The Lead Podcast presented by Heart Rhythm Society

The Lead Podcast presented by Heart Rhythm Society
  • 5.0 (7)
  • COURSES

The Lead – a weekly journal review podcast that is designed to keep you up to date and informed on the latest publications and hottest topics in electrophysiology. Key takeaways, in-depth interpretations, and informative interviews are all fitted into 15 minute time slots, so that they fit easily into your busy schedule. Click the link below to learn more!

  1. 3D AGO

    The Lead Episode 147: Heart Rhythm 2026 Late Breaker Coverage: A Discussion of Proton Beam Cardiac Radioablation for Refractory Ventricular Tachycardia: Results from a Frist-in-Human, Prospective, Non-Randomized Trial

    Welcome to the third in this week's series of Lead episodes covering late breaking clinical trials from Heart Rhythm 2026 in Chicago. Join host Michael Lloyd, MD, FHRS, and his guests Christopher Kowalewski, MD and Karin Benali, MD, PhD for this discussion. This first-in-human, prospective study presented at Heart Rhythm 2026 evaluated noninvasive proton beam cardiac radioablation for patients with refractory ventricular tachycardia who had failed prior ablation and medical therapy. In a small, high-risk cohort, proton therapy was feasible and demonstrated substantial reductions in VT burden (approximately 80%) with no significant treatment-related toxicity observed during follow-up. These early findings highlight proton beam radioablation as a promising, highly targeted, noninvasive treatment option, though larger studies are needed to confirm long-term safety and durability.   Learning Objectives: Describe the principles of cardiac radioablation and the advantages of proton beam therapy compared with photon-based approaches for treating ventricular tachycardia.  Evaluate early feasibility, safety, and efficacy outcomes of proton beam therapy in patients with refractory ventricular tachycardia.  Assess the potential role of noninvasive cardiac radioablation in the treatment algorithm for patients with drug- and ablation-refractory ventricular tachycardia.    Podcast Contributors Michael S. Lloyd, MD, FHRS Christopher Kowalewski, MD Karin Benali, MD, PhD   Host and Contributor Disclosure(s): M. Lloyd •Honoraria/Speaking/Teaching/Consulting: Medtronic •Membership on Advisory Committees: Boston Scientific K. Bemali Nothing to disclose. D. Chew Nothing to disclose.

    16 min

  2. 3D AGO

    The Lead Episode 146: Late Breaker Coverage: A Discussion of LEAP2: A First-In-Human Study of a Chronically-Implanted Novel Leadless Pacemaker for Conduction System Pacing

    Welcome to the second episode this week in our triple header of late breaking clinical trials coverage from Heart Rhythm 2026 in Chicago. Host Christopher C Cheung, MD, MPH, FHRS is joined by Mihail G. Chelu, MD, PhD, FHRS and Derek Chew, MD, MS, FHRS for a conversation in Chicago. The LEAP2 trial, a first-in-human chronic feasibility study presented at Heart Rhythm 2026, evaluated a novel leadless pacemaker designed for conduction system pacing to more closely replicate physiologic cardiac activation. Early results from this small cohort demonstrated high implantation success, reliable device performance, and effective pacing of the heart's native conduction pathways through short-term follow-up. These findings highlight the potential of leadless conduction system pacing as an innovative alternative to traditional pacing strategies, pending further long-term data.   Learning Objectives Describe the principles and clinical rationale for conduction system pacing and how it differs from traditional right ventricular pacing.  Evaluate early safety and performance outcomes of novel leadless pacemaker systems designed for physiologic pacing.  Assess the potential clinical implications and future role of leadless conduction system pacing technologies in patients requiring permanent pacing.   Podcast Contributors Christopher C Cheung, MD, MPH, FHRS Mihail G. Chelu, MD, PhD, FHRS Derek Chew, MD, MS, FHRS   C. Cheung •Honoraria/Speaking/Teaching/Consulting: Medtronic, Biotronik, Biosense Webster, Abbott M. Chelu •Honoraria/Speaking/Teaching/Consulting: Impulse Dynamics, USA •Research: Abbott, Impulse Dynamics USA, VDI Technologies, PCORI, NIH/NHLBI D. Chew •Research: Canadian Institute of Health Research, Heart and Stroke Foundation of Canada

    23 min

  3. 3D AGO

    The Lead Episode 145: Heart Rhythm 2026 Late Breaker Coverage: A Discussion of Cognitive Function and Anticoagulation Discontinuation in Patients Without Long-Term Recurrence After Catheter Ablation for Atrial Fibrillation

