Podcasts about jacc clinical electrophysiology

In this episode, Dr. Kenneth Ellenbogen discusses an important analysis from the PRAETORIAN-DFT trial examining whether shock impedance can reliably predict defibrillation success after subcutaneous ICD implantation. While low impedance values are increasingly used in practice as a surrogate for defibrillation testing, this multicenter study shows that although an impedance

In this episode, Francis Marchlinski, MD, Deputy Editor of JACC: Clinical Electrophysiology, discusses a novel study evaluating high‑voltage pulsed field ablation (hv‑PFA) for redo ventricular tachycardia ablation in patients with nonischemic cardiomyopathy. He highlights why VT ablation remains particularly challenging in this population, the rationale for using high‑voltage PFA to achieve deeper and more durable lesion formation, and the key findings from this early clinical experience. Dr. Marchlinski also comments on the encouraging efficacy signals, important safety considerations—including device and mapping system interactions—and what these results may mean for the future evolution of VT ablation strategies.

In this episode of the JACC: Clinical Electrophysiology podcast, Executive Editor Emile Daoud discusses the primary analysis of the HEAL‑LAA study. The paper by Oluseun Alli, et al, evaluates real‑world outcomes with a next‑generation, fluoropolymer‑coated left atrial appendage occlusion device. In 500 patients across 32 U.S. centers, the study demonstrated excellent early device sealing, no significant peri‑device leaks, and favorable safety outcomes through 12 months, offering timely insights into contemporary LAAC practice and post‑implant antithrombotic management.

In this episode, Jeremy Moore, MD, MS, Associate Editor of JACC: Clinical Electrophysiology, reviews a study showing that adults with Ebstein anomaly face a high lifetime risk of atrial arrhythmias, with more than half developing one by age 60. The most common arrhythmias were intra-atrial re-entrant and focal atrial tachycardias, which were more frequent than atrial fibrillation. Older age, prior cardiac surgery, significant tricuspid valve leakage, and severe right ventricular dysfunction were key risk factors, underscoring the need for lifelong specialized follow-up.

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.

Deputy Editor Kenneth Ellenbogen presents an in‑depth discussion of the study "Long PR Interval Leads to Atrial Remodeling, Fibrosis and Inducible Atrial Fibrillation in a Swine Model." In this episode, Dr. Ellenbogen walks listeners through how prolonged atrioventricular conduction can drive structural and electrical remodeling in the atria, leading to fibrosis and increased susceptibility to atrial fibrillation. He highlights the significance of these findings for understanding AF pathophysiology and considers how this preclinical model may inform future prevention and treatment strategies.

Deputy Editor Francis Marchlinski hosts a deep‑dive discussion on the study "Functional Conduction Block During Extra‑Stimulus Mapping Masks Deceleration Zones and Reveals Additional VT Substrate." In this episode, Dr. Marchlinski explores how extra‑stimulus pacing can alter the visualization of critical conduction deceleration zones and uncover previously hidden components of the ventricular tachycardia substrate. He breaks down the clinical implications of these dynamic changes and what they mean for improving VT mapping and ablation strategies.

Deputy Editor Kenneth Ellenbogen hosts a focused discussion on the study "Return‑to‑Play for Athletes with Desmosomal Arrhythmogenic Cardiomyopathy: A Single Center Experience." In this episode, Dr. Ellenbogen examines how desmosomal arrhythmogenic cardiomyopathy impacts athletic participation and highlights real‑world insights from a single‑center cohort. He walks listeners through the clinical considerations, risk assessment strategies, and decision‑making frameworks that guide safe return‑to‑play recommendations for competitive athletes. This conversation offers valuable perspective for clinicians navigating the balance between athletic performance and long‑term cardiovascular safety.

In this episode of JACC: Clinical Electrophysiology, Deputy Editor Dr. Kenneth Ellenbogen discusses His-Pacing versus Biventricular Pacing for Cardiac Resynchronization Therapy: Long-term follow-up from the His-alternative I Trial.

Dr. Kenneth Ellebogen, Deputy Editor of JACC: Clinical Electrophysiology, discusses the long-term outcomes and safety of His-Purkinje conduction system pacing: a multicenter observational study in China.

