Podcasts about Ablation

In this episode of The Lead, host Christopher C. Cheung, MD, MPH, FHRS, is joined by Edward P. Gerstenfeld, MD, MS, FHRS, and Paul C. Zei, MD, PhD, FHRS, to discuss the journal article, A Prospective Randomized Multicenter Global Study Comparing Pulsed Field Ablation versus Anti-Arrhythmic Drug Therapy as a First Line Treatment for Persistent Atrial Fibrillation (AVANT GUARD). Together, they review the study design and findings, examining pulsed field ablation and anti-arrhythmic drug therapy as first-line treatment approaches for patients with persistent atrial fibrillation. Learning Objectives Review the design and key findings of the AVANT GUARD study comparing pulsed field ablation with anti-arrhythmic drug therapy as first-line treatment for persistent atrial fibrillation. Discuss the potential role of pulsed field ablation as an initial treatment strategy for patients with persistent atrial fibrillation. Examine the comparative considerations of ablation-based and pharmacologic approaches in the management of persistent atrial fibrillation.   Podcast Contributors: Host: Christopher C Cheung, MD, MPH, FHRS       Guests: Edward P. Gerstenfeld, MD, MS, FHRS and Paul C Zei, MD, PhD, FHRS   Disclosures: Christopher C Cheung, MD, MPH, FHRS Honoraria/Speaking/Consulting Fee: Medtronic, Inc., Biotronik, Biosense Webster, Inc., Abbott Edward P. Gerstenfeld, MD, MS, FHRS Honoraria/Speaking/Consulting Fee: Medtronic, Inc., Biosense Webster, Inc., Abbott, Boston Scientific, Varian Medical Systems Other Non-Financial Relationships: Adagio Medical, Boston Scientific, Abbott Medical Research: Abbott Medical Officer, Trustee, Director, Committee Chair, or Other Fiduciary Role: American College of Cardiology Paul C Zei, MD, PhD, FHRS Honoraria/Speaking/Consulting Fee/Speaker's Bureau: Varian Medical Systems, Biosense Webster, Inc., Abbott, Boston Scientific, APT Medical Research: Biosense Webster, Inc.

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.  

With Philipp Sommer, Heart and Diabetes Center NRW, Bad Oeynhausen - Germany and Vanessa Sciacca, Heart and Diabetes Center NRW, Bad Oeynhausen - Germany. Link to European Heart Journal paper Link to European Heart Journal editorial

Dr. Linda Chu and Dr. Christos Georgiades for an in-depth look at thermal and non-thermal liver ablation, explaining how techniques like microwave ablation, cryoablation, and histotripsy work at a mechanistic level. Their conversation also explores how clinicians choose the right approach for each patient and highlights emerging advances in immunologic strategies and AI shaping the future of liver tumor treatment.   Thermal and Nonthermal Liver Ablation: Mechanistic Foundations, Clinical Implementation, Immunologic Trial Design, and Artificial Intelligence.  Centner et al. Radiology 2026; 318(3):e25026.   

In this episode, CardioNerds Dr. Colin Blumenthal, Dr. Kelly Arps, and Dr. Yong Hao Yeo are joined by electrophysiology expert Dr. Bradley Knight to discuss atrial fibrillation (AF) management in challenging clinical scenarios. We explore arrhythmias in patients with pre-excitation syndromes, particularly Wolff-Parkinson-White (WPW) syndrome, and strategies for rhythm control. We also discuss AF management in pregnancy, adult congenital heart disease, and patients with tachycardia-bradycardia (tach-brady) syndrome. This episode provides essential insights into nuanced decision-making for the care of patients with complex arrhythmia profiles. Audio editing by CardioNerds academy intern, Grace Qiu. Enjoy this Circulation 2022 Paths to Discovery article to learn about the CardioNerds story, mission, and values. CardioNerds Atrial Fibrillation PageCardioNerds Episode PageCardioNerds AcademyCardionerds Healy Honor Roll CardioNerds Journal ClubSubscribe to The Heartbeat Newsletter!Check out CardioNerds SWAG!Become a CardioNerds Patron! PEARLS AF in WPW is a true emergency—AV nodal blocking agents can be deadly. In patients with WPW syndrome, AF can rapidly conduct through the accessory pathway, risking ventricular fibrillation and sudden death. Avoid AV nodal blockers like beta-blockers and calcium channel blockers. Catheter ablation is the first-line rhythm control strategy in WPW. Catheter ablation carries a Class I recommendation and offers >90% success. If antiarrhythmic drugs are needed, sodium channel blockers like flecainide or propafenone are preferred in patients without structural heart disease. In pregnancy, protecting the mother is protecting the fetus. An unstable mother means an unstable fetus. Rate control is the first step in AF with rapid ventricular responses and electrical cardioversion is safe when needed. Multidisciplinary care is essential. AF in congenital heart disease is often outside the pulmonary veins. Surgical scars and chamber remodeling in ACHD patients often lead to AF from non-pulmonary vein foci. Electrogram-based mapping and targeted ablation strategies are essential to increase success rate of durable rhythm control. Tachy-brady syndrome may require pacing to unlock therapy. AF may cause atrial myopathy and sinus node dysfunction. These patients often require permanent pacing to allow safe use of rate-controlling medications like beta-blockers and to prevent syncope or chronotropic incompetence. Notes: Notes drafted by Dr. Yong Hao Yeo Why is atrial tachycardia in patients with WPW syndrome dangerous? Patients with WPW commonly present with supraventricular tachycardia (SVT) due to atrioventricular reentrant circuits, either orthodromic or antidromic. This SVT can degenerate into AF. In the absence of AV nodal as the governor between the atrium and ventricles, the accessory pathway may conduct impulses rapidly and frequently. This can lead to dangerously high ventricular rates, predisposing patients to ventricular fibrillation and sudden cardiac arrest. What are some strategies for rhythm control in patients with WPW and atrial tachycardia? Catheter ablation is the first-line therapy (Class I recommendation), with a success rate of over 90%. Ablation reduces the risk of sudden cardiac arrest, though some patients may remain prone to AF. If ablation is not feasible/ contraindicated, sodium channel blockers such as flecainide and propafenone are good options in patients without ischemia or structural heart disease (Class IIa recommendation). Amiodarone should be avoided because it has a long half-life, can accumulate in the system, and may delay definitive treatment with catheter ablation. AV nodal blocking agents like beta blockers and calcium channel blockers should be avoided, as they are less effective at controlling ventricular rate in WPW and can increase conduction over the accessory pathway. These agents can also exacerbate the risk of rapid ventricular rates during AF and worsen left ventricular function. What are some special considerations in managing AF in pregnant patients? The primary goal in managing cardiovascular disease during pregnancy is to protect the mother, as fetal outcomes depend on maternal well-being. Therefore, while caution is necessary, we should avoid undertreating pregnant patients with AF. In cases of AF with rapid ventricular response (RVR), rate control is usually the first-line strategy, with beta blockers preferred over digoxin or non-dihydropyridine calcium channel blockers. It is then reasonable to initially observe for spontaneous conversion in stable patients. Antiarrhythmic drugs (AADs) are generally avoided during the first trimester, but clinical judgment on a case-by-case basis is essential. Evidence for the safety of AADs in pregnancy is limited, often derived from their use in other conditions such as fetal SVT. Flecainide and sotalol are reasonable options for rhythm control (Class IIa recommendation). Electrical cardioversion is considered safe in pregnancy and should be utilized when indicated (Do not forget!). There is no pregnancy-specific thromboembolic risk stratification tool. CHA₂DS₂-VASc scoring and the presence of risk factors like mitral stenosis can help guide anticoagulation decisions, though the magnitude of thromboembolic risk during pregnancy remains unclear. Rate control agents are typically continued during delivery due to the increased physiologic stress of labor and delivery. Multidisciplinary care is crucial and should involve obstetrics, maternal-fetal medicine, cardiology, and electrophysiology specialists. What are some key considerations for AF management in patients with adult congenital heart disease (ACHD)? Patients with repaired congenital heart disease are at increased risk for arrhythmias due to two main factors: surgical scars that create arrhythmogenic foci and mechanical remodeling of the atria or ventricles resulting from the underlying disease. In these patients with structural heart disease, sodium channel blockers may not be ideal antiarrhythmic options. When selecting an antiarrhythmic drug, clinicians must consider the nature of structural or surgical impairments, such as right bundle branch block or prolonged QT interval. It is also essential to assess renal and hepatic function (often impaired in patients with ACHD) to ensure appropriate metabolism and clearance of antiarrhythmic medications. Electrogram-based ablation strategies (those leveraging artificial intelligence are developing!) may help identify effective ablation targets, which are often outside the pulmonary veins in patients with ACHD. These individualized approaches can improve ablation success rates in this complex patient population. What makes tachycardia-bradycardia (tach-brady) syndrome a unique challenge in arrhythmia management? Patients who present with both AF and bradycardia, especially with syncope, require a thoughtful diagnostic approach to identify the underlying rhythm disturbance. Extended cardiac monitoring, including event monitors or implantable loop recorders, can help capture intermittent arrhythmias and correlate them with symptoms. AF may lead to atrial myopathy, and since the sinus node resides within the atrium, this can result in sinus node dysfunction—a hallmark of tachy-brady syndrome. Following spontaneous conversion from AF to sinus rhythm, sinus node dysfunction may persist, leading to prolonged pauses or chronotropic incompetence. Management becomes more complex when beta-blockers are needed for AF with RVR, as they can exacerbate bradycardia. Permanent pacemaker implantation is often the next step to consider. Permanent pacemaker implantation is often considered to facilitate safe rate control in these cases. In younger patients, aggressive AF burden reduction may prevent atrial remodeling and the development of true atrial myopathy, potentially avoiding pacemaker implantation. References Joglar JA, Chung MK, Armbruster AL, et al. 2023 ACC/AHA/ACCP/HRS Guideline for the Diagnosis and Management of Atrial Fibrillation: A Report of the American College of Cardiology/American Heart Association Joint Committee on Clinical Practice Guidelines. Circulation. 2023;149(1). doi:https://doi.org/10.1161/CIR.0000000000001193 ‌ Van IC, Rienstra M, Bunting KV, et al. 2024 ESC Guidelines for the management of atrial fibrillation developed in collaboration with the European Association for Cardio-Thoracic Surgery (EACTS). European Heart Journal. 2024;45(36). doi:https://doi.org/10.1093/eurheartj/ehae176 ‌ Joglar JA, Kapa S, Saarel EV, et al. 2023 HRS expert consensus statement on the management of arrhythmias during pregnancy. Heart Rhythm. Published online May 1, 2023. doi:https://doi.org/10.1016/j.hrthm.2023.05.017 ‌ Stout KK, Daniels CJ, Aboulhosn JA, et al. 2018 AHA/ACC Guideline for the Management of Adults With Congenital Heart Disease: Executive Summary. Journal of the American College of Cardiology. 2019;73(12):1494-1563. doi:https://doi.org/10.1016/j.jacc.2018.08.1028 ‌