    Welcome to the first episode in this week's triple-header of late-breaking clinical trial coverage from Heart Rhythm 2026 in Chicago. In this episode Melissa E. Middeldorp, MPH, PhD from the Digital Education Committee sits down with David H. Birnie, MD and T. Jared Bunch, MD, FHRS to talk through this exciting late breaker. This late-breaking substudy of the ALONE-AF trial presented at Heart Rhythm 2026 evaluated whether discontinuing oral anticoagulation (OAC) after successful atrial fibrillation ablation impacts cognitive function in patients without long-term recurrence. The findings suggest that stopping OAC approximately one year post-ablation does not adversely affect cognitive outcomes, with cognitive scores improving similarly in both discontinuation and continuation groups among patients who remained arrhythmia-free. These results support the potential safety of OAC discontinuation in selected patients, while addressing an important gap in post-ablation management. Learning Objectives Understand the clinical rationale and current uncertainty surrounding continuation versus discontinuation of oral anticoagulation after successful AF ablation. Evaluate the impact of anticoagulation discontinuation on cognitive function in patients without recurrent atrial fibrillation. Apply emerging evidence from ALONE-AF and related studies to inform individualized decision-making on long-term anticoagulation management post-ablation.   Podcast Contributors Melissa E. Middeldorp, MPH, PhD David H. Birnie, MD T. Jared Bunch, MD, FHRS   Contributor Information: M. Middeldorp Nothing to disclose. D. Birnie Nothing to disclose.  T.J. Bunch • Honoraria/Speaking/Teaching/Consulting: Heart Rhythm Society, Pfizer

    15 min

  4. APR 16

    The Lead Episode 144: A Discussion of Enhanced Detection and Prompt Diagnosis of Atrial Fibrillation Using Apple Watch: A Randomized Controlled Trial

    Join host Melissa Middeldorp and her guests Marco Perez and Kristie Coleman for this installment of The Lead! This multicenter randomized controlled trial evaluated whether smartwatch-based rhythm monitoring improves detection of previously undiagnosed atrial fibrillation (AF) in cardiology outpatients aged ≥65 years with elevated stroke risk. A total of 437 participants were randomized to either 6-month monitoring with an Apple Watch integrating photoplethysmography-based irregular rhythm detection and single-lead ECG confirmation, supported by a telemonitoring adjudication pathway, or to standard care. The primary endpoint of new AF occurred significantly more often in the intervention group than in controls (9.6% vs 2.3%; HR 4.40), with many cases asymptomatic and detected earlier through wearable monitoring. All diagnosed patients were initiated on anticoagulation, and major adverse cardiovascular events were similar between groups. Overall, the study demonstrates that prolonged smartwatch-based screening embedded within a clinical workflow substantially increases AF detection in a high-risk population, highlighting the feasibility of wearable-enabled case finding while underscoring ongoing questions regarding clinical outcomes and optimal implementation. Learning Objectives Describe the design and key findings of a randomized trial evaluating smartwatch-based screening for atrial fibrillation in older patients at elevated stroke risk. Discuss the clinical implications, limitations, and broader evidence context of wearable-enabled atrial fibrillation detection within contemporary screening strategies.   Article Authors Nicole J. van Steijn, Isabel S. Blommestijn, Sebastiaan Blok, Shari Pepplinkhuizen, Aernout Somsen, Reinoud E. Knops, Laura Breukel, Jan G.P. Tijssen, Igor I. Tulevski, Philip M. Croon, Michiel M. Winter Podcast Contributors Melissa E. Middeldorp, MPH, PhD Kristie Coleman, MPH, RN Marco Perez, MD Host and Contributor Disclosure(s): M. Middeldorp Nothing to disclose. K. Coleman •Honoraria/Speaking/Teaching/Consulting: Medtronic M. Perez •Honoraria/Teaching/Speaking/Consulting: Boston Scientific, Biontronik •Ownership/Partnership: QALY •Research: Apple, Inc.

