ACCEL Lite: Featured ACCEL Interviews on Exciting CV Research

The detection of subclinical, or "silent," atrial fibrillation (AFib) has increased substantially with the widespread use of implantable devices (e.g., pacemakers, defibrillators) and consumer wearables such as smartwatches. A key clinical question is the threshold of cumulative AFib burden—such as duration identified on device interrogation—at which anticoagulation should be considered. Additionally, clinicians should consider when consumer wearable rhythm monitoring is appropriate, such as in patients with symptoms or elevated stroke risk. Best practices are needed to guide counseling and management of patients with subclinical AFib, including when to initiate stroke and systemic embolism prevention strategies. 

In this interview, W. Douglas Weaver MD, MACC and Deepak Bhakta, MD, MBA, FACC discuss managing subclinical AFib detected by devices, ambulatory monitors and wearables.

Is tirzepatide associated with a broader reduction in cardiorenal adverse outcomes compared with dulaglutide in patients with type 2 diabetes and cardiovascular disease (CVD? The SURPASS-CVOT, the first cardiovascular outcomes trial using an active incretin-based comparator, previously demonstrated that tirzepatide was noninferior to dulaglutide for major adverse cardiovascular events, including CV death, myocardial infarction, and stroke. A current analysis expands these findings by examining a wider spectrum of adverse events to further characterize the comparative cardiorenal effects of tirzepatide. 

 
In this interview, Matthew Martinez, MD, FACC and Steven E. Nissen, MD, MACC examine the SURPASS-CVOT Randomized Clinical Trial.

The Recover-Autonomic Trial evaluates the impact of ivabradine on orthostatic intolerance, quality of life, and heart rate in patients with post-COVID postural orthostatic tachycardia syndrome (POTS). Recognizing that POTS disproportionately affects women, the study addresses a growing clinical need for targeted management strategies in this population. It examines ivabradine as part of a broader treatment approach that combines pharmacotherapy with lifestyle modifications, which together are associated with improved patient outcomes. The trial aims to inform more effective, evidence-based care for individuals experiencing persistent autonomic dysfunction following COVID-19. 

In this interview, Thomas F. Deering, MD, FACC and Pam Taub, MD, FACC discuss the Recover-Autonomic Trial.

Prehospital heparin administration in patients with ST-segment elevation myocardial infarction (STEMI) undergoing primary percutaneous coronary intervention (PCI) offers a practical strategy to facilitate early restoration of blood flow in the infarct-related artery before hospital arrival. A key advantage of heparin over other agents studied for this purpose is its low cost, widespread availability, and well-established safety profile, making it highly accessible in diverse care settings. By initiating anticoagulation early, this approach aims to support reperfusion without introducing additional harm. Given these benefits, it has strong potential for translation into routine clinical practice, particularly in systems focused on rapid, prehospital STEMI care. 

 
In this interview, Kim Allan Williams Sr., MD, MACC and Misa Fister, MD, PhD examine 'Prehospital Heparin Administration In Patients With STEMI Undergoing Primary PCI'.

Iron deficiency (ID) is highly prevalent in patients with heart failure (HF) and is independently associated with poorer functional status, higher hospitalization rates, and increased mortality. ID in HF is typically defined by abnormal iron indices—most commonly low ferritin and/or low transferrin saturation—and is distinct from anemia, as it may be present even when hemoglobin levels are normal. A growing body of randomized clinical trials demonstrates that treating ID, particularly with intravenous iron, improves symptoms, exercise capacity, and quality of life, with emerging evidence for reductions in HF hospitalizations. 

In this interview, Clyde W. Yancy MD, MACC and Robert J. Mentz, MD, FACC examine definitions and treatment of ID in HF.