The Lead Podcast presented by Heart Rhythm Society

The Lead Podcast presented by Heart Rhythm Society
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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. 34m ago

    The Lead Episode 154: A Discussion of Safety and Effectiveness of a Dual-Energy Focal Ablation Catheter to Treat Paroxysmal Atrial Fibrillation: 6- Month Results of the FlexPulse IDE Study

    In this episode of The Lead, host Sandeep A. Saha, MD, MS, FHRS, is joined by Babak Nazer, MD, and Rajesh Kabra, MD, FHRS, to discuss the journal article, Safety and Effectiveness of a Dual-Energy Focal Ablation Catheter to Treat Paroxysmal Atrial Fibrillation: 6-Month Results of the FlexPulse IDE Study. Together, they review the study's six-month findings and explore the safety and effectiveness of a dual-energy focal ablation catheter for the treatment of paroxysmal atrial fibrillation. Learning Objectives Review the six-month results of the FlexPulse IDE Study evaluating a dual-energy focal ablation catheter for the treatment of paroxysmal atrial fibrillation. Discuss the safety outcomes reported in the study and their implications for clinical practice. Examine the effectiveness findings of the dual-energy focal ablation approach in patients with paroxysmal atrial fibrillation. Podcast Contributors Sandeep A Saha, MD, MS, FHRS  Babak Nazer, MD Rajesh Kabra, MD, FHRS   Host and Contributor Disclosure(s): S. Saha • Honoraria/Speaking/Consulting Fee/Speaker's Bureau: Medtronic, Inc. B. Nazer •Honoraria/Speaking/Consulting Fee: Edwards Lifesciences, Biosense Webster, Inc., Siemens Healthineers •Research: Siemens Healthineers R. Kabra •Honoraria/Speaking/Consulting Fee: AtriCure, Inc., Biosense Webster, Inc., Milestone Pharmaceuticals, AltaThera Pharmaceuticals •Research: Abbott Medical, Medtronic, Inc.

    26 min

  2. May 28

    The Lead Episode 153: A Discussion of Exercise Capacity and Quality-of-Life Improvements after Catheter Ablation in Patients with Clinically Asymptomatic Persistent Atrial Fibrillation

    In this episode of The Lead, host Melissa Middeldorp, MPH, PhD, FHRS is joined by Jenelle Dziano, PhD candidate, Clinical Exercise Physiologist and Adrian D. Elliott, PhD for a discussion of the recent journal article, Exercise Capacity and Quality-of-Life Improvements after Catheter Ablation in Patients with Clinically Asymptomatic Persistent Atrial Fibrillation. Together, they explore the study findings and discuss the impact of catheter ablation on exercise capacity and quality of life in patients with clinically asymptomatic persistent atrial fibrillation. Learning Objectives Review the key findings from the journal article examining exercise capacity and quality-of-life outcomes after catheter ablation in patients with clinically asymptomatic persistent atrial fibrillation. Discuss the potential clinical implications of catheter ablation for patients who may not report traditional atrial fibrillation symptoms. Explore the role of exercise capacity and quality-of-life measures in evaluating treatment outcomes for persistent atrial fibrillation. Podcast Contributors: Host: Melissa Middeldorp, MPH, PhD, FHRS Guests: Jenelle Dziano, PhD candidate, Clinical Exercise Physiologist and Adrian D. Elliott, PhD Host and Contributor Disclosure(s): M. Middeldorp: Nothing to disclose J. Dziano: Nothing to disclose A. Elliiott: Nothing to disclose

    18 min

  3. May 21

    The Lead Episode 152: A Discussion of Outcomes of Left Atrial Appendage Closure versus Oral Anticoagulation in Patients with Atrial Fibrillation and Prior Ablation: A Sub-Analysis of the CHAMPION-AF Clinical Trial (New England Journal of Medicine)