    25 min

  5. APR 9

    The Lead Episode 143: A Discussion of The Empirical Evidence in the Successful Anatomical Ablation of Idiopathic LV Summit Ventricular Arrhythmias

    In this discussion, Dr. Deep Chandh Raja, MBBS, MD, PhD, is joined by Dr. Chi Keong Ching, MBBS, FHRS, and Dr. Haris M. Haqqani, MD, PhD, FHRS, to review the growing empirical evidence supporting anatomically guided ablation strategies for idiopathic left ventricular (LV) summit ventricular arrhythmias. The panel highlights how integrating multimodality mapping with a nuanced understanding of the region's complex anatomy can improve procedural success and safety. They also emphasize the role of evolving techniques and shared clinical experience in refining outcomes for these challenging cases.   Learning Objectives Describe the anatomical challenges of the left ventricular (LV) summit and their implications for catheter ablation of idiopathic ventricular arrhythmias. Evaluate the role of multimodality mapping and anatomically guided strategies in improving procedural success and safety.  Identify emerging techniques and clinical insights that inform optimal ablation approaches for LV summit arrhythmias.    Article Authors Takumi Yamada and G. Neal Kay Podcast Contributors Dr. Deep Chandh Raja, MBBS, MD, PhD Dr. Chi Keong Ching, MBBS, FHRS Dr. Haris M. Haqqani, MD, PhD, FHRS   Host and Contributor Disclosure(s): D.C. Raja Nothing to disclose. C.K. Ching •Honoraria/Speaking/Teaching/Consulting: Abbott, Biotronik, Boston Scientific, Biosense Webster, Inc, Medtronic H. Haqqani •Honoraria/Speaking/Teaching/Consulting: Abbott Medical •Membership on Advisory Committees: Boston Scientific

    21 min

  6. APR 2

    The Lead Episode 142: A Discussion of Class 1c Antiarrhythmic Therapy Following PCI in New Onset Atrial Fibrillation: Safety and Clinical Outcomes from a Nationwide Cohort

    Join an expert-led discussion exploring the safety and clinical outcomes of Class 1c antiarrhythmic therapy following percutaneous coronary intervention (PCI) in patients with new-onset atrial fibrillation, based on insights from a nationwide cohort study. Deep Chandh Raja, MBBS, MD, PhD (Australian National University and Kauvery Hospital) hosts a dynamic conversation with Sandeep Gautam, MD, MPH, FHRS (University of Missouri Health) and Deepak Padmanabhan, MD, FHRS (Narayana Institute of Cardiac Sciences, Bengaluru). Together, they examine real-world data on the use of Class 1c agents in a traditionally high-risk population, addressing long-standing concerns about proarrhythmia and ischemic heart disease. The discussion will highlight patient selection, evolving clinical practice patterns, and implications for guideline-directed management, offering clinicians practical insights into optimizing rhythm control strategies in complex post-PCI patients. Learning Objectives Evaluate the safety profile and clinical outcomes associated with Class 1c antiarrhythmic therapy in patients with new-onset atrial fibrillation following PCI.  Identify appropriate patient selection criteria and clinical considerations when prescribing Class 1c agents in the context of ischemic heart disease. Apply evidence from nationwide cohort data to inform decision-making and optimize rhythm management strategies in post-PCI atrial fibrillation patients. Link to the Article for Discussion Article Authors Ting-Chun Huang MD, Po-Hsueh Su MD, Hui-Wen Lin MS, Po-Tseng Lee MD, Yu Liao MD, Chao-Yu Chen MD, Li-Hao Yap MD, Sheng-Hsiang Lin PhD, Yi-Heng Li MD, PhD Podcast Contributors Deep Chandh Raja, MBBS, MD, PhD Sandeep Gautam, MD, MPH, FHRS Deepak Padmanabhan, MD, FHRS   Host and Contributor Disclosure(s): D.C. Raja Nothing to disclose. S. Gautam Honoraria/Teaching/Speaking/Consulting: Biosense Webster Fellowship Support: Medtronic Inc., Abbott D. Padmanabhan Nothing to disclose.

    24 min

  7. MAR 19

    The Lead Episode 141: A Discussion of Impact of GLP-1 Receptor Agonist Therapy on Atrial Fibrillation Recurrence After Catheter Ablation in Obese Patients: A Real-World Data Analysis

