The Lead Podcast presented by Heart Rhythm Society
The Lead – a bi-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!
info_outline
The Lead Episode 118: A Discussion of Atrial Fibrillation Catheter Ablation.....
08/28/2025
The Lead Episode 118: A Discussion of Atrial Fibrillation Catheter Ablation.....
Melissa E. Middeldorp, MPH, PhD, University of Adelaide is joined by Jenelle Dziano, Centre for Heart Rhythm Disorders, The University of Adelaide and Jared Bunch, MD, FHRS, University of Utah School of Medicine, to discuss a study that investigated the relationship between atrial fibrillation (AF), brain glymphatic function, and cognitive performance. Using MRI-derived diffusion tensor imaging along the perivascular space (DTI-ALPS), the authors found that patients with AF especially those with no paroxysmal AF exhibited impaired glymphatic activity compared to healthy controls. This reduced glymphatic function was associated with poorer cognitive performance in domains like attention and executive function, and mediation analyses suggested that glymphatic dysfunction partially explains the link between AF and cognitive decline. Notably, in patients who underwent catheter ablation to restore sinus rhythm, glymphatic function significantly improved post-procedure. These findings highlight a novel mechanistic pathway beyond stroke or vascular risk by which AF may contribute to neurodegeneration, and they suggest that rhythm control could offer protective benefits for brain health. https://www.hrsonline.org/education/TheLead https://academic.oup.com/eurheartj/article/46/18/1733/8029578 Host Disclosure(s): M. Middeldorp: Nothing to disclose. Contributor Disclosure(s): J. Dziano: Nothing to disclose. J. Bunch: Honoraria/Speaking/Consulting: Pfizer, Inc., Heart Rhythm Society
/episode/index/show/884ca9c9-a6ed-4c26-a44c-72f2b3c80b39/id/37982990
info_outline
The Lead Podcast - Episode 117: A Discussion of Can ICD Electrograms Help Ventricular Tachycardia Ablation?
08/21/2025
The Lead Podcast - Episode 117: A Discussion of Can ICD Electrograms Help Ventricular Tachycardia Ablation?
William H. Sauer, MD, FHRS, Brigham and Women's Hospital is joined by Wendy S. Tzou, MD, FHRS, University of Colorado Anschutz Medical Campus and Kishan Padalia, MD, University of Colorado, to discuss the results of ablation of sustained monomorphic ventricular tachycardia (SMVT) are suboptimal. For many patients with implantable cardioverter-defibrillators (ICDs), ICD electrograms (ICD-EGs) provide the only available information on SMVT. ICD-EGs have the ability to distinguish morphologically distinct SMVT and can be used for pace mapping. https://www.hrsonline.org/education/TheLead https://www.jacc.org/doi/10.1016/j.jacc.2024.10.104 Host Disclosure(s): W. Sauer: Honoraria/Speaking/Consulting: Biotronik, Biosense Webster, Inc., Abbott, Boston Scientific, Research: Medtronic Contributor Disclosure(s): W. Tzou: Honoraria/Speaking/Consulting: Medtronic, Biotronik, Biosense Webster, Inc., Mediasphere Medical, Kardium, American Heart Association, Medtronic, Abbott, BioTelemetry, Boston Scientific, Kardium Research: Abbott Medical K. Padalia: Nothing to disclose.
/episode/index/show/884ca9c9-a6ed-4c26-a44c-72f2b3c80b39/id/37896300
info_outline
The Lead Podcast - Episode 116: A Discussion of Multicenter Results of a Novel Pediatric Pacemaker...LIVE from HRS 2025 in San Diego
08/14/2025
The Lead Podcast - Episode 116: A Discussion of Multicenter Results of a Novel Pediatric Pacemaker...LIVE from HRS 2025 in San Diego
Deep Chandh Raja, MBBS, MD, PhD, Australian National University, Kauvery Hospital is joined by Andreas Pflaumer, MD, FHRS, CEPS-P, Royal Children's Hospital Melbourne and Maully J. Shah, MBBS, FHRS, CCDS, CEPS-P Children's Hospital of Philadelphia, to discuss the unmet clinical need for a smaller pacemaker suitable for neonates and infants, researchers developed a specially modified implantable pulse generator incorporating a Medtronic Micra subassembly within a polymer header, connected to a bipolar epicardial lead. This study aimed to evaluate the safety, feasibility, and midterm outcomes of this novel device, reporting follow-up data from multiple centers on patients who underwent implantation. https://www.hrsonline.org/education/TheLead https://www.ahajournals.org/doi/10.1161/CIRCEP.124.013436?doi=10.1161/CIRCEP.124.013436 Host Disclosure(s): D. Raja: Nothing to disclose. Contributor Disclosure(s): M. Shah: Honoraria/Speaking/Consulting: Medtronic, IBHRE Abbott, BioTelemetry, Boston Scientific, Kardium Other Financial Relationships: American College of Cardiology A. Pflaumer: Stock Options - Privately Held: Navi Medical Systems Officer, Trustee, Director, Committee Chair: PACES, Asia Pacific Heart Rhythm Society (APHRS)
/episode/index/show/884ca9c9-a6ed-4c26-a44c-72f2b3c80b39/id/37807485
info_outline
The Lead Podcast - Episode 115: A Discussion of Socio-economic Position and Sudden Cardiac Death...
08/07/2025
The Lead Podcast - Episode 115: A Discussion of Socio-economic Position and Sudden Cardiac Death...
Melissa E. Middeldorp, MPH, PhD is joined by Martin K. Stiles, MBChB, PhD, FHRS, University of Auckland and Waikato Hospital and Eloi Marijon, MD, PhD, Paris University & European Georges Pompidou Hospital, to discuss this Danish nationwide study examines the relationship between socioeconomic position (SEP) and sudden cardiac death (SCD) as well as all-cause mortality (ACM). Analyzing all deaths in Denmark from 2010, researchers found a strong inverse association between both income and education level and the risk of SCD and ACM. Individuals in the lowest income and education groups had significantly higher rates of SCD, even after adjusting for age, sex, and comorbidities. The study highlights that despite Denmark’s universal healthcare system, socioeconomic disparities in health outcomes persist, suggesting that factors beyond healthcare access—such as health literacy, lifestyle, and systemic inequalities—play a crucial role. The findings call for further research into the mechanisms driving these disparities and the development of targeted prevention strategies. https://www.hrsonline.org/education/TheLead https://academic.oup.com/europace/article/27/4/euaf001/7958953?login=false Host Disclosure(s): M. Middeldorp: Nothing to disclose. Contributor Disclosure(s): E. Marijon: Honoraria/Speaking/Consulting: Zoll Medical Corporation, Boston Scientific Research: Biotronik, Boston Scientific, MicroPort Scientific Corporation, Medtronic, Zoll Medical Corporation, Abbott M. Stiles: Honoraria/Speaking/Consulting: Abbott Medical, Medtronic, Inc., Boston Scientific
/episode/index/show/884ca9c9-a6ed-4c26-a44c-72f2b3c80b39/id/37711955
info_outline
The Lead Podcast - Episode 114: A Discussion of Lifestyle and risk factor modification in atrial fibrillation...