    This New England Journal of Medicine study from the CHAMPION-AF trial compared left atrial appendage closure (LAAC) using the WATCHMAN FLX device with non–vitamin K oral anticoagulants (NOACs) in 3,000 patients with nonvalvular atrial fibrillation eligible for anticoagulation therapy. The trial found that LAAC was noninferior to NOACs for preventing stroke, cardiovascular death, and systemic embolism, while significantly reducing non-procedural bleeding over three years of follow-up. These findings suggest LAAC may emerge as a viable first-line alternative to long-term anticoagulation in appropriately selected AF patients. Digital Education Committee Member Danesh Kella, MBBS, FHRS discusses this article from the Heart Rhythm Journal that preceded the Heart Rhythm 2026 Late-Breaking Clinical Trial. He is joined in the conversation by Jason T. Jacobson, MD, FHRS, Ammar M. Killu, MBBS, and Gregory M. Marcus, MD, FHRS.   Learning Objectives Describe the rationale for left atrial appendage closure as an alternative to chronic oral anticoagulation in patients with atrial fibrillation after catheter ablation. Review the efficacy and safety outcomes from the CHAMPION-AF sub-analysis comparing LAAC and NOAC therapy in post-ablation AF patients.  Discuss patient selection considerations and the role of shared decision-making when choosing stroke prevention strategies following AF ablation.    Podcast Contributors Danesh Kella, MBBS, FHRS Jason T. Jacobson, MD, FHRS Ammar M. Killu, MBBS Gregory M. Marcus, MD, FHRS    Host and Contributor Disclosure(s): J.T. Jacobson •Board/Advisory Committee Membership: Abbott Medical •Honoraria/Speaking/Teaching/Consulting: Zoll Medical Corporation, Vektor Medical, Inc. •Research: CardioFocus, Inc., Johnson and Johnson •Stocks, Privately Held: Atlas 5D D. Kella •Honoraria/Speaking/Teaching/Consulting: Zoll Medical Corporation, MBW Spectrum A. Killu •Board/Advisory Committee Membership: Boston Scientific •Honoraria/Speaking/Teaching/Consulting: AtriCure, Inc., Abbott, Biosense Webster, Inc., Siemans Healthineers •Research: Boston Scientific, Access Point Technologies G.M. Marcus •Honoraria/Speaking/Teaching/Consulting: InCarda Therapeutics •Research: NIH, PCORI, TRDRP •Stocks, Publicly Traded: InCarda Therapeutics

    22 min

  4. May 21

    The Lead Episode 151: Heart Rhythm 2026 Late-Breaker Coverage: A Discussion of Outcomes of Left Atrial Appendage Closure versus Oral Anticoagulation in Patients with Atrial Fibrillation and Prior Ablation: A Sub-Analysis of the CHAMPION-AF Clinical Tria

    This late-breaking sub-analysis from the CHAMPION-AF trial evaluated outcomes of left atrial appendage closure (LAAC) with the WATCHMAN FLX device versus oral anticoagulation in patients with atrial fibrillation who had previously undergone catheter ablation. Investigators found that LAAC provided similar protection against stroke, cardiovascular death, and systemic embolism compared with non-vitamin K oral anticoagulants (NOACs), while significantly reducing non-procedural bleeding events, regardless of prior ablation status. These findings suggest LAAC may be a viable alternative to long-term anticoagulation in select post-ablation AF patients through a shared decision-making approach. Join Digital Education Committee member Sandeep A. Saha, MD, MS, FHRS and his colleagues Scott C. Brancato, MD, FHRS and Rakesh Gopinathannair, MBA, MD, FHRS for this late-breaking coverage from Heart Rhythm 2026 in Chicago!   Learning Objectives Review the rationale for left atrial appendage closure as an alternative to long-term oral anticoagulation in patients with atrial fibrillation following catheter ablation. Analyze the CHAMPION-AF sub-analysis outcomes comparing LAAC and NOAC therapy with respect to stroke prevention, cardiovascular outcomes, and bleeding risk. Discuss how these findings may influence patient selection and shared decision-making for stroke prevention strategies in post-ablation atrial fibrillation care.    Podcast Contributors Sandeep A. Saha, MD, MS, FHRS Scott C. Brancato, MD, FHRS Rakesh Gopinathannair, MBA, MD, FHRS    Host and Contributor Disclosure(s): S. Brancato Nothing to disclose. R. Gopinathannair Board/Advisory Committee Membership: Heart Rhythm Society, AltaThera Pharmaceuticals Honoraria/Speaking/Teaching/Consulting: Abbott, Johnson and Johnson, Boston Scientific, Sanofi S. Saha Board/Advisory Committee Membership: Medtronic Honoraria/Speaking/Teaching/Consulting: Medtronic

    33 min

  5. May 14

    The Lead Episode 150: Heart Rhythm 2026 Late-Breaker Coverage: A Discussion of Total Fatal Adverse Events Following Atrial Fibrillation Ablation Reported in an FDA Mandatory Reporting System: A Matter of Concern? The TiFFANY Study

    This discussion reviews the late-breaking HRS 2026 study Total Fatal Adverse Events Following Atrial Fibrillation Ablation Reported in an FDA Mandatory Reporting System: A Matter of Concern? The TiFFANY Study, which examined fatal adverse event reports associated with atrial fibrillation ablation using data from the FDA MAUDE database. Faculty discuss the incidence and mechanisms of rare but serious complications across ablation technologies, including pulsed field ablation and thermal energy sources, and explore the implications for procedural safety, post-market surveillance, and clinical decision-making in AF ablation. Join host Melissa E. Middeldorp, MPH, PhD and her esteemed guests Christopher F. Liu, MD, FHRS and James Freeman, MD, MPH, Msci for this late-breaking coverage from Heart Rhythm 2026 in Chicago! Learning Objectives Describe the methodology and key findings of the TiFFANY study evaluating fatal adverse events following atrial fibrillation ablation. Compare reported safety signals and complication profiles among pulsed field ablation and traditional thermal ablation technologies. Assess the role and limitations of post-market adverse event databases in evaluating procedural safety and informing electrophysiology practice.  Podcast Contributors Melissa E. Middeldorp, MPH, PhD, FHRS Christopher F. Liu, MD, FHRS James Freeman, MD, MPH, Msci  Host and Contributor Disclosure(s): D.C. Raja Nothing to disclose. A. Deshmukh Honoraria/Speaking/Teaching/Consulting: GE Healthcare, Biotronik, Medtronic, Biosense Webster Research: AltaThera Pharmaceuticals P. Lim Nothing to disclose.