This April 2026 Heart Rhythm Journal publication reports a sub-analysis of the CHAMPION-AF trial evaluating left atrial appendage closure (LAAC) versus oral anticoagulation in patients with atrial fibrillation who previously underwent catheter ablation. The analysis demonstrated that LAAC with the WATCHMAN FLX device provided comparable protection against stroke, systemic embolism, and cardiovascular death when compared with NOAC therapy, while also reducing long-term non-procedural bleeding events. These findings support consideration of LAAC as an alternative stroke prevention strategy in selected post-ablation AF patients through individualized, shared decision-making. 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  

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 

What Do I Need to Know About Pulsed Field Ablation?   Guest: Christopher DeSimone, Host: Anthony Kashou, M.D.   In this episode of “ECG Making Waves, hosted by Dr. Anthony Kashou with guest Dr. Christopher DeSimone, the focus is on understanding the evolution of ablation technology, particularly why the field has shifted toward pulsed field ablation. The conversation explores the key differences between traditional thermal ablation methods and pulsed field ablation, highlighting mechanisms, safety profiles, and clinical advantages. Additionally, it provides insight into what patients and clinicians can expect on the day of an ablation procedure, as well as important considerations for post-procedure follow-up and recovery.   Topics Discussed: What is pulsed field ablation? What are some of the differences between risks seen with thermal ablation vs. those seen with pulsed field ablation? How does efficiency of the procedure or speed of the procedure change what you do for ablation?   Connect with Mayo Clinic's Cardiovascular Continuing Medical Education online at https://cveducation.mayo.edu or on Twitter @MayoClinicCV and @MayoCVservices. LinkedIn: Mayo Clinic Cardiovascular Services Cardiovascular Education App: The Mayo Clinic Cardiovascular CME App is an innovative educational platform that features cardiology-focused continuing medical education wherever and whenever you need it. Use this app to access other free content and browse upcoming courses. Download it for free in Apple or Google stores today! No CME credit offered for this episode.   Podcast episode transcript found here.   Recorded on: 28-January-2026

Episode 81 - Freeze, Heat, Treat - The New Era of Bronchoscopic Ablation by AABIP

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 

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.  

Experience the 40 minutes of absolute silence during the Artemis II Loss of Signal (LOS). This deep dive explains the Hybrid Free Return Trajectory that acts as a cosmic safety belt for the four astronauts. Learn about the Radio Shadow behind the Moon, the terrifying beauty of the Earthrise, and the physics of the Mach 32 atmospheric re-entry. We break down the Ablation process of the Avcoat heat shield and the physiological effects of G-force on the human body. Discover how this mission bridges the gap between the Apollo era and future Mars exploration.