07/31/2025
The Lead Podcast - Episode 114: A Discussion of Lifestyle and risk factor modification in atrial fibrillation...
Melissa E. Middeldorp, MPH, PhD is joined by Thomas F. Deering, BS, MBA, MD, FHRS, CCDS, and T. Jared Bunch, MD, FHRS to discuss a 31-item questionnaire was developed and distributed among healthcare professionals via the EHRA network and social media between 23 September and 21 October 2024. https://www.hrsonline.org/education/TheLead https://academic.oup.com/europace/article/27/4/euaf075/8099191?login=false Host Disclosure(s): M. Middeldorp: Nothing to disclose. Contributor Disclosure(s): T. Deering: Honoraria/Speaking/Consulting: Sanofi, Pacemate, Pfizer, Inc., Omny Health, Preventice Research: Abbott, Boston Scientific, Medtronic, Biotronik, Biosense Webster, Inc., Stock Options - Privately Held: HeartBeam Officer, Trustee, Director, Committee Chair: Board Membership T. Bunch: Honoraria/Speaking/Consulting: Pfizer, Inc. Heart Rhythm Society
/episode/index/show/884ca9c9-a6ed-4c26-a44c-72f2b3c80b39/id/37613970
info_outline
The Lead Podcast - Episode 113: A Discussion on the Effect of Pulsed Field Ablation on Human Coronary Arteries...
07/24/2025
The Lead Podcast - Episode 113: A Discussion on the Effect of Pulsed Field Ablation on Human Coronary Arteries...
Please join host Michael S. Lloyd, MD, FHRS at HRS 2025 in San Diego as he discusses this article with Stephanie Wang, MD and Emily Zeitler, MD. The study investigated whether PFA-induced coronary spasms during ablation could cause lasting changes—such as mild lumen narrowing—at the ablation site over a three-month period. https://www.hrsonline.org/education/TheLead https://www.jacc.org/doi/10.1016/j.jacep.2025.03.014 Host Disclosure(s): M. Lloyd: Honoraria/Speaking/Consulting: Medtronic, Arga Medtech, Circa Scientific Membership on Advisory Committees: Boston Scientific Contributor Disclosure(s): E. Zeitler: Honoraria/Speaking/Consulting: Biosense Webster, Inc., Medtronic Inc., Boston Scientific, Element Science, Inc., Sanofi, V-Wave S. Wang: Nothing to disclose.
/episode/index/show/884ca9c9-a6ed-4c26-a44c-72f2b3c80b39/id/37527765
info_outline
The Lead Podcast - Episode 112: A Discussion of Brugada Syndrome Ablation...
07/17/2025
The Lead Podcast - Episode 112: A Discussion of Brugada Syndrome Ablation...
Please join host Jason T. Jacobson, MD, FHRS at HRS 2025 in San Diego as he discusses this article with Marmar Vaseghi, MD, MS, PhD, FHRS and Mayank Sardana, MBBS, MS. The prospective, multicenter, randomized BRAVE trial evaluated epicardial catheter ablation targeting the arrhythmogenic substrate in Brugada syndrome patients with implantable cardioverter-defibrillators (ICDs) to prevent ventricular fibrillation (VF). After a planned interim analysis of 52 patients, ablation significantly reduced VF episodes compared with controls (hazard ratio 0.29; P = .018), prompting early trial termination—approximately 83% remained VF-free after one procedure and 90% after a repeat, with a low complication rate (one hemopericardium). https://www.hrsonline.org/education/TheLead https://www.heartrhythmjournal.com/article/S1547-5271(25)02381-1/fulltext?uuid=uuid%3A6285a37b-899f-4fcb-bab8-f79564e1bd57 Host Disclosure(s): J. Jacobson: Honoraria/Speaking/Consulting: Zoll Medical, Abbott Medical, Vektor Medical Stocks, Privately Held: Atlas 5D Research: CardioFocus, Inc. Contributor Disclosure(s): M. Vaseghi: Honoraria/Speaking/Consulting: Medtronic Inc., Zoll Inc. Stock Options, Privately Held: NeuCures, Anumana M. Sardana: Nothing to disclose.