    18 min

  6. May 14

    The Lead Episode 149: Heart Rhythm 2026 Late-Breaker Coverage: A Discussion of Safety and Performance of a Novel ICD Lead for Left Bundle Branch Area Pacing: Results from the ASCEND CSP Trial

    Welcome to the latest episode of late-breaker coverage from Heart Rhythm 2026 in Chicago, with host Deep Chandh Raja, MBBS, MD, PhD, FHRS and his guests Paul Chun Yih Lim, MBBS, FHRS and Abhishek Deshmukh, MD. This discussion reviews the late-breaking HRS 2026 trial Safety and Performance of a Novel ICD Lead for Left Bundle Branch Area Pacing: Results from the ASCEND CSP Trial Arrhythmia, which evaluated a novel implantable cardioverter-defibrillator (ICD) lead designed specifically for left bundle branch area pacing (LBBAP). Faculty discuss the safety profile, implant success, pacing performance, and clinical implications of conduction system pacing using dedicated ICD technology, as well as how these findings may influence future device implantation strategies and physiologic pacing approaches in patients requiring defibrillator therapy.   Learning Objectives Assess the safety and procedural performance outcomes associated with left bundle branch area pacing in patients requiring ICD therapy.  Evaluate the potential role of conduction system pacing technologies in advancing physiologic pacing and device-based arrhythmia management. Describe the design and intended clinical application of the novel ICD lead evaluated in the ASCEND CSP trial.    Podcast Contributors Deep Chandh Raja, MBBS, MD, PhD, FHRS Paul Chun Yih Lim, MBBS, FHRS Abhishek Deshmukh, MD   Host and Contributor Disclosure(s): D.C. Raja Nothing to disclose. A. Deshmukh Honoraria/Speaking/Teaching/Consulting: GE Healthcare, Biotronik, Medtronic, Biosense Webster Research: AltaThera Pharmaceuticals P. Lim Nothing to disclose.

    15 min

  7. May 14

    The Lead Episode 148: HRS 2026 Late-Breaker Coverage, A Discussion of Ventricular Intramyocardial Navigation and Tachycardia Ablation Guided by Electrograms (VINTAGE): First-in-Human Experience with a Novel Therapy for Refractory Ventricular Arrhythmias

    Join Digital Education Committee member Jason T. Jacobson, MD, FHRS, and his guests John L. Sapp, Jr., MD, FHRS and Kyoko Soejima, MD for this conversation at Heart Rhythm 2026 in Chicago. This discussion reviews the late-breaking clinical trial Ventricular Intramyocardial Navigation and Tachycardia Ablation Guided by Electrograms (VINTAGE): First-in-Human Experience with a Novel Therapy for Refractory Ventricular Arrhythmia, presented at HRS 2026 in Chicago. Faculty discuss the novel VINTAGE technique, which enables catheter-based navigation and ablation within the myocardial wall to target deep intramural ventricular arrhythmia substrates that are often inaccessible with conventional endocardial or epicardial approaches. The conversation highlights the potential clinical impact of this first-in-human experience, including procedural feasibility, mechanistic innovation, and future implications for the treatment of patients with refractory ventricular tachycardia and complex ventricular arrhythmias.   Learning Objectives Describe the VINTAGE intramyocardial navigation approach and its proposed role in the treatment of refractory ventricular arrhythmias.  Evaluate the clinical challenges associated with mapping and ablating deep intramural ventricular tachycardia substrates using conventional techniques.  Assess the potential implications of first-in-human feasibility and safety findings for future ventricular arrhythmia ablation strategies.    Podcast Contributors Jason T. Jacobson, MD, FHRS John L. Sapp, Jr., MD, FHRS Kyoko Soejima, MD   Host and Contributor Disclosure(s): J. Jacobson • Honoraria/Speaking/Teaching/Consulting: Zoll Medical Corporation, Vektor Medical Inc. • Stocks, Privately Held: Atlas 5D • Research: CardioFocus, Inc. • Membership on Advisory Committees: Abbott Medical, Johnson and Johnson J. Sapp • Honoraria/Speaking/Teaching/Consulting: Medtronic, Varian Medical Systems, Biosense Webster • Research: Abbott Medical, Biosense Webster K. Soejima • Honoraria/Speaking/Consulting: Medtronic Japan, Boston Scientific Japan, Abbott Medical, Abbott Japan, Boehringer Ingelheim, Daiichi Sankyo

    16 min

  8. May 7

    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
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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!

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