The Lead Episode 131: A Discussion of Caffeinated Coffee Consumption or Abstinence to Reduce Atrial Fibrillation: The DECAF Randomized Clinical Trial (English Language Episode)
The Lead Podcast presented by Heart Rhythm Society
Release Date: 01/08/2026
The Lead Episode 134: A Discussion of Bachmann Bundle Pacing Target: Retrograde Mapping and Microstructural Correlation
The Lead Podcast presented by Heart Rhythm Society
Join Digital Education Committee Member and podcast host Deep Chandh Raja, MBBS, MD, PhD , and his guests Georgios Leventopoulos, MD, and Muthiah Subramanian, MD, CCDS, CEPS-A, for this week's Lead episode. This Heart Rhythm article investigates the Bachmann bundle as a target for pacing by using retrograde electrical mapping and correlating findings with underlying myocardial microstructure. The piece provides detailed insights into how Bachmann bundle activation pathways relate to tissue architecture, with implications for optimizing physiologic pacing strategies. These findings may...
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The Lead Episode 133: A Discussion of Feasibility and Safety of PFA for Coronary Sinus and Left Atrial Appendage Isolation and Mitral Isthmus Ablation Acute and Chronic Findings (LIVE at APHRS 2025)
The Lead Podcast presented by Heart Rhythm Society
Join Digital Education Committee Chair and podcast host Michael S. Lloyd, MD, FHRS, and his guests Kelvin C. Chua, MBBS, MD, FHRS, CEPS-A, and Rahul N Doshi, MD, FHRS, for this week's Lead episode, which was recorded live at APHRS 2025 in Kyoto, Japan. This discussion will review recent evidence on the feasibility and safety of pulsed field ablation (PFA) for coronary sinus and left atrial appendage isolation, as well as mitral isthmus ablation, focusing on both acute and chronic outcomes. Panelists will examine procedural considerations, lesion durability, and safety signals highlighted in...
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The Lead Episode 132: A Discussion of Antithrombotic Therapy after Successful Catheter Ablation for Atrial Fibrillation (English Language Episode)
The Lead Podcast presented by Heart Rhythm Society
Join Digital Education Committee Member and podcast host Melissa E. Middeldorp, MPH, PhD, and her guests Helmut Pürerfellner, MD, FHRS, and Jonathan M. Kalman, MBBS, PhD, FHRS for this week's Lead episode. This episode was recorded LIVE at APHRS 2025 in Yokohama, Japan. The OCEAN randomized trial found that in patients who remained free of atrial arrhythmia at least one year after successful catheter ablation for atrial fibrillation, continuing anticoagulation with rivaroxaban did not significantly reduce the risk of stroke, systemic embolism, or covert cerebral infarcts compared with...
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A Discussion of Antithrombotic Therapy after Successful Catheter Ablation for Atrial Fibrillation (Japanese Language Episode)
The Lead Podcast presented by Heart Rhythm Society
Join podcast host Takanori Yamaguchi, MD, PhD, and his guests Masato Fukunaga, MD, PhD and Masateru Takigawa, MD, PhD, for this week's Lead episode. This episode was recorded LIVE at APHRS 2025 in Yokohama, Japan. This episode was recorded entirely in Japanese. The OCEAN randomized trial found that in patients who remained free of atrial arrhythmia at least one year after successful catheter ablation for atrial fibrillation, continuing anticoagulation with rivaroxaban did not significantly reduce the risk of stroke, systemic embolism, or covert cerebral infarcts compared with...
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The Lead Episode 131: A Discussion of Caffeinated Coffee Consumption or Abstinence to Reduce Atrial Fibrillation: The DECAF Randomized Clinical Trial (English Language Episode)
The Lead Podcast presented by Heart Rhythm Society
Join Digital Education Committee Member and podcast host Melissa E. Middeldorp, MPH, PhD, and her guests Eue-Keun Choi, MD, PhD, and Sandeep Prabhu, MBBS, PhD for this week's Lead episode. This episode was recorded LIVE at APHRS 2025 in Yokohama, Japan. The DECAF trial investigated whether continuing regular caffeinated coffee consumption versus complete abstinence affected the recurrence of atrial fibrillation (AF) or atrial flutter in patients after successful cardioversion. Over six months in this randomized study of 200 adults, those who drank at least one cup of caffeinated coffee...
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The Lead Episode 131: A Discussion of Caffeinated Coffee Consumption or Abstinence to Reduce Atrial Fibrillation: The DECAF Randomized Clinical Trial (Japanese Episode)
The Lead Podcast presented by Heart Rhythm Society
Join podcast host Takanori Yamaguchi, MD, PhD, and his guests Koichi Magashina, MD, PhD, and Michifumi Tokuda, MD, PhD for this week's Lead episode. This episode was recorded LIVE at APHRS 2025 in Yokohama, Japan. This episode is recorded entirely in Japanese. The DECAF trial investigated whether continuing regular caffeinated coffee consumption versus complete abstinence affected the recurrence of atrial fibrillation (AF) or atrial flutter in patients after successful cardioversion. Over six months in this randomized study of 200 adults, those who drank at least one cup of caffeinated...