/episode/index/show/884ca9c9-a6ed-4c26-a44c-72f2b3c80b39/id/37435305
info_outline
The Lead Podcast - Episode 111: A Discussion of Computed Tomography-Guided Catheter Ablation for Ventricular Tachycardia LIVE at HRS 2025 in San Diego
07/09/2025
The Lead Podcast - Episode 111: A Discussion of Computed Tomography-Guided Catheter Ablation for Ventricular Tachycardia LIVE at HRS 2025 in San Diego
This late-breaking randomized trial, published online on April 26, 2025 in Heart Rhythm, demonstrated that using CT scan guidance for ventricular tachycardia (VT) ablation significantly shortens procedure time while maintaining a safety profile comparable to conventional methods. In essence, CT-guided ablation offers a faster, equally safe alternative for VT treatment. A discussion of the late breakers was recorded live in San Diego at Heart Rhythm 2025. https://www.hrsonline.org/education/TheLead https://www.heartrhythmjournal.com/article/S1547-5271(25)02182-4/fulltext Host Disclosure(s): J. Jacobson: Honoraria/Speaking/Consulting: Zoll Medical, Abbott Medical, Vektor Medical Stocks, Privately Held: Atlas 5D Research: CardioFocus, Inc. Contributor Disclosure(s): T. Dickfield: Honoraria/Speaking/Consulting: Impulse Dynamics USA Stock Options, Privately Held: inHeart N. Trayanova: Honoraria/Speaking/Consulting: Medtronic Inc., Volta Medical, Catheter Precision, Mediasphere Medical, Medical Device Business Services Research: National Institutes of Health
/episode/index/show/884ca9c9-a6ed-4c26-a44c-72f2b3c80b39/id/37340980
info_outline
The Lead Podcast - Episode 110: A Discussion of Left bundle area pacing in hypertrophied hearts...LIVE from HRS 2025 in San Diego
07/03/2025
The Lead Podcast - Episode 110: A Discussion of Left bundle area pacing in hypertrophied hearts...LIVE from HRS 2025 in San Diego
Left Bundle Area Pacing in Hypertrophied Hearts: An Ex Vivo Ovine Model to Study Deployment of Pacing Leads in Thick Septum describes the development of a novel ex vivo sheep heart model with induced septal hypertrophy to simulate challenging left bundle branch area pacing (LBBAP) scenarios. The study evaluates the deployment characteristics and fixation behavior of pacing leads in thickened septal tissue, aiming to improve procedural safety and lead placement strategies in patients with left ventricular hypertrophy. This model offers a valuable tool for preclinical testing and refinement of lead technologies and techniques. https://www.hrsonline.org/education/TheLead https://pubmed.ncbi.nlm.nih.gov/40294732/ Host Disclosure(s): D. Raja: Nothing to disclose. Contributor Disclosure(s): P. Sharma: Honoraria/Speaking/Consulting: Medtronic, Abbott, Biotronik
/episode/index/show/884ca9c9-a6ed-4c26-a44c-72f2b3c80b39/id/37256545
info_outline
The Lead Podcast - Episode 109: A Discussion of Survival Outcomes after SCA in Young, Competitive Athletes in the US
06/26/2025
The Lead Podcast - Episode 109: A Discussion of Survival Outcomes after SCA in Young, Competitive Athletes in the US
Join us at Heart Rhythm 2025 for the discussion of this study. Between July 2014 and June 2023, researchers tracked 641 sudden cardiac arrest (SCA) incidents in U.S. athletes aged 11–29. Overall survival was 49%, rising to 57% during exercise, and reaching 70% in game/competition settings compared to 53% during practice. Survival rates improved significantly over the nine years, yet notable racial disparities persisted: Black athletes were 37% less likely, and athletes of other non-White races 31% less likely, to survive exertional SCAs than White athletes. The authors emphasize that while improvements in emergency preparedness (CPR/AED access) likely contributed to better outcomes, targeted efforts are needed to address equity and bolster response during practices and in under-resourced communities. https://www.hrsonline.org/education/TheLead https://www.sciencedirect.com/science/article/abs/pii/S0735109725053379 Host Disclosure(s): M. Middeldorp: Nothing to disclose. Contributor Disclosure(s): E. Chung: Nothing to disclose. R. Lampert: Nothing to disclose.
/episode/index/show/884ca9c9-a6ed-4c26-a44c-72f2b3c80b39/id/37154245
info_outline
The Lead Podcast - Episode 108: A Discussion of LBBAP compared with biventricular pacing for Cardiac Resynchronization Therapy...
06/19/2025
The Lead Podcast - Episode 108: A Discussion of LBBAP compared with biventricular pacing for Cardiac Resynchronization Therapy...
This global, multicenter registry included 2,579 CRT recipients with LVEF ≤ 50% who underwent either LBBAP or conventional biventricular pacing (BVP), with 780 matched pairs analyzed. Over a mean follow-up of 34 ± 15 months, LBBAP significantly reduced the combined endpoint of all-cause death or first heart failure hospitalization (22.2% vs 30.8%; HR 0.81; P≈0.048), largely driven by fewer HF hospitalizations (13.6% vs 20.8%; HR 0.63; P<0.001). Patients in the LBBAP arm also experienced shorter paced QRS duration (129 vs 143 ms) and fewer procedural complications (3.5% vs 6.5%; P=0.004). Mortality rates were similar between groups, reinforcing LBBAP's safety and potential efficacy for CRT in this patient population. Join host Michael S. Lloyd, MD, FHRS and guests Hakeem Ayinde, MD, FHRS, and Prashant Bhave, MD, FHRS for this discussion, recorded at Heart Rhythm 2025 in San Diego, California. https://www.hrsonline.org/education/TheLead https://www.heartrhythmjournal.com/article/S1547-5271%2825%2902312-4/abstract?utm Host Disclosure(s): M. Lloyd: Honoraria/Speaking/Consulting: Medtronic, Arga Medtech, Circa Scientific Membership on Advisory Committees: Boston Scientific Contributor Disclosure(s): H. Ayinde: Honoraria/Speaking/Consulting: Johnson and Johnson P. Bhave: Honoraria/Speaking/Consulting: American Collge of Cardiology, Boston Scientific, Abbott Medical
/episode/index/show/884ca9c9-a6ed-4c26-a44c-72f2b3c80b39/id/37079085
info_outline
The Lead Podcast - Episode 107: A Discussion of Catheter Ablation of AFib in Cardiac Sarcoidosis and Amyloidosis...
06/12/2025
The Lead Podcast - Episode 107: A Discussion of Catheter Ablation of AFib in Cardiac Sarcoidosis and Amyloidosis...
Join HRS Board Member Prashanthan Sanders, MBBS, PhD, FHRS (University of Adelaide) as he discusses this exciting paper, presented at Heart Rhythm 2025. He is joined in the Heart Rhythm Tv Studio in San Diego, California by Louise Segan, MBBS, MPH (Alfred Health), and Takanori Yamaguchi, MD, PhD (Saga University). This discussion took place on-site at Heart Rhythm 2025. https://www.hrsonline.org/education/TheLead https://www.heartrhythmjournal.com/article/S1547-5271(25)01245-7/fulltext Host Disclosure(s): P. Sanders: Honoraria/Speaking/Consulting: Boston Scientific, Abbott Medical, Research: Boston Scientific, Abbott, Medtronic, Becton Dickinson, CathRx, Pacemate, Kalyan Technologies, Ceryx Medical, Biosense Webster, Inc., Hello Alfred, Abbott Medical Membership on Advisory Committees: Pacemate, Medtronic PLC, Boston Scientific, CathRx, Abbott Medical Contributor Disclosure(s): T. Yamaguchi: Honoraria/Speaking/Consulting: Abbott Japan, Biotronik, Boston Scientific, Abbott Medical, Japan Medtronic, Inc., Daiichi Sankyo, Novartis, Japan Lifeline, Nihon Kohden, Bayer Healthcare Pharmaceuticals Japan, Boehringer Ingelheim L. Segan: Nothing to disclose.
/episode/index/show/884ca9c9-a6ed-4c26-a44c-72f2b3c80b39/id/36947230
info_outline
The Lead Podcast - Episode 106: A Discussion of 1st-in-Human Study of a Leadless Pacemaker System...
06/05/2025
The Lead Podcast - Episode 106: A Discussion of 1st-in-Human Study of a Leadless Pacemaker System...
