PRAGUE-25 Trial: Catheter Ablation Versus Antiarrhythmic Drugs With Risk Factor Modification for Treatment of AF
ACCEL Lite: Featured ACCEL Interviews on Exciting CV Research
Release Date: 06/03/2025
How Does Imaging Guide Management in Patients with Obesity?
ACCEL Lite: Featured ACCEL Interviews on Exciting CV Research
Imaging is a powerful tool in managing obesity, helping clinicians visualize fat distribution and detect complications like fatty liver disease or heart issues. Advanced techniques like magnetic resonance imaging (MRI) and computed tomography (CT) scans guide personalized treatment plans and monitor progress over time. Despite challenges with equipment limitations, innovations like artificial intelligence and specialized scanners are making imaging more accessible and accurate for patients with obesity. In this interview, W. Douglas Weaver MD, MACC and Mouaz H. Al-Mallah, MD, FACC...
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TACSI Trial: Dual or Single Antiplatelet Therapy After CABG in Patients With ACS
ACCEL Lite: Featured ACCEL Interviews on Exciting CV Research
In the TACSI trial, researchers evaluated ticagrelor plus aspirin versus aspirin alone in about 2,200 patients who underwent coronary artery bypass grafting (CABG) for acute coronary syndrome (ACS). At 12 months, dual antiplatelet therapy (DAPT) did not reduce major adverse cardiac events compared to aspirin alone. However, it was associated with a higher risk of major bleeding. These findings do not support routine DAPT use post-CABG in ACS patients, though longer-term follow-up is still needed. In this interview, Drs. Steven E. Nissen and Anders Jeppsson...
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VICTORION-Difference: Inclisiran-Based Strategy vs. Standard of Care
ACCEL Lite: Featured ACCEL Interviews on Exciting CV Research
Current clinical challenges in lipid control include achieving and maintaining target LDL-cholesterol levels in patients at high risk for atherosclerotic cardiovascular disease, especially those who do not respond adequately to standard therapies. The VICTORION-Difference trial demonstrated that an inclisiran-based treatment strategy significantly outperformed usual care in helping patients reach early and sustained LDL-C goals. This approach also resulted in fewer muscle-related side effects, a common barrier to adherence. Inclisiran offers a...
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Aortopathies: What A Cardiologist Needs to Know
ACCEL Lite: Featured ACCEL Interviews on Exciting CV Research
What if your genes could predict a life-threatening condition before symptoms ever appear? Explore how medical science uncovered the genetic roots of thoracic aortic aneurysm—and why that discovery changed everything. From famous historical figures to modern patients, the implications are profound: understanding the exact genetic mutation can guide treatment and safeguard entire families. In this interview, Drs. Jeroen J. Bax and John A. Elefteriades discuss “Aortopathies: What A Cardiologist Needs to Know”.
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PhysioSync-HF: Conduction System vs. Biventricular Pacing in Cardiac Resynchronization in HFrEF
ACCEL Lite: Featured ACCEL Interviews on Exciting CV Research
Can a newer, more targeted pacing method revolutionize heart failure treatment? The PhysioSync-HF trial investigates conduction system pacing as a potentially more effective and affordable alternative to traditional cardiac resynchronization therapy. Explore the surprising differences between this study and prior research and hear firsthand what it was like to lead a nationwide, publicly funded clinical trial across Brazil. This episode dives deep into innovation, equity, and the future of heart care. In this interview, Drs. Joseph Marine and André Zimerman discuss...
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DAPT-SHOCK-AMI Trial: Cangrelor in Cardiogenic Shock
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The DAPT SHOCK AMI trial is the first major study to evaluate antiplatelet therapy specifically in patients with cardiogenic shock (CS) following acute myocardial infarction (AMI). It compares initial treatment strategies using cangrelor versus crushed ticagrelor. Early and potent platelet inhibition is critical for restoring microvascular reperfusion in this high-risk population. Previous randomized trials have excluded these patients, leaving a gap in evidence for optimal antiplatelet management in AMI-CS. In this interview, Drs. Dipti Itchhaporia and Zuzana Motovska...
