Science News from #AHA24

Catheter Ablation or Antiarrhythmic Drugs for Ventricular Tachycardia in Ischemic Cardiomyopathy
John L Sapp | QEII Health Sciences Centre, Halifax, NS, Canada

RESULTS: In patients with ischemic cardiomyopathy and ventricular tachycardia, there was a lower rate of the composite outcome among patients treated with ablation as compared with antiarrhythmic drug therapy (amiodarone or sotalol).

• VANISH2 Published in NEMJ
• ClinicalTrials ID: NCT02830360
• AHA News Release: Ablation may be better than medication for those with dangerous heartbeat after heart attack
• Read all abstracts from Session LBS.02

Randomized Comparison of Left Atrial Appendage Closure with Oral Anticoagulation after Catheter Ablation for Atrial Fibrillation
Oussama Musbah Wazni | Cleveland Clinic Foundation, Cleveland, OH

RESULTS: In patients undergoing catheter-based atrial fibrillation (AF) ablation that are moderate-high risk for stroke, left atrial appendage closure (LAAC) led to significantly less non-procedure-related major bleeding or clinically relevant nonmajor bleeding compared to oral anticoagulation (OAC), while maintaining similar rates of stroke, systemic embolism, or death.

• OPTION Published in NEJM
• ClinicalTrials ID: NCT03795298
• Read all abstracts from Session LBS.02

Blinded Randomized trial of Anticoagulation to prevent Ischemic stroke and Neurocognitive impairment in Atrial Fibrillation
Lena Rivard |Montreal Heart Institute, Montreal, QC, Canada

RESULTS: In patients with nonvalvular atrial fibrillation (AF) and no traditional stroke risk factors, treatment with rivaroxaban showed no significant difference in reducing cognitive decline, stroke, or transient ischemic attach (TIA) compared to standard care after a median of 3.7 years of follow-up.

• BRAIN-AF Study website
• ClinicalTrials ID: NCT02387229
• AHA Press Release: Blood thinners didn’t reduce cognitive decline in adults 65 and younger with AFib
• Read all abstracts from Session LBS.02

Evaluation of Randomized Audit and Feedback to Increase Heart Failure Medication Optimization Among Primary Care Pharmacists in the Veterans Affairs Health Care System
Alexander T Sandhu | Stanford University, Stanford, CA

RESULTS: Pharmacists in the AF/AF+ groups averaged 1.2 more HF-related encounters per month compared to the education only group (p<0.01) and 0.2 more HF medication adjustment encounters per month (p=0.01). AF/AF+ groups also showed a higher rate of new or increased mineralocorticoid receptor antagonist (MRA) prescriptions (11.6% vs. 9.2%, p<0.01).

• Pharm Optimal HF ClinicalTrials ID: NCT05623358
• See abstracts from LBS.03

Artificial Intelligence-based Automated ECHOcardiographic Measurements and the Workflow of Sonographers (AI-ECHO): Randomized Crossover Trial
Nobuyuki Kagiyama | Juntendo University, Tokyo, Japan

RESULTS: AI assisted analysis of echocardiographic images from 585 patients scanned over 38 study days reduced the average examination time from 14.3 minutes to 13.0 minutes and increased the number of examinations per day to 16.7 from 14.1. Number of parameters analyzed increased 3.4 times on AI days with acceptable accuracy, and sonographers reported less mental fatigue.

• UMIN ID: UMIN000053259

Efficacy of a Glucagon-Like Peptide-1 Agonist in Patients undergoing Coronary Artery Bypass Grafting or Aortic Valve Replacement – a randomized clinical trial
Sebastian Wiberg | Rigshospitalet, Copenhagen, Denmark

RESULTS: Infusion of 17.4 mg of exenatide prior to cardiopulmonary bypass did not significantly reduce the incidence of composite event of death, stroke, renal failure, or new or worsening heart failure over placebo.

• ClinicalTrials ID: NCT02673931
• AHA Press Release: Major CVD event risk cut by 20% in adults without diabetes, with overweight or obesity
• See all abstracts in LBS.04

Trial: A 2x2 Factorial Randomized Controlled Trial of Colchicine versus placebo and Spironolactone versus placebo in Patients with Myocardial Infarction
Sanjit S Jolly | Hamilton Health Sciences, Hamilton, ON, Canada

RESULTS: Spironolactone may reduce the risk of new or worsening heart failure (HF); however, it did not significantly impact the rate of death, new heart attack, or stroke.

• CLEAR SYNERGY Published in NEJM
• ClinicalTrials ID: NCT03874338
• See all abstracts in LBS.04

Preliminary Results of Randomized Trial of New Versus Reconditioned Pacemakers for Patients Unable to Obtain a New Device in Low and Middle-Income Countries: The My Heart Your Heart (MHYH) Randomized Trial
Thomas Crawford | University of Michigan, Ann Arbor, MI

RESULTS: Reconditioned pacemakers demonstrate comparable safety and efficacy to new pacemaker (PM) devices when assessed up to 90 days post-implementation.

• MHYH Project
• ClinicalTrials ID: NCT04016870

Joseph C. Wu, MD, PhD, Immediate Past President of the American Heart Association, talks with Dhruv S. Kazi, MD, MS, one of the organizers of the International Symposium, about the purpose of the symposium and how it evolved out of work the American Heart Association does around the world to improve cardiovascular health.

Joseph C. Wu, MD, PhD, Immediate Past President of the American Heart Association, talks with Joselyn Rwebembera, MD and  Andrea Z. Beaton, MD about their experiences as participants in the American Heart Association's International Visiting Professorship Program.

Joseph C. Wu, MD, PhD, Immediate Past President of the American Heart Association, talks with Joselyn Rwebembera, MD and  Andrea Z. Beaton, MD about the importance of international collaboration in advancing cardiovascular research and improving global health.