Ein fremdelndes Hallo aus dem Hotelzimmer. Lasst euch von uns im präpandemischen Déjà-vu beruhigen und informieren, denn Iris kennt die Wahrheit. Sie ist der Kanarienvogel im Hantaschacht und hilf jedem blöden Kopf, der auf Sicherheit setzen will. Lasst uns neue Kapitel beginnen, bevor wir das alte nicht mehr aushalten. Wir widerstehen dem Fluch des Wissens wie Neil deGrasse Tyson. Der Fluch der Dummheit ist eh viel gefährlicher. Matthias erträgt keine Angriffe gegen die Wissenschaft, Iris stellt erstmal Fragen. Lohnt sich eine Ablation mit der Gabel? Wir haben noch keine guten Antworten, das ist die Kehrseite des Dunning-Kruger-Effekts. Erfahrt das Geheimnis der Schwarzmarkt-Zahnärztin, aber glaubt es nicht, sonst landet ihr mit Globuli am Arsch. Sprich, in der Intensivmedizin. Cui bono? Wir haben keine Zeit, uns provoziert zu fühlen, denn wir müssen mittendrin auschecken und schnell auf die Bühne. Gibt es unter euch eigentlich Leute, die KI ein Bewusstsein zutrauen? Meldet euch und erzählt mal. Du möchtest uns eine Sprachnachricht für den Podcast schicken? Folge uns auf Instagram und nutze dort den Chat: https://www.instagram.com/coupleof_podcast/ Du möchtest mehr über unsere Werbepartner erfahren? Hier findest du alle Infos und Rabatte: https://linktr.ee/CoupleOf Du möchtest Werbung in diesem Podcast schalten? Dann erfahre hier mehr über die Werbemöglichkeiten bei Seven.One Audio: https://www.seven.one/portfolio/sevenone-audio

Dr. Ashwin Singh Parihar sits down with Dr. Iben Lyskjær and Dr. Tommy Kjærgaard Nielsen to unpack new nationwide registry data comparing ablation and surgical approaches for small renal masses. Together, they explore how minimally invasive treatments stack up in real-world practice and what the findings mean for patient selection, outcomes, and future care decisions. Ablation and Surgery Show Comparable Long-term Outcomes for T1a Renal Cell Carcinoma: A Danish Nationwide Registry Study. Ahrenfeldt et al. Radiology 2026; 318(3):e251485.

When a liver tumor is hard to see, the limits of conventional image guidance can become the limits of treatment. In this episode of the BackTable Podcast, Netherlands interventional oncologist Dr. Maarten (M.L.J.) Smits shares a step-by-step walkthrough of the new hepatic arteriography and C-arm CT–guided ablation (HepACAGA) technique, punctuated with a real-world case series at the end. Find out how intra-arterial contrast, cone-beam CT, and 3D needle guidance can improve tumor conspicuity, targeting accuracy, and ablation margin assessment within a single angiography suite. --- Get the BackTable apphttps://www.backtable.com/app --- Timestamps 00:00 - Introduction02:55 - Netherlands Tech Access04:31 - Origin of HepACAGA07:14 - Why Use a Catheter?11:24 - Tools and Setup13:13 - Catheters and Devices17:06 - Contrast Protocol Basics22:51 - Targeting and Needle Guidance31:09 - Patient Selection35:56 - Extra Benefits and Multimodal39:58 - Workflow and Outcomes46:14 - Evidence and Early Studies51:41 - Rethinking Size Cutoffs57:54 - HCC Case Walkthrough01:02:27 - Hard-to-See Metastasis01:06:22 - Margin Driven Reablation01:11:04 - Bleeding and Embolization01:16:05 - Renal ACAGA Expansion01:23:31 - Adoption and Next Steps --- More about this episode Dr. Smits explains the origins of HepACAGA and why catheter-based contrast delivery can meaningfully change ablation planning, particularly for small lesions, poorly visualized tumors, and cases where ultrasound or conventional CT guidance may be insufficient. He walks through the practical setup, including catheter positioning, contrast dilution, timing protocols, needle navigation, apnea/end-expiration technique, and built-in fusion for immediate ablation verification. He also describes how the angio suite environment supports multimodal treatment, including intraprocedural embolization when bleeding occurs or when additional transarterial therapy is needed. The episode also examines early outcomes from Dr. Smits' group, including a reported reduction in local recurrence from approximately 25% to 5%, with a modest increase in procedure time. Case examples include HCC, small colorectal liver metastases, margin-driven re-ablation, hemorrhage management, and extension of the ACAGA concept to renal tumors (RenACAGA). --- Resources Hepatic Arteriography and C-Arm CT-Guided Ablation (HepACAGA) to Improve Tumor Visualization, Navigation and Margin Confirmation in Percutaneous Liver Tumor Ablationhttps://pubmed.ncbi.nlm.nih.gov/37704863/ Renal Arteriography and C-arm CT-Guided Ablation (RenACAGA) for Thermal Ablation of Challenging Renal Tumorshttps://pubmed.ncbi.nlm.nih.gov/40295401/ --- BackTable Vascular & Interventional (VI) is the go-to podcast for interventional radiologists, vascular surgeons, and interventional cardiologists. Download the free BackTable app to get early access to new episodes, cases, and courses curated by physicians in your specialty. ► https://www.backtable.com/app

New cardiovascular data suggest pulsed field ablation may challenge antiarrhythmic drugs as first-line therapy for persistent atrial fibrillation, while real-world evidence positions apixaban as the preferred DOAC for younger patients with nonvalvular AF due to superior safety and effectiveness. Additional findings from the SENIOR-RITA trial indicate that routine invasive management may not benefit frail older adults with NSTEMI and could worsen outcomes in the most frail patients. Together, these studies highlight a growing shift toward more individualized cardiovascular treatment strategies.

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In this podcast, Francis Marchlinski, MD, Deputy Editor of JACC: Clinical Electrophysiology, discusses a large multicenter study evaluating the incidence and clinical significance of aortic regurgitation following mapping and ablation of ventricular arrhythmias in the aortic cusps and commissures. Drawing on contemporary data from four high‑volume centers, the paper provides important reassurance regarding the safety of aortic cusp ablation, demonstrating that clinically significant aortic regurgitation is rare and infrequently progressive. Dr. Marchlinski highlights the key findings, procedural considerations, and implications for everyday practice in ventricular arrhythmia ablation.

In this podcast, Francis Marchlinski, MD, Deputy Editor of JACC: Clinical Electrophysiology, discusses a novel pulsed field ablation–based endocardial strategy for ventricular tachycardia in patients with arrhythmogenic right ventricular cardiomyopathy. The paper presents an early consecutive experience demonstrating the feasibility, acute effectiveness, and safety of PFA for VT without the need for epicardial access. Dr. Marchlinski highlights the clinical implications of this approach and how tissue-selective, nonthermal energy may expand treatment options for this challenging patient population.

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 AuthorsTakumi Yamada and G. Neal Kay Podcast ContributorsDr. 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

In this episode, Mansour Razminia, MD, Medical Director of Electrophysiology for the Bluhm Cardiovascular Institute at Northwestern Medicine Palos Hospital, shares how intracardiac echo is transforming ablation by eliminating radiation exposure and improving safety for patients and care teams while challenging traditional training models.