Prashanthan Sanders, MBBS, PhD, FHRS, University of Adelaide is joined by Jenish Shroff, MBBS, MD, Australian National University, and Pugazhendhi Vijayaraman, MD, FHRS, Geisinger Heart Institute, to discuss this first-in-human feasibility study evaluated a novel helix-based leadless pacemaker (LPCSP) designed to achieve left bundle branch area pacing (LBBAP), a capability current LPs lack. The device was temporarily implanted via the internal jugular vein into the interventricular septum in 14 patients, with successful implantation in 10. Electrical performance metrics, including pacing threshold, R-wave amplitude, and impedance, were within acceptable clinical ranges. LBBAP capture was achieved in 5 patients, with no serious device-related adverse events in 85.7% of cases. The study supports the acute safety and feasibility of LPCSP for conduction system pacing. https://www.hrsonline.org/education/TheLead https://www.heartrhythmjournal.com/article/S1547-5271(25)02378-1/fulltext Host Disclosure(s): P. Sanders: Honoraria/Speaking/Consulting: Boston Scientific, Abbott Medical, Research: Boston Scientific, Abbott, Medtronic, Becton Dickinson, CathRx, Pacemate, Kalyan Technologies, Ceryx Medical, Biosense Webster, Inc., Hello Alfred, Abbott Medical Membership on Advisory Committees: Pacemate, Medtronic PLC, Boston Scientific, CathRx, Abbott Medical Contributor Disclosure(s): P. Vijayaraman: Honoraria/Speaking/Consulting: Biotronik, Boston Scientific, Abbott Medical, Medtronic, Inc. Research (Contracted Grants for PIs and Named Investigators only): Medtronic Fellowship Support: Medtronic J. Shroff: Nothing to disclose.
/episode/index/show/884ca9c9-a6ed-4c26-a44c-72f2b3c80b39/id/36856965
info_outline
The Lead Podcast - Episode 105: A Discussion of...Acute Results of the Volt-AF IDE Trial...
05/29/2025
The Lead Podcast - Episode 105: A Discussion of...Acute Results of the Volt-AF IDE Trial...
Michael S. Lloyd, MD, FHRS, Emory University is joined by Edward P. Gerstenfeld, MD, MS, FHRS, University of California, San Francisco, and Christopher C Cheung, MD, MPH, FHRS, Sunnybrook HSC, University of Toronto, to discuss the VOLT-AF IDE study evaluated the safety and effectiveness of a novel balloon-based pulsed field ablation (PFA) catheter system for treating paroxysmal and persistent atrial fibrillation (PAF and PsAF). Conducted at 34 global sites, the study enrolled 394 subjects, with 320 included in the primary analysis. Acute pulmonary vein isolation (PVI) success was achieved in over 99% of veins, and primary serious adverse events occurred in only 1.9% of patients, with no significant complications like esophageal injury or hemolysis. Procedure metrics showed efficient operation times, and early 6-month data suggest promising effectiveness. These initial findings support the Volt™ PFA system as a safe and effective treatment option for AF. https://www.hrsonline.org/education/TheLead https://www.heartrhythmjournal.com/article/S1547-5271(25)02168-X/fulltext Host Disclosure(s): M. Lloyd: Honoraria/Speaking/Consulting: Medtronic, Arga Medtech, Circa Scientific Membership on Advisory Committees: Boston Scientific Contributor Disclosure(s): E. Gerstenfeld: Honoraria/Speaking/Consulting: Medtronic, Boston Scientific, Biosense Webster, Abbott, Varian Medical Systems, Biotronik Other Non-Financial Relationships: Farapulse, Adagio Medical, Boston Scientific, Abbott Medical, Research (Contracted Grants for PIs and Named Investigators only): Abbott Medical Officer, Trustee, Director, Committee Chair, or Any Other Fiduciary Role: American College of Cardiology Foundation C. Cheung: Nothing to disclose.
/episode/index/show/884ca9c9-a6ed-4c26-a44c-72f2b3c80b39/id/36763670
info_outline
The Lead Podcast - Episode 104: A Discussion of Implantable Loop Recorder &Arrhythmia Detection in HCM...Live at HRS 2025
05/22/2025
The Lead Podcast - Episode 104: A Discussion of Implantable Loop Recorder &Arrhythmia Detection in HCM...Live at HRS 2025
Sandeep A Saha, MD, MS, FHRS, Oregon Heart Center PC is joined by Saket Sanghai, MD, FHRS, Oregon Health & Science University, and Naga Venkata Krishna Chand Pothineni, MD, Kansas City Heart Rhythm Institute, to discuss how the study evaluated the effectiveness of implantable loop recorders (ILRs) in detecting arrhythmias in patients with hypertrophic cardiomyopathy (HCM). Traditional monitoring methods, like Holter monitors, often miss intermittent arrhythmic events in HCM patients. ILRs, offering continuous long-term monitoring, were found to identify clinically significant arrhythmias that might otherwise go undetected. The findings suggest that ILRs can play a crucial role in risk stratification and management of HCM patients, potentially guiding decisions regarding interventions such as implantable cardioverter-defibrillator (ICD) implantation. Overall, ILRs enhance the detection of arrhythmias in HCM, leading to improved patient care. https://www.hrsonline.org/education/TheLead https://www.jacc.org/doi/10.1016/j.jacep.2025.03.005 Host Disclosure(s): S. Saha: Honoraria/Speaking/Consulting Fee: Medtronic Membership on Advisory Committees: Medtronic Inc. Contributor Disclosure(s): S. Sanghai: Research: Siemens Healthcare Stocks (Publicly Traded): Apple Inc., Alphabet Inc., Amazon Stock Options (Publicly Traded): Intel K. Pothineni: Honoraria/Speaking/Consulting Fee: Medtronic, Inc., Biosense Webster, Inc., Boston Scientific
/episode/index/show/884ca9c9-a6ed-4c26-a44c-72f2b3c80b39/id/36650930
info_outline
The Lead Podcast - Episode 103: A Discussion of Independent External Evaluation of Pediatric Hypertrophic Cardiomyopathy Risk Scores... Live at HRS 2025 in San Diego
05/15/2025
The Lead Podcast - Episode 103: A Discussion of Independent External Evaluation of Pediatric Hypertrophic Cardiomyopathy Risk Scores... Live at HRS 2025 in San Diego
Join host Elizabeth S DeWitt, MD, CEPS-P, and episode guests Cheyenne Beach, MD, FHRS, CEPS-P, and Robert Przybylski, MD as they discuss Sudden cardiac death is the leading cause of mortality in children with hypertrophic cardiomyopathy (HCM). Two risk scores—HCM Risk-Kids and PRIMaCY—have been developed to estimate 5-year risk, but their performance in an independent cohort showed limitations. Both tools tended to overestimate risk and showed imperfect ability to distinguish between low- and high-risk patients. However, their predictive accuracy significantly improved when risk assessments were repeated over time during follow-up. https://www.hrsonline.org/education/TheLead https://www.ahajournals.org/doi/abs/10.1161/CIRCEP.124.012932 Host Disclosure(s): E. DeWitt: Nothing to disclose. Contributor Disclosure(s): C. Beach: Nothing to disclose. R. Przybylski: Nothing to disclose.