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A Holiday Message from the Producers of The Lead
The Lead Podcast presented by Heart Rhythm Society
Hello everyone! We're writing to wish you a very happy holiday season. The Lead will be going dark for the next two weeks, as we celebrate with friends and family. As the year comes to a close, we want to thank all of you for being a part of The Lead podcast. We couldn't do it without you! We will be back with more cutting edge content and important discussions the week of January 5, 2026. In the meantime, we wish you a joyful end to 2025 and great beginnings in 2026!
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The Lead Episode 130: A Discussion of MEPPC Syndrome: A Systematic Review and State-of-the-Art Paper
The Lead Podcast presented by Heart Rhythm Society
Join Digital Education Committee Member and podcast host Deep Chandh Raja, MBBS, MD, PhD (Kauvery Hospital), and his guests Nitish Badhwar, MBBS, FHRS (Stanford University), and Yash Lokhandwala, MD, DM, FACC (Holy Family Hospital) for this week's Lead episode. This state-of-the-art review synthesizes current knowledge on multifocal ectopic Purkinje-related premature contractions (MEPPC) syndrome, highlighting its genetic underpinnings, distinctive electrophysiologic features, and clinical presentation across age groups. The authors emphasize advances in diagnosis and management,...
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The Lead Episode 129: A Discussion of Worldwide Chronic Retrieval Experience of the Helix Fixation Leadless Cardiac Pacemaker
The Lead Podcast presented by Heart Rhythm Society
Join Tina Baykaner, MD, MPH, HRS Digital Education Committee Vice-Chair, and her guests Mikhael F. El-Chami, MD, FHRS and Devi G. Nair, MD, FHRS for this week's Lead episode. This article summarizes the worldwide experience retrieving chronically implanted active helix-fixation leadless ventricular pacemakers (the Aveir/Abbott platform) across regulatory clinical trials. The authors assess real-world feasibility, procedural techniques, success rates, and complications of retrieval after long dwell times, demonstrating that devices can be removed safely and effectively even years after...
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The Lead Episode 128: A Discussion of Long-Term Anticoagulation Discontinuation After Catheter Ablation for Atrial Fibrillation: The ALONE-AF Randomized Clinical Trial
The Lead Podcast presented by Heart Rhythm Society
Join Phillip Cuculich, MD and his guests Tina Baykaner, MD, MPH and Atul Verma, MD, FHRS for this lively discussion of a cutting edge topic. The ALONE-AF trial evaluated whether patients who remained free of atrial fibrillation for at least one year after catheter ablation could safely discontinue long-term oral anticoagulation. In this randomized study of more than 800 patients, stopping anticoagulation resulted in similarly low rates of stroke or systemic embolism and significantly fewer major bleeding events compared with continuing therapy. The findings suggest that, in carefully selected...
info_outlineJoin Digital Education Committee Member and podcast host Melissa E. Middeldorp, MPH, PhD, and her guests Eue-Keun Choi, MD, PhD, and Sandeep Prabhu, MBBS, PhD for this week's Lead episode. This episode was recorded LIVE at APHRS 2025 in Yokohama, Japan.
The DECAF trial investigated whether continuing regular caffeinated coffee consumption versus complete abstinence affected the recurrence of atrial fibrillation (AF) or atrial flutter in patients after successful cardioversion. Over six months in this randomized study of 200 adults, those who drank at least one cup of caffeinated coffee daily had a significantly lower rate of AF or flutter recurrence compared to those who abstained (47% vs. 64%), suggesting moderate coffee intake may be safe and potentially beneficial for rhythm stability in this setting.
Learning Objectives
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Evaluate the impact of caffeinated coffee consumption versus abstinence on atrial fibrillation recurrence following cardioversion.
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Interpret the design and key outcomes of the DECAF randomized clinical trial and their relevance to clinical practice.
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Apply the trial findings to patient counseling regarding caffeine intake and atrial fibrillation management.
Article Authors
Christopher X. Wong, MBBS, MPH, PhD; Christopher C. Cheung, MD, MPH; Gabrielle Montenegro, BA, Hannah H. Oo, BS; Isabella J. Peña, BA; Janet J. Tang, MPH, PhD; Samuel J. Tu, MBBS; Grace Wall, BA1; Thomas A. Dewland, MD; Joshua D. Moss, MD; Edward P. Gerstenfeld, MD; Zian H. Tseng, MD, MAS; Henry H. Hsia, MD; Randall J. Lee, MD, PhD; Jeffrey E. Olgin, MD; Vasanth Vedantham, MD; Melvin M. Scheinman, MD; Catherine Lee, PhD; Prashanthan Sanders, MBBS, PhD; Gregory M. Marcus, MD, MAS
Podcast Contributors
Melissa E. Middeldorp, MPH, PhD
Eue-Keun Choi, MD, PhD
Sandeep Prabhu, MBBS, PhD
Host and Contributor Disclosure(s):
E.K. Choi
S. Prabhu
M. Middeldorp
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.