This Special Episode on Atrial Fibrillation covers: Cardiology this Week: A concise summary of recent studies Atrial fibrillation burden: clinical relevance of a new outcome Pulsed field ablation: game changer? Drug treatment following atrial fibrillation ablation Spotlight: Holiday Heart Syndrome Host: Rick Grobbee Guests: Rick Grobbee, Konstantinos Koskinas, Jason Andrade, Arian Sultan, Michiel Rienstra Want to watch that special episode? Go to: https://esc365.escardio.org/event/2549 Disclaimer: ESC TV Today is supported by Novartis through an independent funding. The programme has not been influenced in any way by its funding partner. This programme is intended for health care professionals only and is to be used for educational purposes. The European Society of Cardiology (ESC) does not aim to promote medicinal products nor devices. Any views or opinions expressed are the presenters' own and do not reflect the views of the ESC. All declarations of interest are listed at the end of the episode. The ESC is not liable for any translated content of this video. The English language always prevails. Declarations of interests: Stephan Achenbach, Jason Andrade, Yasmina Bououdina, Rick Grobbee and Nicolle Kraenkel have declared to have no potential conflicts of interest to report. Carlos Aguiar has declared to have potential conflicts of interest to report: personal fees for consultancy and/or speaker fees from Abbott, AbbVie, Alnylam, Amgen, AstraZeneca, Bayer, BiAL, Boehringer-Ingelheim, Daiichi-Sankyo, Ferrer, Gilead, GSK, Lilly, Novartis, Pfizer, Sanofi, Servier, Takeda, Tecnimede. John-Paul Carpenter has declared to have potential conflicts of interest to report: stockholder MyCardium AI. Davide Capodanno has declared to have potential conflicts of interest to report: Abbott Vascular, Bristol Myers Squibb, Daiichi Sankyo, Edwards Lifesciences, Novo Nordisk, Sanofi Aventis, Terumo. Konstantinos Koskinas has declared to have potential conflicts of interest to report: honoraria from MSD, Daiichi Sankyo, Sanofi. Felix Mahfoud has declared to have potential conflicts of interest to report: research grants from Deutsche Forschungsgemeinschaft (SFB TRR219), Deutsche Gesellschaft für Kardiologie (DGK), Deutsche Herzstiftung, Ablative Solutions, ReCor Medical. Consulting fees, payment honoraria lectures, presentations, speaker, support travel costs: Ablative Solutions, Astra-Zeneca, Novartis, Inari, Recor Medical, Medtronic, Philips, Merck. Steffen Petersen has declared to have potential conflicts of interest to report: consultancy for Circle Cardiovascular Imaging Inc. Calgary, Alberta, Canada.  Michiel Rienstra has declared to have potential conflicts of interest to report: consultancy fees from Bayer (OCEANIC-AF national PI) , InCarda Therapeutics (RESTORE-SR national PI), Novartis to the institution. Speaker fee from Daiichi-Sankyo, Pfizer to the institution. Unrestricted research grant from the Dutch Heart Foundation and is conducted in collaboration with and supported by the Dutch CardioVascular Alliance, 01-002-2022-0118 EmbRACE. Unrestricted research grant from ZonMW and the Dutch Heart Foundation; DECISION project 848090001. Unrestricted research grants from the Netherlands Cardiovascular Research Initiative: an initiative with support of the Dutch Heart Foundation; RACE V (CVON 2014–9), RED-CVD (CVON2017-11). Unrestricted research grant from Top Sector Life Sciences & Health to the Dutch Heart Foundation (PPP Allowance; CVON-AI (2018B017). Unrestricted research grant from the European Union's Horizon 2020 research and innovation programme under grant agreement; EHRA-PATHS (945260). This research is funded by the Dutch Heart Foundation and is conducted in collaboration with and supported by the Dutch CardioVascular Alliance, 01 -002 -2022 -0118 EmbRACE.  Emma Svennberg has declared to have potential conflicts

Treatment for atrial fibrillation (A-fib) is becoming safer and more efficient with the addition of pulsed field ablation (PFA). Cardiac electrophysiologist William Maddox, M.D., explains how PFA targets cardiac tissue while sparing nearby structures and how it can be combined with radiofrequency ablation when needed.

Dave Rosa, CEO and President of NeuroOne, medtech entrepreneur, board member and former executive at St. Jude Medical, Boston Scientific and C.R. Bard. With three decades in medical devices and more than $200 million raised, Dave brings a rare mix of operator, inventor and capital markets experience to the future of neurotechnology and pain care.In this episode, we unpack one of the biggest mistakes medtech companies make: building technology without enough real-world user feedback. Dave explains why innovation for the sake of innovation often fails, especially in larger companies, and why the best products are shaped by how physicians and patients actually use them. We also explore NeuroOne's unique approach of combining diagnostics and therapeutics through the same electrode, and why that kind of multifunctional platform thinking can be both clinically powerful and commercially strategic.A major theme in this conversation is regulatory strategy. Dave walks through NeuroOne's deliberate “diagnostic first, therapeutic second” FDA pathway, explaining why starting with an easier regulatory indication can de-risk the technology, shorten timelines and create a stronger platform for later therapeutic claims. We also discuss the value of reusing the same generator across multiple indications, how founders often wait too long to engage with FDA, and why platform leverage matters from both a business and development perspective.We also go deep on chronic pain and lower back pain. Dave shares why today's pain solutions often fall short, how different triggers require different treatment approaches, and where technologies like ablation, stimulation and smarter electrode design could shift outcomes. He also highlights how seemingly small user-experience issues, like frequent recharging, can destroy patient adherence and wipe out billions in company value.Timestamps[00:00:08] Why MedTech Companies Fail When They Ignore Real User Feedback[00:02:04] Innovation vs Iteration: When “New” Adds No Real Value[00:02:22] Combining Diagnostics and Therapeutics With the Same Electrode[00:03:52] Why NeuroOne Chose a Diagnostic-First FDA Strategy[00:05:21] Pain Management Today: Ablation, Stimulation and Complex Back Pain[00:08:21] What Is Fundamentally Broken in Lower Back Pain Solutions[00:09:26] How Small Patient Frictions Can Destroy Adoption and Valuation[00:11:11] The Power of Reusing the Same Generator Across Multiple Indications[00:13:00] The FDA Mistake Many Founders Still Make[00:21:15] Where Neurotechnology and Pain Management Are Heading NextConnect with Dave - https://www.linkedin.com/in/daverosa/Learn more about NeuroOne - ⁠https://nmtc1.com/Get in touch with Karandeep Badwal - ⁠⁠⁠⁠⁠⁠https://www.linkedin.com/in/karandeepbadwal/ ⁠⁠⁠⁠⁠⁠Follow Karandeep on YouTube - ⁠⁠⁠⁠⁠⁠https://www.youtube.com/@KarandeepBadwal⁠⁠⁠⁠⁠⁠Subscribe to the Podcast