In this episode, Dr. Kenneth Ellenbogen, Deputy Editor of JACC: Clinical Electrophysiology, discusses new long-term findings from the His-Alternative I trial, the first European randomized study comparing His-bundle pacing with conventional biventricular pacing for cardiac resynchronization therapy (CRT). He highlights five-year outcomes demonstrating that when His-bundle pacing is achieved with low implant thresholds, its long-term performance—including lead stability, generator replacements, and clinical response—closely mirrors that of biventricular CRT. Dr. Ellenbogen explores the implications of these results for contemporary conduction system pacing practice, the importance of strict implant criteria, and how these data help refine patient selection and procedural strategy in CRT.

Commentary by JACC: Clinical Electrophysiology Deputy Editor Francis Marchlinski, MD.

Commentary by JACC: Clinical Electrophysiology Executive Editor Emile Daoud, MD.

Dr. Emile Daoud, Deputy Editor of JACC Clinical Electrophysiology discusses Cerebrovascular Ischemic Lesions After Pulsed Field Ablation for Atrial Fibrillation Using Variable-Loop Ablation Catheter.

CardioNerds (Dr. Colin Blumenthal, Dr. Kelly Arps, and Dr. Natalie Marrero) discuss anti-arrhythmic drugs in the management of atrial fibrillation and atrial flutter with electrophysiologist Dr. Andrew Epstein. We discuss two major classes of anti-arrhythmic drugs, class IC and class III, as well as digoxin. Dr. Epstein explains their mechanisms of action, indications and specific patient populations in which they would be particularly helpful, efficacy, adverse side effects, contraindications, and key drug-drug interactions. We also elaborate on defining clinical trials and their clinical implications. Given the large burden of atrial fibrillation and atrial flutter in our patient population and the high prevalence of anti-arrhythmic drug use, this episode is sure to be applicable to many practicing physicians and trainees. 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 Anti-arrhythmic drugs should not be thought of as an alternative to ablation but, instead, should be considered an adjunct to catheter ablation.   Class IC anti-arrhythmic drugs, flecainide and propafenone, are highly efficacious for acute cardioversion and a great option for patients with infrequent episodes of AF who do not have a history of ischemic heart disease.    Class III anti-arrhythmic drugs like ibutilide, sotalol, and dofetilide, are highly effective for acute conversion; however, they require hospitalization for close monitoring during initiation and dose titration given the risk of prolonged QT.   Amiodarone should not be used as a first line agent given its toxicities, prolonged half-life, large volume of distribution, and drug-drug interactions.   Dr. Epstein notes that, “All drugs are poisons with a few beneficial side effects,” when highlighting the many adverse side effects of anti-arrhythmic drugs, particularly amiodarone, and the importance of balancing their benefit in rhythm control with their side effect profile.   Notes Notes: Notes drafted by Dr. Natalie Marrero. What are the Class IC anti-arrhythmic drugs and what indications exist for their use?   Class IC anti-arrhythmic drugs are anti-arrhythmic drugs that work by blocking sodium channels and, thereby, prolonging depolarizing.   Class IC anti-arrhythmic drugs include flecainide and propafenone.   Class IC anti-arrhythmic drugs are good agents to use in patients that have infrequent episodes of AF and do not want daily dosing as these agents can be used by patients when they feel palpitations and desire acute conversion back to sinus rhythm (“pill in the pocket” approach).    What are the adverse consequences and/or contraindications to using a class IC agent?  Class IC anti-arrhythmic agents are contraindicated in patients with a history of ischemic heart disease based on increased mortality associated with their use in these patients in the CAST trial.   Given the results of the CAST trial, providers should screen annually for ischemia via a functional stress test in patients on these drugs at risk for coronary disease.   These drugs can increase 1:1 conduction of atrial flutter and, therefore, require concomitant use of a beta blocker.   These agents are generally well-tolerated without any organ toxicities; however, they can precipitate heart failure in patients with cardiomyopathies, cause sinus node depression, and unmask genetic arrythmias such as a Brugada pattern.   What are the class III agents and what are indications for their use?   Class III agents are drugs that block the potassium channel, prolonging the QT, and include Ibutilide, Sotalol, and Dofetilide.    Class III agents can be considered in patients with or without a history of ischemic heart disease that desire effective acute chemical cardioversion and are willing to go to the hospital for close monitoring during dose initiation and titration.   Other specific circumstances in which one can use these agents, specifically Ibutilide, are in patients with recurrent atrial fibrillation and Wolf Parkinson White (due to slowed conduction via the accessory pathway).  What are the adverse consequences and/or contraindications to using a class III agent?  Ibutilide, Sotalol, and Dofetilide prolong the QT and increase the risk of torsade de pointes, which is why they require ECG monitoring in-patient during drug initiation and dose titration.    These agents are generally well-tolerated.   Sotalol should be avoided or used cautiously in patients with left ventricular dysfunction, while dofetilide can be used and has dose-response beneficial effects in patients with left ventricular dysfunction.   Both sotalol and dofetilide are renally cleared with specific creatinine clearance cutoffs (CrCl < 20 for dofetilide and CrCl

