In this discussion, Drs. Georgia Vasilakis Tsatiris and Anna Radhakrishnan of the CardioNerds speak with Dr. Kevin Alexander, who explores the baseline differences observed in patients with transthyretin amyloidosis with and without atrial fibrillation (AF), noting that patients with AF generally present with worse biomarkers, quality of life, and functional capacity. However, findings from recent data, including the ATTRibute trial—indicate that disease-modifying therapies offer clinical benefit across a wide range of disease severities and comorbidity profiles, underscoring the value of initiating treatment even in advanced stages. He emphasizes the need for ongoing research to refine disease progression metrics and optimize therapy adjustments as the treatment landscape expands with multiple FDA-approved options.