Join Digital Education Committee member and podcast host Melissa E. Middeldorp, MPH, PhD, along with this week's guest contributors, Nino Isakadze, MD, MHS, and Geraldine A. Lee, PhD, FESC for this week's episode. The POP-AF trial was a prospective, randomized controlled study evaluating whether a nurse-led, integrated lifestyle intervention before AF ablation improves outcomes. A total of 145 patients with symptomatic paroxysmal or persistent AF and at least one modifiable risk factor were randomized to either standard pre-ablation care or a structured, multidisciplinary lifestyle program targeting weight loss, physical activity, alcohol reduction, smoking cessation, blood pressure, lipid and glycemic control, and obstructive sleep apnea treatment. After pulsed-field pulmonary vein isolation, patients were followed for 12 months. The primary endpoint, a composite of repeat ablations and cardioversions was reduced by 51% in the intervention group (IRR 0.49, 95% CI 0.30–0.78). Successful index ablation without antiarrhythmic drugs was also significantly higher (76% vs 53%). Notably, these benefits were achieved with an average weight loss (~5.5%), suggesting that comprehensive, personalized risk-factor management meaningfully enhances rhythm control outcomes when implemented before ablation.  Read the Article   Learning Objectives Understand how a structured, nurse-led integrated lifestyle intervention before AF ablation significantly reduces repeat procedures and cardioversions compared with standard care. Evaluate the role of comprehensive risk-factor modification which includes weight, blood pressure, alcohol use, and OSA management improves rhythm control outcomes in patients undergoing PVI.    Article Authors Jasper Vermeer, Tineke Vinck-de Greef, Maarten van den Broek, Bianca de Louw, Gijs van Steenbergen, Dennis van Veghel, Lukas Dekker Podcast Contributors Melissa E. Middeldorp, MPH, PhD Nino Isakadze, MD, MHS Geraldine A. Lee, PhD, FESC   All relevant financial relationships have been mitigated. Host and Contributor Disclosure(s): M. Middeldorp Nothing to disclose.   N. Isakadze Research: Apple, Inc., Itamar Medical Board Membership: Boston Scientific   G. Lee Research: H2020 (EHRA-PATHS)   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.

With data increasingly positioning thermal ablation as a viable alternative to surgery for select liver metastases, the demands on the interventional oncologist have never been higher. Mastering the nuances of patient selection and precise margin assessment is now essential for ensuring effective disease control locally. In this episode of the BackTable Podcast, interventional radiologist Dr. Jonas Redmond of UC San Diego Health joins host Dr. Sabeen Dhand to discuss the current state of microwave ablation (MWA) in the management of oligometastatic liver disease, focusing on tumor assessment, preprocedural planning, and the integration of local and systemic therapies. --- This podcast is supported by: Varian IntelliBlatehttps://www.varian.com/products/interventional-solutions/microwave-ablation-solutions --- SYNPOSIS The conversation delves into the complexities of timing systemic versus local ablative therapies and explores questions surrounding adequate treatment margins. Dr. Redmond goes on to emphasize the need for operators to approach procedures with a high level of adaptability, advocating for interdisciplinary preprocedural planning and thoughtful modality selection. Exploring the complications that could arise from injury to adjacent viscera, the physicians speak to the critical importance of rigorous intraprocedural reassessment and discuss how modern software and robotics are transforming procedural precision and safety. Framing these MWA pearls within the context of recent clinical trials like COLLISION and ACCLAIM, the episode underscores the transition of interventional oncology from providing palliative services to increasingly curative solutions that may offer better prospects for patients with metastatic disease. --- TIMESTAMPS 00:00 - Introduction04:30 - Role of Local Therapy in Systemic Disease09:49 - Patient Selection and Treatment Modalities13:15 - Challenging Lesion Characteristics and Locations19:56 - Y-90 Radioembolization versus Microwave Ablation23:04 - Intraoperative Ablation and Combining Locoregional Modalities29:36 - Complications of Microwave Ablation in the Liver36:43 - Future of Ablation and Liver Metastases Treatment39:25 - Final Thoughts and Closing Remarks --- RESOURCES UC San Diego Health. Cryoablation and Arterial Infusion of SD-101 in Combination with Durvalumab and Tremelimumab.https://clinicaltrials.ucsd.edu/trial/NCT06710223 COLLISION trialhttps://clinicaltrials.gov/study/NCT03088150 ACCLAIM trialhttps://clinicaltrials.gov/study/NCT05265169

Commentary by Dr.  Jian'an Wang

Commentary by Dr. Takeshi Aiba

This week, we cover a range of topics: urinary vs cervical HPV collection, the benefits and harms of Tramadol, whether patients need anticoagulation after successful ablation for afib, and the ongoing value of COVID vaccines in the omicron era. Plus a quiz: is TAVR now indicated for everyone with severe aortic stenosis? Stay tuned!

Join Digital Education Committee member and podcast host Deep Chandh Raja, MBBS, MD, PhD, along with this week's guest contributors, Senthil Thambidorai, MD, FHRS  and Lee Karl Thien, MD, CCDS for this week's episode. This real-world registry study evaluated the safety, feasibility, and mid-term outcomes of pulsed field ablation (PFA) for cavotricuspid isthmus (CTI)–dependent atrial flutter. Acute bidirectional CTI block was achieved in nearly all patients, with a low complication rate and high freedom from recurrent flutter at mid-term follow-up. The findings suggest that PFA is an effective non-thermal alternative for typical atrial flutter ablation, though long-term durability and comparisons with conventional thermal energy sources require further investigation.    Learning Objectives Describe the procedural success rates and safety profile of pulsed field ablation for CTI-dependent atrial flutter. Compare pulsed field ablation with traditional thermal ablation strategies for typical atrial flutter. Discuss the role of emerging ablation technologies in the management of supraventricular tachyarrhythmias.    Article AuthorsJuan F. Rodriguez-Riascos, MD, Hema S. Vemulapalli, MBBS, Poojan Prajapati, MBBS, Padmapriya Muthu, MBBS, James Y. Kim, MD, Dan Sorajja, MD, Win-Kuang Shen, MD, Hicham El Masry, MD, Mayank Sardana, MBBS, MD, Arturo M. Valverde, MD, Thomas M. Munger, MD, and Komandoor Srivathsan, MD Podcast ContributorsSenthil Thambidorai, MD, FHRS Lee Karl Thien, MD, CCDS Deep Chandh Raja, MBBS, MD, PhD   All relevant financial relationships have been mitigated. Host and Contributor Disclosure(s): D. Raja Nothing to disclose.   S. Thambidorai Nothing to disclose.   L. K. Thien Nothing to disclose.   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.

Dr. Philip Petrou discusses radiofrequency ablation (RFA), a cutting-edge treatment for chronic pain. He highlights the benefits of this innovative procedure and goes over the conditions it treats. He reviews how this minimally invasive procedure targets nerve endings to provide long-lasting relief for conditions like back and joint pain; helping to improve quality of life for many chronic pain patients.  To scchedule with Dr. Philip Petrou 

Feb. 25, 2026 ~ On this episode of HealthWatch, Lloyd Jackson speaks with Dr. Ian Lee, neurosurgeon at Henry Ford Health and co‑director of the Hermelin Brain Tumor Center, about how this minimally invasive technique is changing outcomes for patients with brain tumors, epilepsy, and hard‑to‑reach lesions. Using a tiny MRI‑guided laser to precisely target and destroy problematic tissue, laser ablation offers faster recovery, fewer complications, and new hope for cases once considered inoperable. Hosted by Simplecast, an AdsWizz company. See https://pcm.adswizz.com for information about our collection and use of personal data for advertising.