Dr. Francis Marchlinski, Deputy Editor of JACC Clinical Electrophysiology, discusses Anatomy of the Isthmus: Unraveling the Tissue Composition of the Ventricular Tachycardia Diastolic Pathway.

Dr. Emile Daoud, Deputy Editor of JACC Clinical Electrophysiology discusses Tricuspid Right Ventricular lead entrapment in transcatheter tricuspid interventions.

Dr. Emile Daoud, Deputy Editor of JACC Clinical Electrophysiology discusses Atrial Fibrillation Recurrence After Left Atrial Appendage Occlusion in Patients Undergoing Atrial Fibrillation Ablation.

Dr. Emile Daoud, Deputy Editor of JACC Clinical Electrophysiology, discusses Risk Stratification in LBBB after TAVI: Comparison Between a Novel ECG Algorithm and ESC Criteria.

Dr. Emile Daoud, Deputy Editor of JACC Clinical Electrophysiology discusses Impact of Device Compression on Peridevice Leak After Left Atrial Appendage Closure: The Impression LAAC Study

Dr. Emile Daoud, Deputy Editor of JACC Clinical Electrophysiology discusses Prevalence of peri-device leak in Watchman patients with versus without electrically isolated left atrial appendage.

Dr. Francis Marchlinski, Deputy Editor of JACC: Clinical Electrophysiology, discusses Electrode Thermal Profile During Ventricular RF Ablation: A novel indication to potentially inform energy delivery.

Dr. Kenneth Ellenbogen, Deputy Editor of JACC: Clinical Electrophysiology, discusses Mental Disorders Following Implantable Cardioverter-Defibrillator Therapy: Incidence and Prognostic Implications in a Nationwide Cohort Study.

Dr. Emile Daoud, Deputy Editor of JACC Clinical Electrophysiology discusses Outcomes of Left Atrial Appendage Occlusion in Patients With and Without Gastrointestinal Bleeds.

Dr. Ratika Parkash, Deputy Editor of JACC Clinical Electrophysiology, discusses The Association Between Atrial Fibrillation Burden and Quality of Life in Patients Undergoing Pulmonary Vein Isolation.

Dr. Emile Daoud, Deputy Editor of JACC Clinical Electrophysiology discusses Risk Stratification in LBBB after TAVI: Comparison Between a Novel ECG Algorithm and ESC Criteria.

Dr. Ratika Parkash, Deputy Editor of JACC Clinical Electrophysiology, discusses The Association Between Atrial Fibrillation Burden and Quality of Life in Patients Undergoing Pulmonary Vein Isolation: A Sub-study of the SHAM-PVI Trial.

Dr. Emile Daoud, Deputy Editor of JACC Clinical Electrophysiology discusses Pulsed-Field Ablation of Atrial Flutter.

Dr. Kenneth Ellenbogen, Deputy Editor of JACC Clinical Electrophysiology discusses Pressure-Volume Analysis Demonstrates Short and Long-Term Hemodynamic Effects of Atrioventricular Interval Modulation Therapy in Hypertension.

Dr. Francis Marchlinski, Deputy Editor of JACC: Clinical Electrophysiology, discusses electrical storm in patients with hypertrophic cardiomyopathy.

Dr. Emile Daoud, Deputy Editor of JACC Clinical Electrophysiology discusses mechanistic insights into reduced arrhythmia prevalence in female endurance athletes.