/episode/index/show/884ca9c9-a6ed-4c26-a44c-72f2b3c80b39/id/36573825
info_outline
The Lead Podcast - Episode 102: A Discussion of Repeat Procedures After Pulsed Field Ablation for Atrial Fibrillation
05/08/2025
The Lead Podcast - Episode 102: A Discussion of Repeat Procedures After Pulsed Field Ablation for Atrial Fibrillation
Join host Michael S. Lloyd, MD, FHRS and episode guests Ante Anic, MD and Konstantinos Vlachos, MD as they discuss the recent article Repeat Procedures after Pulsed Field Ablation for Atrial Fibrillation, the MANIFEST-REDO Study, from Europace. This episode was recorded in-person at EHRA 2025. Bonus video footage of the episode is available on heartrhythm265.org. https://www.hrsonline.org/education/TheLead https://academic.oup.com/europace/advance-article/doi/10.1093/europace/euaf012/7958418 Host Disclosure(s): M. Lloyd: Honoraria/Speaking/Consulting: Medtronic, Arga Medtech, Circa Scientific Membership on Advisory Committees: Boston Scientific Contributor Disclosure(s): A. Anic: Honoraria/Speaking/Consulting: Boston Scientific Research: Biosense Webster, Inc., AtaCor Medical Inc., Arga Medtech K. Vlachos: Nothing to disclose.
/episode/index/show/884ca9c9-a6ed-4c26-a44c-72f2b3c80b39/id/36461425
info_outline
The Lead Podcast - Episode 101: A Discussion of Pulsed Field or Cryoballoon Ablation...
05/01/2025
The Lead Podcast - Episode 101: A Discussion of Pulsed Field or Cryoballoon Ablation...
Join host Prashanthan Sanders, MBBS, PhD, FHRS, and episode guests Jason G. Andrade, MD, FHRS, and Melanie Gunawardene, MD, as they discuss Pulsed Field or Cryoballoon Ablation for Paroxysmal Atrial Fibrillation. This discussion was recorded in person at EHRA 2025 in Vienna, Austria. The article under discussion was presented at EHRA 2025 and simultaneously published in the New England Journal of Medicine. https://www.hrsonline.org/education/TheLead https://www.nejm.org/doi/full/10.1056/NEJMoa2502280 Host Disclosure(s): P. Sanders: Honoraria/Speaking/Consulting: Boston Scientific, Abbott Medical Research: Boston Scientific, Abbott, Medtronic, Becton Dickinson, CathRx, Pacemate, Kalyan Technologies, Ceryx Medical, Biosense Webster, Inc., Hello Alfred, Abbott Medical; Membership on Advisory Committees: Pacemate, Medtronic PLC, Boston Scientific, CathRx, Abbott Medical Contributor Disclosure(s): M. Gunawrdene: Honoraria/Speaking/Consulting: Farapulse, Abbott Medical, Boston Scientific, Medtronic, Biotronik, Luma Vision, Bristol Myers Squibb J. Andrade: Honoraria/Speaking/Consulting: Boston Scientific, Medtronic, Inc., Biosense Webster, Inc.
/episode/index/show/884ca9c9-a6ed-4c26-a44c-72f2b3c80b39/id/36383600
info_outline
The Lead Podcast - Episode 100: A Discussion of Subcutaneous Implantable Defibrillators in Young Patients...
04/17/2025
The Lead Podcast - Episode 100: A Discussion of Subcutaneous Implantable Defibrillators in Young Patients...
Join host Michael S. Lloyd, MD,FHRS and episode participants Karim Benali, MD, PhD and Reinoud Knops, MD, PhD as they discuss this recent article that focuses on unique aspects of implantable defibrillators as experienced by young patients. The team gathered in person for this lively discussion at EHRA 2025 in Vienna. Bonus video footage of the episode is available on heartrhythm365.org. https://www.hrsonline.org/education/TheLead https://www.ahajournals.org/doi/10.1161/CIRCEP.124.013365 Host Disclosure(s): M. Lloyd: Honoraria/Speaking/Consulting: Medtronic, Arga Medtech, Circa Scientific Membership on Advisory Committees: Boston Scientific Contributor Disclosure(s): K. Benali: Nothing to disclose. R. Knops: Honoraria/Speaking/Consulting: Boston Scientific, Metronic, Inc., Cairdac, Abbott Membership on Advisory Committees: Kestra, Inc.
/episode/index/show/884ca9c9-a6ed-4c26-a44c-72f2b3c80b39/id/36211925
info_outline
The Lead Podcast - Episode 99: A Discussion of Artificial Intelligence for Individualized Treatment...
04/10/2025
The Lead Podcast - Episode 99: A Discussion of Artificial Intelligence for Individualized Treatment...
Join host and Digital Education Chair Prashanthan Sanders, MBBS, PhD, FHRS, as he discusses this article from Nature with guests Anand N Ganesan, MBBS, PhD, and Tina Baykaner, MD, MPH. This trial was also presented as a late-breaking clinical trial at Heart Rhythm 2024. https://www.hrsonline.org/education/TheLead https://www.nature.com/articles/s41591-025-03517-w Host Disclosure(s): P. Sanders: Honoraria/Speaking/Consulting: Boston Scientific, Abbott Medical Research: Boston Scientific, Abbott, Medtronic, Becton Dickinson, CathRx, Pacemate, Kalyan Technologies, Ceryx Medical, Biosense Webster, Inc., Hello Alfred, Abbott Medical; Membership on Advisory Committees: Pacemate, Medtronic PLC, Boston Scientific, CathRx, Abbott Medical Contributor Disclosure(s): A. Ganesan: Honoraria/Speaking/Consulting: Biosense Webster, Inc. T. Baykaner: Honoraria/Speaking/Consulting: Medtronic, Pacemate, Volta Medical, iRhythm Technologies; Research: NIH This episode is worth 0.25 ACE credits. If you want credit for listening to this episode, please visit the episode page on HRS365: https://www.heartrhythm365.org/URL/TheLeadEpisode99
/episode/index/show/884ca9c9-a6ed-4c26-a44c-72f2b3c80b39/id/36084920
info_outline
The Lead Podcast - Episode 98: A Discussion of Effect of targeted education of patients with atrial fibrillation...