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ODYSSEY-HCM: Mavacamten in nHCM
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The ODYSSEY-HCM trial found that mavacamten did not significantly improve exercise capacity or patient-reported outcomes in individuals with symptomatic nonobstructive hypertrophic cardiomyopathy. Safety concerns emerged, including more frequent reductions in ejection fraction and treatment interruptions among those receiving mavacamten. The trial's limited diversity and short duration raise questions about the generalizability and long-term implications of the findings. Despite the lack of approved therapies for this patient group, the study underscores the complexity of using surrogate...
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DAN-RSV: RSVpreF Vaccine for Preventing Cardiorespiratory Hospitalizations
ACCEL Lite: Featured ACCEL Interviews on Exciting CV Research
The DAN-RSV trial is one of the largest individually randomized studies ever conducted, enrolling over 131,000 participants aged 60 and older to evaluate the effectiveness of the RSVpreF vaccine. Using a pragmatic design with electronic consent and national health registry data, the trial successfully met its primary objective of reducing RSV-related respiratory tract disease hospitalizations. It also achieved all key secondary endpoints, showing favorable outcomes for RSV-related and all-cause respiratory and cardiorespiratory hospitalizations. These results demonstrate the vaccine’s...
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The Role of Prevention During and After Reproduction
ACCEL Lite: Featured ACCEL Interviews on Exciting CV Research
Adverse pregnancy outcomes (APOs), affecting up to 20% of pregnancies, serve as early indicators of a woman’s future cardiovascular risk and should be treated as critical markers in preventive care. Pregnancy offers a unique opportunity—a “window”—to identify and address cardiovascular vulnerabilities, making routine screening for heart health essential at every clinical encounter. Long-term monitoring beyond the postpartum period is vital, as cardiovascular risks persist and evolve over time. Improving women’s heart health requires a collaborative, lifelong approach across...
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The Role of Imaging in Cardiovascular Prevention
ACCEL Lite: Featured ACCEL Interviews on Exciting CV Research
Cohort studies have provided robust data on cardiovascular risk factors, forming the basis for predictive models like the Pooled Cohort Equations and PREVENT. Clinical trials confirm that treating these risk factors effectively reduces cardiovascular events. Over the past 50 years, age-adjusted mortality from acute myocardial infarction has dropped by 89%, reflecting major progress. To advance further, we must consider integrating imaging to identify those at highest risk, using risk factors to guide treatment decisions. This dual approach could enhance precision and improve outcomes in...
info_outlineThe PRAGUE-25 study evaluated the effectiveness of two treatment strategies in patients with both atrial fibrillation (AF) and obesity: catheter ablation versus lifestyle modification (including weight loss and increased physical activity) combined with antiarrhythmic drug therapy. While motivated patients who adhered to lifestyle changes experienced a reduction in AF episodes, the study found that catheter ablation was significantly more effective in achieving and maintaining sinus rhythm.
In this episode, Drs. Joseph Marine and Pavel Osmancik discuss the trial’s findings, highlighting that catheter ablation outperformed lifestyle modification and medication in restoring and sustaining normal heart rhythm.
SUGGESTED MATERIALS
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Osmancik P, Havránek Š, Bulková V, et al. Catheter ablation versus antiarrhythmic drugs with risk factor modification for treatment of atrial fibrillation: a protocol of a randomised controlled trial (PRAGUE-25 trial). BMJ Open. 2022 Jun 15;12(6):e056522. doi: 10.1136/bmjopen-2021-056522.
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Pathak RK, Middeldorp ME, Meredith M, Mehta AB, Mahajan R, Wong CX, Twomey D, Elliott AD, Kalman JM, Abhayaratna WP, Lau DH, Sanders P. Long-Term Effect of Goal-Directed Weight Management in an Atrial Fibrillation Cohort: A Long-Term Follow-Up Study (LEGACY). J Am Coll Cardiol. 2015 May 26;65(20):2159-69. doi: 10.1016/j.jacc.2015.03.002.
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