The Lead Podcast presented by Heart Rhythm Society

Description: In this episode of The Lead, recorded live at HRX 2026, host Jason T. Jacobson, MD, FHRS, is joined by Michael S. Lloyd, MD, FHRS, and Igor R. Efimov, PhD, FHRS, to discuss the article "The Forgotten History of Semi-Implanted Radiofrequency and Inductively Powered Cardiac Pacing Systems," published in Pacing and Clinical Electrophysiology (PACE). The panel explores the evolution of early cardiac pacing technologies, the challenges associated with externally powered systems, and how historical innovations in wireless energy transfer may inform future developments in pacemaker design, miniaturization, and alternative power sources.
Learning Objectives:
Describe the historical development of semi-implanted radiofrequency- and inductively powered cardiac pacing systems and their role in the evolution of pacemaker technology.

Compare the technical advantages and limitations of early externally powered pacing systems with fully implanted, battery-powered pacemakers.

Evaluate the potential applications of wireless energy transfer and alternative power sources in future cardiac pacing technologies.

Host: Jason T. Jacobson, MD, FHRS | Westchester Med Center-New York Med Coll
Guests:
Michael S. Lloyd, MD, FHRS | Emory University
Igor R. Efimov, PhD, FHRS | Northwestern University
Faculty Disclosures:
J. Jacobson
Honoraria/Speaking/Consulting Fee: Zoll Medical Corporation, Vektor Medical, Inc., CardioFocus, Inc., Abbott Medical, Johnson and Johnson
Stock Options-Privately Held: Atlas 5D
M. Lloyd
Honoraria/Speaking/Consulting Fee: Medtronic
Membership on Advisory Committee: Boston Scientific, ABIM
I. Efimov
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.
M. Baldwin: No relevant financial relationships with ineligible companies to disclose.

Description:
In this episode of The Lead, host Lisa Roelle, PAC, Washington University in St. Louis, is joined by M. Cecilia Gonzalez Corcia, MD, MDCM, PhD, CEPS-P, Sainte-Justine, and John K. Triedman, MD, FHRS, Children's Hospital Boston, Cardiology, to discuss "Artificial Intelligence-Enhanced Implantable Loop Recorders in Pediatric Patients: Effects on Device Performance and Clinical Workflow in a Single-Center Experience." The panel examines the potential for AI-based filtering to reduce nonactionable alerts and clinical workload associated with remote monitoring while considering pediatric-specific physiology, the limitations of extrapolating from adult data, and the need to preserve diagnostic sensitivity and clinical judgment when incorporating these technologies into pediatric electrophysiology practice.
Learning Objectives:
Describe the effects of AI-based filtering on nonactionable alerts and clinical workflow in pediatric patients with implantable loop recorders.

Evaluate pediatric-specific physiologic and clinical factors that may influence the performance of AI-based arrhythmia detection algorithms.

Assess the benefits and limitations of incorporating AI-enhanced remote monitoring into pediatric electrophysiology practice while maintaining diagnostic sensitivity and appropriate clinical oversight.

Host: Lisa Roelle, PA-C
Guests: John K. Triedman, MD, FHRS and M. Cecilia Gonzalez Corcia, MD, MDCM, PhD, CEPS-P
Faculty Disclosures:
All relevant financial relationships have been mitigated.
Host and Contributor Disclosure(s):

L. Roelle

Nothing to disclose

J. Triedman
Honoraria/Speaking/Consulting Fees: Biosense Webster, Inc.


Royalty Income: UpToDate, Inc.
M. C. Gonzalez Corcia
Nothing to disclose

In this episode of The Lead, host Melissa E. Middeldorp, MPH, PhD, FHRS, is joined by David J. Slotwiner, MD, FHRS, and Alessandra Pina, MBBS, MD, to discuss "Integrated Care Management and Comprehensive Geriatric Assessment Using an mHealth-Based Approach in Older Multimorbid Patients With Atrial Fibrillation: The AFFIRMO Cluster Randomised Trial." The panel examines the trial's evaluation of an mHealth-based integrated care approach for older patients with atrial fibrillation and comorbidities, exploring its neutral effect on hospitalization, challenges with patient engagement, characteristics of the study population, and implications for developing and implementing digital health interventions.
 