04/02/2025
The Lead Podcast - Episode 98: A Discussion of Effect of targeted education of patients with atrial fibrillation...
Host Melissa E. Middeldorp, MPH, PhD, of the University Medical Centre Groningen & University of Adelaide, is joined by Andrea Robinson, MSN, ACNP, from Riverside Methodist Hospital, OhioHealth, and Jeroen ML Hendriks, PhD, RN, of Maastricht University Medical Centre, in this episode. The AF-EduCare trial investigated whether targeted patient education (delivered in-person or online) could reduce unplanned cardiovascular events in patients with atrial fibrillation (AF). The study found that while education improved patient knowledge, medication adherence, and risk factor awareness, it did not significantly reduce cardiovascular hospitalizations, emergency visits, or mortality compared to standard care. However, subgroup analyses suggested that younger patients, those without heart failure, and asymptomatic AF patients might benefit more from in-person education. The findings highlight that while education enhances patient engagement, comprehensive medical management and timely clinical interventions remain the key drivers of improved cardiovascular outcomes in AF care. Join us for this in-depth conversation about the trial. https://www.hrsonline.org/education/TheLead https://academic.oup.com/europace/article/27/1/euae211/7964628 Host Disclosure(s): M. Middeldorp: Nothing to disclose. Contributor Disclosure(s): A. Robinson: Honoraria/Speaking/Consulting: Medtronic, Inc., AtriCure, Inc., Biosense Webster, Inc. J. Kendriks: Honoraria/Speaking/Consulting: Biotronik This episode has .25 ACE credits associated with it. If you want credit for listening to this episode, please visit the episode page on HRS365: https://www.heartrhythm365.org/URL/TheLeadEpisode98
/episode/index/show/884ca9c9-a6ed-4c26-a44c-72f2b3c80b39/id/35983345
info_outline
The Lead Podcast - Episode 97: A Discussion of Pulmonary Vein Isolation versus SHAM Intervention...
03/27/2025
The Lead Podcast - Episode 97: A Discussion of Pulmonary Vein Isolation versus SHAM Intervention...
Michael S. Lloyd, MD, FHRS, Emory University, is joined by Harish Doppalapudi, MD, FHRS, University of Alabama at Birmingham, to discuss this provocative article from late 2024 on Pulmonary Vein Isolation versus SHAM Intervention in Symptomatic Atrial Fibrillation. Special thanks to Prashant D. Bhave, MD, FHRS for his contributions to the discussion. https://www.hrsonline.org/education/TheLead https://jamanetwork.com/journals/jama/fullarticle/2823283#google_vignette Host Disclosure(s): M. Lloyd: Honoraria/Speaking/Consulting: Medtronic, Membership on Advisory Committees: Boston Scientific Contributor Disclosure(s): H. Doppalapudi: Honoraria/Speaking/Consulting: Boston Scientific, Abbott Medical, Fellowship Support: Medtronic, Inc., Biosense Webster, Inc., Boston Scientific, Abbott Medical, Biotronik This episode has .25 ACE credits associated with it. If you want credit for listening to this episode, please visit the episode page on HRS365: https://www.heartrhythm365.org/URL/TheLeadEpisode97
/episode/index/show/884ca9c9-a6ed-4c26-a44c-72f2b3c80b39/id/35886200
info_outline
The Lead Podcast - Episode 96: A Discussion of Racial Differences and Similarities in Atrial Fibrillation Epidemiology...
03/20/2025
The Lead Podcast - Episode 96: A Discussion of Racial Differences and Similarities in Atrial Fibrillation Epidemiology...
Melissa E. Middeldorp, MPH, PhD, University Medical Centre, Groningen & University of Adelaide, is joined by So-Ryoung Lee, MD, PhD, Seoul National University Hospital, and Adrian D. Elliott, PhD, University of Adelaide/Royal, Adelaide Hospital, to discuss a study that compares atrial fibrillation (AF) epidemiology and risk factors between the UK Biobank (a predominantly European cohort) and the Korean NHIS-HEALS cohort to explore racial differences in AF incidence. Findings revealed that AF was more prevalent in the UK cohort than in the Korean cohort, with BMI and smoking showing stronger associations with AF risk in the UK population. Despite these differences, several risk factors, including hypertension and diabetes, were common predictors in both populations. The study highlights the complex interplay of lifestyle and healthcare system factors along with analysis of different large cohort studies in AF development and underscores the need for population-specific risk assessment and prevention strategies. https://www.hrsonline.org/education/TheLead https://www.heartrhythmjournal.com/article/S1547-5271(25)00128-6/fulltext Host Disclosure(s): M. Middeldorp: Nothing to disclose. Contributor Disclosure(s): S. Lee: Nothing to disclose. A. Elliott: Nothing to disclose. This episode has .25 ACE credits associated with it. If you want credit for listening to this episode, please visit the episode page on HRS365: https://www.heartrhythm365.org/URL/TheLeadEpisode96
/episode/index/show/884ca9c9-a6ed-4c26-a44c-72f2b3c80b39/id/35777280
info_outline
The Lead Podcast - Episode 95: A Discussion of Personalized Voltage Maps Guided by Cardiac Magnetic Resonance...
03/13/2025
The Lead Podcast - Episode 95: A Discussion of Personalized Voltage Maps Guided by Cardiac Magnetic Resonance...
William H. Sauer, MD, FHRS, CCDS, Brigham and Women's Hospital, is joined by Arif Elvan, MD, PhD, Klinikum Braunschweig, and Usha B. Tedrow, MD, MS, FHRS, Brigham and Women’s Hospital, to discuss if Voltage mapping could identify the conducting channels potentially responsible for ventricular tachycardia (VT). Standard thresholds (0.5–1.5 mV) were established using bipolar catheters. No thresholds have been analyzed with high-density mapping catheters. In addition, channels identified by cardiac magnetic resonance (CMR) have been proven to be related to VT. https://www.hrsonline.org/education/TheLead https://doi.org/10.1016/j.hrthm.2024.04.074 Host Disclosure(s): W. Sauer: Honoraria/Speaking/Consulting: Biotronik, Biosense Webster, Inc., Abbott, Boston Scientific, Research: Medtronic Contributor Disclosure(s): A. Elvan: Honoraria/Speaking/Consulting: Abbott Medical U. Tedrow: Honoraria/Speaking/Consulting/Teaching: Medtronic, Biosense Webster, Inc., St. Jude Medical, Thermedical, Boston Scientific, Baylis Medical Company This episode has .25 ACE credits associated with it. If you want credit for listening to this episode, please visit the episode page on HRS365: https://www.heartrhythm365.org/URL/TheLeadEpisode95
/episode/index/show/884ca9c9-a6ed-4c26-a44c-72f2b3c80b39/id/35656850
info_outline
The Lead Podcast - Episode 94: A Discussion of Atrial Fibrillation Nomenclature, Definitions, and Mechanisms...