Feb. 25, 2026 ~ On this episode of HealthWatch, Lloyd Jackson speaks with Dr. Ian Lee, neurosurgeon at Henry Ford Health and co‑director of the Hermelin Brain Tumor Center, about how this minimally invasive technique is changing outcomes for patients with brain tumors, epilepsy, and hard‑to‑reach lesions. Using a tiny MRI‑guided laser to precisely target and destroy problematic tissue, laser ablation offers faster recovery, fewer complications, and new hope for cases once considered inoperable. Hosted by Simplecast, an AdsWizz company. See https://pcm.adswizz.com for information about our collection and use of personal data for advertising.

Feb. 25, 2026 ~ On this episode of HealthWatch, Lloyd Jackson speaks with Dr. Ian Lee, neurosurgeon at Henry Ford Health and co‑director of the Hermelin Brain Tumor Center, about how this minimally invasive technique is changing outcomes for patients with brain tumors, epilepsy, and hard‑to‑reach lesions. Using a tiny MRI‑guided laser to precisely target and destroy problematic tissue, laser ablation offers faster recovery, fewer complications, and new hope for cases once considered inoperable. Hosted by Simplecast, an AdsWizz company. See https://pcm.adswizz.com for information about our collection and use of personal data for advertising.

From anesthesia decisions to ablation strategy, what really separates a good outcome from a great one in bone tumor ablation? This BackTable MSK Brief features an enlightening conversation between host Kavi Krishnasamy and bone ablation pioneer Dr. Damian Dupuy. They cover anesthesia choices for different patient scenarios, optimal procedural techniques and agent selection for bone ablations, and the combination of local and systemic therapies for oligometastatic and oligo-progressive diseases. The doctors also tackle myths and realities around thermal and cryoablation, examining both clinical trial data and real-world experiences.  Episode Outline 00:00 - Introduction 00:40 - Selecting General Anesthesia vs. MAC 03:30 - Approach to Multiple Bony Lesions in Metastatic Disease 07:27 - Ablation Confirmation and Techniques Utilized in Bone Ablation  09:00 - Research Insights Surrounding RFA in Bone 12:16 - Sclerotic vs. Lytic Lesions: Techniques and Considerations 14:47 - Skin Protection During Superficial Lesion Treatments 16:38 - Analyzing Clinical Trials: Motion and OPuS One 20:51 - Conclusion Resources Dr. Damian E. Dupuy, MD, FACR https://www.linkedin.com/in/damian-e-dupuy-md-facr-6b080b1b/  Radiofrequency Ablation Provides Rapid and Durable Pain Relief for the Palliative Treatment of Lytic Bone Metastases Independent of Radiation Therapy: Final Results from the OsteoCool Tumor Ablation Post-Market Study https://pmc.ncbi.nlm.nih.gov/articles/PMC10156864/  Cryoablation for Palliation of Painful Bone Metastases: The MOTION Multicenter Study https://pmc.ncbi.nlm.nih.gov/articles/PMC8011449/

Join Digital Education Committee Vice-Chair and podcast host Tina Baykaner, MD, MPH, along with this week's guest contributors, Jackson J. Liang, DO and Edward P. Gerstenfeld, MD, MS, FHRS for this week's episode. This study evaluates the relationship between hospital ventricular tachycardia (VT) ablation volume and post-procedural complications, examining whether institutional procedural experience influences patient outcomes. The authors analyze complication rates across centers with varying VT ablation volumes to assess potential volume–outcome associations. Findings from this work provide important insights into procedural risk, quality metrics, and the potential impact of case volume on VT ablation safety.    Learning Objectives Describe the relationship between hospital VT ablation procedural volume and post-procedural complication rates. Identify patient, procedural, and institutional factors that may contribute to complications following ventricular tachycardia ablation. Discuss how volume–outcome findings can inform quality improvement initiatives, referral patterns, and procedural planning for VT ablation programs.    Article Authors Agam Bansal, Anirudh Nandan, Jakub Sroubek, Justin Lee, Koji Higuchi, Ayman Hussein, Shady Nakhla, Mina Chung, Niraj Varma, Walid Saliba, Mandeep Bhargava, Tyler Taigen, Mohamed Kanj, Oussama Wazni, and Pasquale Santangeli Podcast Contributors Tina Baykaner, MD, MPH Jackson J. Liang, DO Edward P. Gerstenfeld, MD, MS, FHRS   All relevant financial relationships have been mitigated. Host and Contributor Disclosure(s): T. Baykaner•Honoraria/Speaking/Consulting: Volta Medical, Medtronic, Pacemate, Johnson and Johnson, Abbot Medical, Boston Scientific •Research: NIH   E. Gerstenfeld •Speaking/Teaching/Consulting: Medtronic, Adiago Medical, Biosense Webster, Inc., Abbott, Boston Scientific, Abbott Medical, Varian Medical Systems •Research: Boston Scientific, Abbott Medical •Board Membership: American College of Cardiology Foundation   J. Liang •Speaking/Teaching/Consulting: Biotronik, Abbott, Bionsense Webster, Inc.   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.

Join us as we review and appraise recent practice-changing articles on oral semaglutide for obesity, fish oil in ESRD, IV iron during infection, the new US Dietary Guidelines, & anticoagulation after ablation in AFib. Fill your brain hole with a delicious stack of hotcakes! Featuring Paul Williams (@PaulNWilliamz), Rahul Ganatra (@rbganatra), Josh Gilman, & Matt Watto (@doctorwatto).Claim CME for this episode at curbsiders.vcuhealth.org!Patreon | Episodes | Subscribe | Spotify | YouTube | Newsletter | Contact | Swag! | CMECredits Written and Hosted by: Rahul Ganatra MD, MPH; Paul Williams, MD, FACP, Joshua Gilman, MD, & Matthew Watto MD, FACP Cover Art: Rahul Ganatra, MD MPH Reviewer: Emi Okamoto, MD Technical Production: Pod Paste Showrunners: Matthew Watto MD, FACP; Paul Williams MD, FACP Show Segments Intro, disclaimer Oral Semaglutide for obesity Fish Oil for CV risk reduction in hemodialysis patients IV Iron for iron deficiency anemia during infection New USA Dietary Guidelines Anticoagulation after catheter ablation for AF Outro Sponsor: FIGSCheck out the limited-edition Team USA collection, and get 15 percent off your first order at Wearfigs.com with code FIGSRX. Sponsor: Continuing Education CompanyVisit CMEmeeting.org/curbsiders and use promo code Curb30 for 30% off all online courses and webcasts.  Sponsor: GustoTry Gusto today at gusto.com/CURB, and get three months free when you run your first payroll.Sponsor: MDProgress For our listeners, enjoy your first month free at mdprogress.ca/promo/curbsiders