Dr. Emile Daoud, Deputy Editor of JACC Clinical Electrophysiology discusses the impact of prior exercise practice on disease characteristics in Desmoplakin-related arrhythmogenic left ventricular cardiomyopathy.

In this episode of JACC This Week, Editor-in-Chief Harlan M. Krumholz, MD, SM, FACC spotlights major electrophysiology research and clinical insights from the July 8 issue of JACC. This week's issue features new findings on left atrial appendage occlusion techniques, comparisons of atrial fibrillation stroke prevention guidelines across regions, and device-related complications such as pacemaker lead perforation and device embolization. You'll also hear highlights from JACC: Clinical Electrophysiology, including striking Amara Yad anatomical visuals and real-world clinical scenarios.

Dr. Kenneth Ellenbogen, Deputy Editor of JACC Clinical Electrophysiology discusses new ECG morphologic criteria for the identification of left bundle branch capture.

Dr. Emile Daoud, Deputy Editor of JACC Clinical Electrophysiology discusses mechanistic insights into reduced arrhythmia prevalence in female endurance athletes.

Dr. Emile Daoud, Deputy Editor of JACC Clinical Electrophysiology discusses Premature Ventricular Complexes after Ablation for Paroxysmal Atrial Fibrillation and Recurrent Atrial Arrhythmias: admIRE Subanalysis.

Dr. Kenneth Ellenbogen, Deputy Editor of JACC Clinical Electrophysiology discusses Septal intra-myocardial Purkinje network: a potential new mechanism explaining left bundle branch area pacing physiology.

Dr. Kenneth Ellenbogen, Deputy Editor of JACC Clinical Electrophysiology discusses the Clinical Response to Resynchronization Therapy: Conduction System Pacing vs Biventricular Pacing. CONSYST-CRT trial.

Dr. Francis Marchlinski, MD, Deputy Editor of JACC Clinical Electrophysiology, discusses Ablation Targeting Rotational Activation Pattern Around Localized Line of Conduction Block for Scar-Related Ventricular Tachycardia.

Dr. Emile Daoud, Deputy Editor of JACC Clinical Electrophysiology discusses Characterization and Clinical Outcomes of High-Risk Device-Related Thrombus in the Amulet IDE Trial.

Dr. Francis Marchlinski, MD, Deputy Editor of JACC Clinical Electrophysiology, discusses the Olive Strategy: improved pulmonary vein isolation durability with the pentaspline pulsed field catheter.

Dr. Francis Marchlinski, MD, Deputy Editor of JACC Clinical Electrophysiology, discusses Optimizing Interelectrode Distance for Accurate Mapping of Post-Infarct Scars: Insights on Electrogram Characteristics

Dr. Ratika Parkash, MD, MSc, Deputy Editor of JACC Clinical Electrophysiology, discusses the reduction of atrial fibrillation burden after cryoballoon ablation in patients with early persistent atrial fibrillation

Dr. Kenneth Ellenbogen, MD, Deputy Editor of JACC Clinical Electrophysiology, discusses Optimizing CRT Lead Placement Accuracy with MRI-Guided On-Screen Targeting: a Randomized Controlled Trial (ADVISE-CRT III)

Dr. Kenneth Ellenbogen, MD, Deputy Editor of JACC Clinical Electrophysiology, discusses Clinical outcomes and electrophysiological characteristics of partial perforation after left bundle branch area pacing

Edward Gerstenfeld, MD, Executive Editor of JACC: Clinical Electrophysiology discusses a recently published original research paper on pulsed-field vs thermal catheter ablation of atrial fibrillation in patients with hypertrophic cardiomyopathy

Ratika Parkash, MD, Deputy Editor of JACC: Clinical Electrophysiology discusses a recently published original research paper on cardioverter-defibrillator implantation as a risk factor for motor vehicle crashes.

Emile Daoud, MD, Deputy Editor of JACC: Clinical Electrophysiology discusses a recently published original research paper on the results of ICE-Guided isolation of the superior vena cava with pulsed field ablation.

Emile Daoud, MD, Deputy Editor of JACC: Clinical Electrophysiology discusses a recently published new research artle on the clinical and electrophysiological characteristics of Marshall bundle-related atrial tachycardia