03/06/2025
The Lead Podcast - Episode 94: A Discussion of Atrial Fibrillation Nomenclature, Definitions, and Mechanisms...
Deep Chandh Raja, MBBS, MD, PhD, Australian National University, Kauvery Hospital, is joined by Dhiraj Gupta, MBBS, MD, Liverpool Heart and Chest Hospital, and Dominik K Linz, MD, PhD, Maastricht University Medical Center, to discuss a international position paper, developed by the Working Group of the Signal Summit, highlights the challenges in understanding and treating atrial fibrillation (AF), the most common arrhythmia in adults. Despite technological advancements in pulmonary vein isolation (PVI), progress in understanding AF mechanisms, structural changes, and phenotypic differences has been limited due to inconsistent terminology, suboptimal mapping techniques, and the complex nature of AF itself. The paper aims to establish clearer definitions, promote standardized approaches, and propose research pathways to improve AF therapies and patient outcomes. https://www.hrsonline.org/education/TheLead https://www.heartrhythmjournal.com/article/S1547-5271(24)03564-1/fulltext Host Disclosure(s): D. Raja: Nothing to disclose. Contributor Disclosure(s): D. LInz: Nothing to disclose. D. Gupta: Research: Medtronic Bakken Research Center, Biosense Webster, Inc., Boston Scientific This episode has .25 ACE credits associated with it. If you want credit for listening to this episode, please visit the episode page on HRS365: https://www.heartrhythm365.org/URL/TheLeadEpisode94
/episode/index/show/884ca9c9-a6ed-4c26-a44c-72f2b3c80b39/id/35560430
info_outline
The Lead Podcast - Episode 93: A Discussion of Safety of pulsed field ablation in more than 17,000 patients with AFib...
02/27/2025
The Lead Podcast - Episode 93: A Discussion of Safety of pulsed field ablation in more than 17,000 patients with AFib...
William Sauer, MD, FHRS, CCDS, Brigham and Women's Hospital is joined by Tobias Reichlin, MD, University Hospital Basel, Switzerland, and Nikolas Nozica, MD, Brigham and Women's Hospital, to discuss the Nature Medicine article Safety of pulsed field ablation in more than 17,000 patients with atrial fibrillation in the MANIFEST-17K study. The following is a brief summary of the study covered in the article. Pulsed field ablation (PFA) is an emerging technology for the treatment of atrial fibrillation (AF), for which pre-clinical and early-stage clinical data are suggestive of some degree of preferentiality to myocardial tissue ablation without damage to adjacent structures. Here in the MANIFEST-17K study, we assessed the safety of PFA by studying the post-approval use of this treatment modality. Of the 116 centers performing post-approval PFA with a pentaspline catheter, data were received from 106 centers (91.4% participation) regarding 17,642 patients undergoing PFA (mean age 64, 34.7% female, 57.8% paroxysmal AF, and 35.2% persistent AF). No esophageal complications, pulmonary vein stenosis, or persistent phrenic palsy was reported (transient palsy was reported in 0.06% of patients; 11 of 17,642). Major complications, reported for ~1% of patients (173 of 17,642), were pericardial tamponade (0.36%; 63 of 17,642) and vascular events (0.30%; 53 of 17,642). Stroke was rare (0.12%; 22 of 17,642) and death was even rarer (0.03%; 5 of 17,642). Unexpected complications of PFA were coronary arterial spasm in 0.14% of patients (25 of 17,642) and hemolysis-related acute renal failure necessitating hemodialysis in 0.03% of patients (5 of 17,642). Taken together, these data indicate that PFA demonstrates a favorable safety profle by avoiding much of the collateral damage seen with conventional thermal ablation. PFA has the potential to be transformative for the management of patients with AF. https://www.hrsonline.org/education/TheLead https://doi.org/10.1038/s41591-024-03114-3 Host Disclosure(s): W. Sauer: Honoraria/Speaking/Consulting: Biotronik, Biosense Webster, Inc., Abbott, Boston Scientific, Research: Medtronic Contributor Disclosure(s): N. Nozica: Nothing to disclose. T. Reichlin: Nothing to disclose. This episode has .25 ACE credits associated with it. If you want credit for listening to this episode, please visit the episode page on HRS365 https://www.heartrhythm365.org/URL/TheLeadEpisode93
/episode/index/show/884ca9c9-a6ed-4c26-a44c-72f2b3c80b39/id/35440640
info_outline
The Lead Podcast - Episode 92: A Discussion of Substrate Mapping for Ventricular Tachycardia Ablation...
02/20/2025
The Lead Podcast - Episode 92: A Discussion of Substrate Mapping for Ventricular Tachycardia Ablation...