    Join Digital Education Committee member and podcast host Melissa E. Middeldorp, MPH, PhD, along with this week's guest contributors,Sheldon Litwin, MD from the Medical University of South Carolina and Abhishek Deshmuckh, MBBS from the Mayo Clinic for this week's episode. This real-world retrospective cohort study evaluated whether glucagon-like peptide-1 receptor agonist (GLP-1RA) therapy is associated with improved outcomes after atrial fibrillation (AF) ablation in obese patients using a large multicenter electronic health record database (TriNetX). After propensity matching 6,700 patients (3,350 GLP-1RA users and 3,350 non-users), GLP-1RA therapy was associated with significantly lower AF recurrence, progression to permanent AF, cardiovascular and heart failure hospitalizations, and all-cause mortality over a median ~2-year follow-up, although repeat ablation rates were unchanged. The authors propose that benefits may be mediated through weight-loss, reduction in systemic inflammation and epicardial fat, improved metabolic control, and potential direct atrial effects, but emphasize that causal inference is limited due to observational design and lack of weight-loss trajectory or adherence data. Overall, the study suggests GLP-1RAs could become an adjunct rhythm-control strategy in obese AF patients undergoing ablation, warranting prospective randomized trials.   Learning Objectives Understand the association between GLP-1 RA therapy and reduced AF recurrence and cardiovascular outcomes after catheter ablation in obese patients. Evaluate the potential mechanisms and clinical implications of GLP-1 RAs as an adjunctive metabolic therapy in rhythm control strategies for AF. Article for Discussion Article Authors Sandrine Venier, Pascal Defaye, Lisa Lochon, Rémi Benali, Arnaud Bisson, Adrien Carabelli, Youssou Diouf, Peggy Jacon, Laurent Fauchier Podcast Contributors Melissa E. Middeldorp, MPH, PhD Abhishek Deshmuckh, MBBS Sheldon Litwin, MD Host and Contributor Disclosure(s): M. Middeldorp Nothing to disclose. A. Deshmukh •Honoraria/Teaching/Speaking/Consulting: GE Healthcare   S. Litwin Honoraria/Teaching/Speaking/Consulting: Axon Therapies, Novo Nordisk, Alleviant, Corvia Medical Staff Disclosure(s) (note: HRS staff are NOT in control of educational content. Disclosures are provided solely for full transparency to the learner): S. Sailor: No relevant financial relationships with ineligible companies to disclose.

    20 min

  8. MAR 12

    The Lead Episode 140: A Discussion of Atrial Cardiomyopathy: Markers and Outcomes

    Join Digital Education Committee member and podcast host Melissa E. Middeldorp, MPH, PhD, along with this week's guest contributors, Joshua Silverstein MD, FHRS from Allegheny Health Network and Jonathan Ariyaratnam, BChir, MA, MB, CCDS, CEPS-A from the University of Adelaidefor this week's episode. This study by Vad and colleagues examined markers of atrial cardiomyopathy (AtCM) in 26,467 UK Biobank participants without prior atrial fibrillation (AF), heart failure (HF), or stroke, integrating cardiac MRI, ECG, clinical risk factors, and genetic data. AtCM was defined using four markers: left atrial dilation, reduced left atrial emptying fraction (120 ms), and abnormal P-wave terminal force and 15.7% of individuals had at least one marker, while 2.3% had two or more. Over a median follow-up of nearly five years, the presence of AtCM markers showed a dose–response relationship with incident AF, with a HR: 4.59 in those with ≥2 markers and was also strongly associated with HF and ischemic stroke. Adding AtCM markers to clinical and genetic risk models improved AF risk prediction, supporting the concept that atrial cardiomyopathy may represent a common substrate linking AF, HF, and stroke and may help refine future risk stratification strategies. Article for Discussion Learning Objectives Understand how imaging- and ECG-based markers of atrial cardiomyopathy are defined and how they relate to the risk of incident AF, heart failure, and stroke. Evaluate how integrating atrial cardiomyopathy markers with clinical and genetic risk scores may improve risk stratification for AF and related cardiovascular outcomes. Article Authors Oliver B Vad, Nick van Vreeswijk, Ahmed S Yassin, Yuri Blaauw, Christian Paludan-Müller, Jørgen K Kanters, Claus Graff, Ulrich Schotten, Emelia J Benjamin, Jesper H Svendsen, Michiel Rienstra Podcast Contributors Melissa E. Middeldorp, MPH, PhD Joshua R. Silverstein, MD, FHRS Jonathan Ariyaratnam, BChir, MA, MB, CCDS, CEPS-A Host and Contributor Disclosure(s): M. Middeldorp Nothing to disclose. J. Ariyaratnam  Nothing to disclose.   J. Silverstein Honoraria/Speaking/Consulting: Medical Device Business Services, Biosense Webster, Inc., Medtronic Stocks, Privately Held: Heart Rhythm Clinical Solutions/3PH Alliance Staff Disclosure(s) (note: HRS staff are NOT in control of educational content. Disclosures are provided solely for full transparency to the learner): S. Sailor: No relevant financial relationships with ineligible companies to disclose.

    21 min
See All (151)

Ratings & Reviews

5
out of 5
7 Ratings

About

The Lead – a weekly journal review podcast that is designed to keep you up to date and informed on the latest publications and hottest topics in electrophysiology. Key takeaways, in-depth interpretations, and informative interviews are all fitted into 15 minute time slots, so that they fit easily into your busy schedule. Click the link below to learn more!

Information

You Might Also Like