CardioNerds (Dr. Ramy Doss, Dr. Kelly Arps, and Dr. Naima Maqsood) dive into the nuances of atrial fibrillation (AF) ablation with Dr. Jon Piccini. They provide a high-yield overview of AF ablation, guiding listeners from patient selection through post-procedural management. We review appropriate candidacy for catheter ablation across AF phenotypes, key elements of pre-procedural evaluation including imaging and anticoagulation strategy, and the fundamental procedural steps with pulmonary vein isolation as the cornerstone. The discussion compares lesion set strategies in de novo ablation and reviews currently used energy sources—including radiofrequency, cryoablation, and pulsed-field ablation—highlighting differences in safety and efficacy. They also examine surgical and hybrid approaches for selected patients and outline essential components of post-ablation care, including rhythm monitoring, anticoagulation decisions, and management of complications. This episode integrates contemporary evidence with practical insights to support clinicians delivering comprehensive AF ablation care. Audio editing for this episode was performed by CardioNerds intern Dr. Bhavya Shah. NOTE: This episode was recorded in March 2025. Since then, the OCEAN trial showed that among patients who had had successful catheter ablation for atrial fibrillation at least 1 year earlier and had risk factors for stroke, treatment with rivaroxaban did not result in a significantly lower incidence of a composite of stroke, systemic embolism, or new covert embolic stroke than treatment with aspirin.  Enjoy this Circulation 2022 Paths to Discovery article to learn about the CardioNerds story, mission, and values. CardioNerds Atrial Fibrillation PageCardioNerds Episode PageCardioNerds AcademyCardionerds Healy Honor Roll CardioNerds Journal ClubSubscribe to The Heartbeat Newsletter!Check out CardioNerds SWAG!Become a CardioNerds Patron!

Full article: Associations of Pleural Puncture Angle and Other Factors With Major Adverse Events After Thermal Lung Tumor Ablation: A Two-Center Study What is the preferred angle of applicator insertion during thermal lung tumor ablation? Osvaldo Berlina, MD, discusses the AJR article by Graur et al. exploring associations of the pleural puncture angle with adverse events after lung ablation.

You're about to biopsy a renal lesion; should you ablate at the same time? In this episode of the BackTable Podcast, host Michael Barraza talks with Dr. Steven Huang from MD Anderson Cancer Center about building an efficient and effective renal biopsy and ablation service line. --- This podcast is supported by: Varian IntelliBlatehttps://www.varian.com/products/interventional-solutions/microwave-ablation-solutions --- SYNPOSIS Dr. Huang first covers referral patterns and the typical pathway that patients take to end up in his clinic. The discussion covers the types of lesions he treats, imaging requirements, and criteria for patient eligibility. He emphasizes the importance of shared decision making when deciding between active surveillance, interventional treatment, and partial nephrectomy. Dr. Huang explains his preferred procedural approach and ablation modalities, including cryo, microwave (MWA), and radiofrequency ablation (RFA). He shares his experiences with challenging cases and integrating new technologies like histotripsy and the Siemens interventional package. They also discuss the possibility of a preoperative embolization for larger lesions that could be susceptible to the heat sink effect. Both experts emphasize the importance of collaboration with urologists and ensuring patient safety and expectations. They also touch on the future of the field, discussing the use of AI and robotics. --- TIMESTAMPS 00:00 - Introduction 02:17 - Training Programs at MD Anderson03:23 - Referral Patterns for Renal Ablations07:25 - Patient Management and Virtual Consultations10:59 - Ablation Techniques and Device Selection26:44 - Challenges and Complications27:25 - Approach to Lesions Near Renal Vasculature28:02 - Patient Expectations and Urologist Collaboration33:26 - Post-Procedure Care and Patient Recovery35:30 - Managing Recurrences and Multiple RCCs47:17 - Closing Remarks

What if the symptoms you have been told are “just part of hormonal changes and perimenopause” are actually a misdiagnosed medical condition that's progressively getting worse without being properly addressed?In this episode of Maximizing Hormones, Physique, and Running Through Perimenopause, Louise Valentine, one of the world's leading integrative health practitioners and exercise physiologists, sits down with Dr. Ryan Armstrong to break down fibroids, chronic pain, and vascular issues in a way that finally makes sense. Together, they explore why heavy bleeding, chronic fatigue, knee pain, plantar fasciitis, and leg cramping are so common in active women and why they should never be ignored or normalized.Dr. Ryan explains minimally invasive treatments like uterine fibroid embolization that preserve the uterus while dramatically improving quality of life, often with faster recovery and fewer long-term risks than traditional surgery. Louise adds critical context around hormone balance, nutrition, and strength training, showing how medical care, targeted fitness and lifestyle strategies work best together.Listeners will walk away with clarity around symptoms to watch for, questions to ask their doctors, and reassurance that there are modern, effective options that do not require extreme or life-altering procedures. This episode is empowering, practical, and especially valuable for women who want to stay active, strong, and pain-free through perimenopause and beyond.Learn more about Dr. Armstrong's practice Texas Endovascular at https://texaseva.com/ Learn & level up with my free nutrition guide and award-winning Badass Breakthrough Academy to thrive through perimenopause with less stress: https://www.breakingthroughwellness.com/Link to our FullScript where you can see curated best supplement picks & save 20%: https://us.fullscript.com/welcome/breakingthroughwellness/store-start Take advantage of our podcast listener discount and save 20% off all of Kion's science-backed clean products. Code "LOUISE" saves on all future orders: https://www.getkion.com/pages/maximizing Episode Highlights:(0:00) Intro and natural hormone balance for long-term relief(3:00) Fibroids explained in simple terms(6:10) Hormones, inflammation, and injury risk(12:50) Uterine fibroid embolization explained(18:11) Risks of hysterectomy and why alternatives matter(20:38) Innovative treatments for knee pain and plantar fasciitis(23:29) Venous insufficiency, cramping, and varicose veins(30:20) Heavy bleeding, anemia, and athletic performance(32:29) Ablation vs embolization for fibroid care(36:06) OutroTune in weekly to "Maximizing Hormones, Physique, and Running Through Perimenopause" for our simple female-specific science-based revolution. Let's unlock our best with less stress!I'd love to connect! Email

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 the study, and explore how these findings may inform evolving ablation strategies for complex atrial arrhythmias.   Learning Objectives Summarize the acute and chronic feasibility and safety outcomes of pulsed field ablation (PFA) for coronary sinus isolation, left atrial appendage isolation, and mitral isthmus ablation as reported in the study. Evaluate procedural techniques and lesion durability considerations associated with using PFA in anatomically complex atrial structures. Assess the potential clinical implications of these findings for incorporating PFA into ablation strategies for complex atrial arrhythmias, including patient selection and risk mitigation.   Podcast Contributors Michael S. Lloyd, MD, FHRS Kelvin C. Chua, MBBS, MD, FHRS, CEPS-A Rahul N Doshi, MD, FHRS   Host and Contributor Disclosure(s): K.C. Chua•Nothing to disclose. R. N. Doshi•Speaking/Teaching/Consulting/Authoring: Boston Scientific, Kestra Inc., Abbott, Impulse Dynamics USA    M. S. Lloyd •Honoraria/Speaking/Consulting: Medtronic, Agra MedTech, Circa Scientific •Membership on Advisory Committees: Boston Scientific   Article for Discussion

