejm.org/doi/10.1056/NEJMoa2407791
• Subanalysis of Senior RITA Trial https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2847995
• Timing of Invasive Strategy in Patients With Non-ST-Elevation Acute Coronary Syndrome -- Meta-analysis https://doi.org/10.1016/S0140-6736(17)31490-3

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