William Sauer, MD, FHRS, CCDS, Brigham and Women's Hospital is joined by Wendy Tzou, MD, FHRS, University of Colorado Anschutz Medical Campus, and Arif Elvan, MD, PhD, Klinikum Braunschweig, to discuss a partial delineation of targets for ablation of ventricular tachycardia (VT) during a stable rhythm is likely responsible for a suboptimal success rate. The abnormal low-voltage near-field functional components may be hidden within the high-amplitude far-field signal. https://www.hrsonline.org/education/TheLead https://doi.org/10.1016/j.jacep.2024.04.023 Host Disclosure(s): W. Sauer: Honoraria/Speaking/Consulting: Biotronik, Biosense Webster, Inc., Abbott, Boston Scientific, Research: Medtronic Contributor Disclosure(s): A. Elvan: Honoraria/Speaking/Consulting: Abbott Medical W. Tzou: Honoraria/Speaking/Consulting/Teaching: Medtronic, Biotronik, Mediasphere Medical, Biosense Webster, Inc., American Heart Association, Abbott, Boston Scientific, Membership on Advisory Committees: Medtronic, Inc., Biosense Webster, Inc., Kardium, BioTelemetry, Inc., Research: Abbott Medical This episode has .25 ACE credits associated with it. If you want credit for listening to this episode, please visit the episode page on HRS365 https://www.heartrhythm365.org/URL/TheLeadEpisode92
/episode/index/show/884ca9c9-a6ed-4c26-a44c-72f2b3c80b39/id/35356575
info_outline
The Lead Podcast - Episode 91: A Discussion of LAA Closure after Ablation for AFib
02/13/2025
The Lead Podcast - Episode 91: A Discussion of LAA Closure after Ablation for AFib
Bruce Koplan, MD, FHRS, Brigham and Women's Hospital is joined by Erik Andrews, MD, MPH, Brigham and Women’s Hospital, and Matthew Reynolds, MD, MS, FHRS, Lahey Hospital & Medical Center to discuss why Oral anticoagulation is recommended after ablation for atrial fibrillation among patients at high risk for stroke. Left atrial appendage closure is a mechanical alternative to anticoagulation, but data regarding its use after atrial fibrillation ablation are lacking. https://www.hrsonline.org/education/TheLead https://www.nejm.org/doi/full/10.1056/NEJMoa2408308 Host Disclosure(s): B. Koplan: Honoraria/Speaking/Consulting: GE Healthcare Contributor Disclosure(s): E. Andrews: Stocks, Publicly Traded: Apple, Inc. Microsoft, Intel, Inc., Moderna Therapeutics, Fellowship Support: Boston Scientific, Medtronic, Inc. M. Reynolds: Honoraria/Speaking/Consulting: Medtronic, Edwards Lifesciences, Philips, iRhythm Technologies, Membership on Advisory Committees: Affera, Inc. This episode has .25 ACE credits associated with it. If you want credit for listening to this episode, please visit the episode page on HRS365 https://www.heartrhythm365.org/URL/TheLeadEpisode91
/episode/index/show/884ca9c9-a6ed-4c26-a44c-72f2b3c80b39/id/35257115
info_outline
The Lead Podcast - Episode 90: A Discussion of Catheter Ablation or Antiarrhythmic Drugs for VT
02/06/2025
The Lead Podcast - Episode 90: A Discussion of Catheter Ablation or Antiarrhythmic Drugs for VT
William H. Sauer, MD, FHRS, CCDS, Brigham and Women's Hospital is joined by Isabella Alviz, MD, Brigham, and Women’s Hospital, and Usha B. Tedrow, MD, MS, FHRS, Brigham and Women’s Hospital to discuss how patients with ventricular tachycardia and ischemic cardiomyopathy are at high risk for adverse outcomes. Catheter ablation is commonly used when antiarrhythmic drugs do not suppress ventricular tachycardia. Whether catheter ablation is more effective than antiarrhythmic drugs as a first-line therapy in patients with ventricular tachycardia is uncertain. https://www.hrsonline.org/education/TheLead https://www.nejm.org/doi/full/10.1056/NEJMoa2409501 Host Disclosure(s): W. Sauer: Honoraria/Speaking/Consulting: Biotronik, Biosense Webster, Inc., Abbott, Boston Scientific, Research: Medtronic Contributor Disclosure(s): I. Alviz: Nothing to disclose. U. Tedrow: Honoraria/Speaking/Consulting/Teaching: Medtronic, Biosense Webster, Inc., St. Jude Medical, Thermedical, Boston Scientific, Baylis Medical Company This episode has .25 ACE credits associated with it. If you want credit for listening to this episode, please visit the episode page on HRS365 https://www.heartrhythm365.org/URL/TheLeadEpisode90
/episode/index/show/884ca9c9-a6ed-4c26-a44c-72f2b3c80b39/id/35162290
info_outline
The Lead Podcast - Episode 89: A Discussion of Vasovagal Responses to Human Monomorphic Ventricular Tachycardia...
01/30/2025
The Lead Podcast - Episode 89: A Discussion of Vasovagal Responses to Human Monomorphic Ventricular Tachycardia...
Dr. Jason T. Jacobson, MD, FHRS, Westchester Medical Center, New York Medical College is joined by Melissa Robinson, MD, FHRS, Providence Heart Institute of Montana, and Dr. Sei Iwai, MD, FHRS, Westchester Medical Center, New York Medical College to discuss: BACKGROUND Factors determining hemodynamic stability during human ventricular tachycardia (VT) are incompletely understood. OBJECTIVES This study aimed to characterize sinus rate (SR) responses during monomorphic VT in association with hemodynamic stability and prospectively assess the effects of vagolytic therapy on VT tolerance. METHODS This is a retrospective analysis of patients undergoing scar-related VT ablation. Vasovagal responses were evaluated by analyzing sinus cycle length before VT induction and during VT. SR responses were classified into 3 groups: increasing ($5 beats/min, sympathetic), decreasing ($5 beats/min, vagal), and unchanged, with the latter 2 categorized as inappropriate SR. In a prospective cohort (n . 30) that exhibited a failure to increase SR, atropine was administered to improve hemodynamic tolerance to VT. RESULTS In 150 patients, 261 VT episodes were analyzed (29% untolerated, 71% tolerated) with a median VT duration of 1.6 minutes. A total of 52% of VT episodes were associated with a sympathetic response, 31% had unchanged SR, and 17% of VTs exhibited a vagal response. A significantly higher prevalence of inappropriate SR responses was observed during untolerated VT (sustained VT requiring cardioversion within 150 seconds) compared with tolerated VT (84% vs 34%; P < 0.001). Untolerated VT was significantly different between groups: 9% (sympathetic), 82% (vagal), and 32% (unchanged) (P < 0.001). Atropine administration improved hemodynamic tolerance to VT by 70%. CONCLUSIONS Nearly one-half of VT episodes are associated with failure to augment SR, indicative of an underrecognized pathophysiological vasovagal response to VT. Inappropriate SR responses were more predictive of hemodynamic instability than VT rate and ejection fraction. Vagolytic therapy may be a novel method to augment blood pressure during VT. https://www.hrsonline.org/education/TheLead https://www.jacc.org/doi/10.1016/j.jacc.2023.06.033 Host Disclosure(s): J. Jacobson: Honoraria/Speaking/Consulting: Zoll Medical, Abbott Medical, Vektor Medical, Stocks, Privately Held: Atlas 5D, Research: CardioFocus, Inc. Contributor Disclosure(s): M. Robinson: Honoraria/Speaking/Consulting: Biosense Webster, Inc., Boston Scientific, Abbott, Membership on Advisory Committees: Medtronic Inc. S. Iwai: Honoraria/Speaking/Consulting: Alta Thera Pharmaceuticals, Biotronik
/episode/index/show/884ca9c9-a6ed-4c26-a44c-72f2b3c80b39/id/35072165