Drs Kaniksha Desai and Ralph Tufano discuss nanosecond pulsed field ablation technique. This podcast is intended for healthcare professionals only. To read a partial transcript or to comment, visit: https://www.medscape.com/index/list_15483_0 Kaniksha Desai, MD, Associate Professor of Medicine, Department of Endocrinology, Stanford School of Medicine, Palo Alto, California Ralph P. Tufano, MD, MBA, Clinical Professor, Department of Otolaryngology-Head and Neck Surgery, Florida State University College of Medicine, Sarasota Memorial Health Care System, Sarasota, Florida

A viral video claims your OB/GYN can “scoop out” your period every month, and the internet ran with it. In this episode, Dr. Stephanie Hack, MD, MPH breaks down what people are actually talking about when they confuse endometrial biopsy, D&C, and endometrial ablation. She'll unpack what these procedures really do, who they're for, and why mixing them up can be misleading or even dangerous. If you want clear, evidence-based answers instead of internet myths, this one's for you.

This episode reviews recent evidence on microwave and radiofrequency ablation as minimally invasive treatments for primary and secondary hyperparathyroidism, highlighting efficacy, safety, and complication profiles compared with surgery. Focusing on a multicenter prospective Radiology study in older patients, the discussion shows that both ablation techniques achieve meaningful biochemical improvement with acceptable risk, particularly as alternatives for patients who may not be ideal surgical candidates. Efficacy and Safety of Microwave and Radiofrequency Ablationin the Treatment of Hyperparathyroidism in Older Individuals:A Multicenter Prospective Study. Zhang and Liu et al. Radiology 2025; 317(1):e243359. 

Why might simultaneous ablation and biopsy be the new standard for high-probability lung cancer cases where surgery isn't an option? In the penultimate episode of the 2025 NSCLC Creator Weekend™ series, our multidisciplinary tumor board panel discusses the intricacies and decision-making processes surrounding biopsy and ablation procedures in thoracic oncology. --- This podcast is supported by an educational grant from Johnson & Johnson and Varian. --- SYNPOSIS Topics include the prioritization of treatment versus tissue acquisition, the nuances of bronchoscopic versus percutaneous biopsies, and the latest advancements in robotic and cryo-biopsy techniques. The experts also share their approaches to managing pneumothorax, the value of multidisciplinary collaboration, and case studies that highlight personalized patient care. Listeners gain valuable insights into the evolving landscape of thoracic oncology procedures and the importance of patient-centered decision-making. --- TIMESTAMPS 00:00 - Introduction04:12 - Cryobiopy vs. Non-Cryobiopsy08:43 - Biopsy and Ablation: Strategies and Considerations15:31 - Post-Therapy Imaging and Follow-Up25:18 - Treatment Options and Patient Decisions27:08 - Evaluating Ablation Techniques28:59 - Managing Lung Cancer Recurrence39:41 - Case Study: Young Male with Ground Glass Nodule43:15 - Concluding Thoughts

Collaboration between interventional radiology and radiation oncology has enabled high-dose brachytherapy in central lung lesions that were previously untreatable. This episode of the 2025 NSCLC Creator Weekend™ series offers a deep dive into recent advancements in lung ablation and brachytherapy techniques for primary lung cancer. --- This podcast is supported by an educational grant from Johnson & Johnson and Varian. --- SYNPOSIS Key discussion points include ablation zone sizes, confirmation methods for effective treatment, and the integration of different modalities such as microwave and cryoablation. Our tumor board panel also explores the practical and logistic challenges of implementing high-dose brachytherapy, especially for central lesions, and its role in palliative care. Despite the intricate processes and potential complications like pneumothorax, these methods show promising local control rates and provide crucial options for non-operative candidates. --- TIMESTAMPS 00:00 - Introduction and Overview of Lung Ablation07:01 - Microwave Ablation and Ground Glass Attenuation17:53 - Artificial Pneumothorax Techniques27:09 - Technical Aspects and Innovations32:35 - Bronchial Brachytherapy Techniques37:47 - Conclusion and Credits --- RESOURCES 2021 Central Lesion Studyhttps://pmc.ncbi.nlm.nih.gov/articles/PMC8186067/

Why might the standard RECIST criteria fail to accurately track success after tumor ablation, and what should you look for instead? In the 4th installment of the 2025 NSCLC Creator Weekend™ series, hosts Drs. Scott Genshaft and Kavi Krishnasamy are joined by specialists from UCLA and USC to discuss and debate advanced treatment options for primary lung cancer. --- This podcast is supported by an educational grant from Johnson & Johnson and Varian. --- SYNPOSIS The panel, including interventional radiologists, pulmonologists, and a radiation oncologist, discusses the intricacies of photon versus proton therapies, the physics behind radiation treatment, and the evolving landscape of ablation technologies. The conversation covers the efficacy and limitations of different treatments, patient selection criteria, and the role of newer technologies like electroporation and robotic-assisted bronchoscopy in enhancing precision and outcomes. Additionally, the panel addresses the practical challenges of intraprocedural imaging, the importance of adequate margins, and the complexities of managing local recurrences and radiation-induced toxicities. --- TIMESTAMPS 00:00 - Tumor Ablation and Recurrence Rates12:53 - Advancements in Ablation Technologies23:31 - Bronchoscopic Approaches in Lung Cancer Treatment38:46 - Challenges in Radiation Dose and Delivery49:21 - Ablation and Radiation Margins01:07:19 - Final Thoughts --- RESOURCES Thierry de Baere Paper on Ablation Margins https://pmc.ncbi.nlm.nih.gov/articles/PMC9815739/

With the range of interventional modalities that are available for metastatic liver tumors, when should you advocate for thermal ablation at the tumor board? In this episode of BackTable, host Dr. Sabeen Dhand welcomes back Dr. Jason Hoffman, an interventional radiologist from New York University, to discuss tools, techniques, and multidisciplinary collaboration around microwave ablation for liver metastases. --- This podcast is supported by: Varian https://www.varian.com/products/interventional-solutions/microwave-ablation-solutions --- SYNPOSIS The physicians discuss the decision-making process behind using microwave ablation for metastatic liver disease, and strategies for advocating for the technology in tumor boards. Dr. Hoffman especially emphasizes the value of educating patients about their options and using thoughtful clinical judgement as an IR. The discussion delves into the benefits and advancements in microwave ablation, including his experience with the Varian system in light of NeuWave's discontinuation. Dr. Hoffman shares the utility of software guidance, system fusion with CT machines, temperature monitoring, and the ability to achieve a more spherical ablation zone. --- TIMESTAMPS 00:00 - Introduction04:39 - Practice Growth11:10 - Microwave Ablation Technology12:43 - Multidisciplinary Approach to Liver Metastases26:48 - Microwave Technology and Probe Placement28:42 - Guidance Software and Technological Integration30:40 - Planning and Intraoperative Decisions40:28 - Future of Microwave Ablation48:35 - Conclusion and Final Thoughts