Learning Objectives:
Describe the design, patient population, integrated care intervention, and clinical outcomes of the AFFIRMO cluster randomized trial.

Evaluate factors that may have contributed to the trial's neutral primary outcome, including characteristics of the study population, baseline management of atrial fibrillation, and patient engagement with the mHealth intervention.

Assess the opportunities and challenges associated with using mHealth tools to support integrated atrial fibrillation and comorbidity management in older adults.

Podcast Contributors
Host: Melissa E. Middeldorp, MPH, PhD, FHRS
Guests: David J. Slotwiner, MD, FHRS and Alessandra Pina, MBBS, MD
All relevant financial relationships have been mitigated.
Host and Contributor Disclosure(s):

M. Middeldorp

Nothing to disclose

D. Slotwiner
Nothing to disclose


A. Pina
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.
M. Baldwin: No relevant financial relationships with ineligible companies to disclose.

Description:
In this episode of The Lead, host Jason T. Jacobson, MD, FHRS, is joined by Sei Iwai, MD, FHRS, and Jeanne E. Poole, MD, FHRS, CCDS, to discuss "Cardiovascular Magnetic Resonance to Guide Defibrillator Implantation for LVEF of 36% to 50%: The CMR GUIDE Randomized Clinical Trial." The panel examines the trial's findings on using cardiovascular magnetic resonance–identified myocardial scar to guide primary prevention ICD implantation, including limitations of the study and current approaches to sudden cardiac death risk stratification, as well as the potential role of more sophisticated, dynamic risk-prediction models.
Learning Objectives:
Describe the design, patient population, primary outcome, and key findings of the CMR GUIDE randomized clinical trial.

Evaluate the limitations of using cardiovascular magnetic resonance–identified myocardial scar to guide primary prevention ICD implantation in patients with an LVEF of 36% to 50%.

Assess current challenges and emerging approaches to sudden cardiac death risk stratification, including the potential use of multimodal and dynamic risk-prediction models.

Host: Jason T. Jacobson, MD, FHRS
Guests: Sei Iwai, MD, FHRS and Jeanne E. Poole, MD, FHRS, CCDS
Faculty Disclosures:
J. Jacobson
Honoraria/Speaking/Consulting Fee: Zoll Medical Corporation, Vektor Medical, Inc., CardioFocus, Inc., Abbott Medical, Johnson and Johnson

Stock Options-Privately Held: Atlas 5D

S. Iwai
Honoraria/Speaking/Consulting Fee: Alta Thera Pharmaceuticals, Biotronik, Johnson and Johnson, CardioFocus, Inc.
J. Poole
Honoraria/Speaking/Consulting Fee: Heart Rhythm Society

Research (Contracted Grants): Boston Scientific, AtriCure, Inc., Kestra, Inc., Biotronik

In this episode of The Lead, host Cinzia Monaco, MD, PhD, is joined by Kinan Kneizeh, MD,  and Konstantinos Vlachos, MD, PhD, to discuss "Pulsed Field Ablation Versus Sham to Treat Atrial Fibrillation: The PFA-SHAM Randomized Clinical Trial." The panel examines the trial's sham-controlled evidence for the effects of pulsed field ablation on atrial fibrillation recurrence, quality of life, AF burden, and psychological well-being, while considering placebo effects, study limitations, and the applicability of the findings to clinical practice.
Learning Objectives: 
1. Describe the design, patient population, endpoints, and key findings of the PFA-SHAM randomized clinical trial.
2. Evaluate the effects of pulsed field ablation compared with a sham procedure on atrial fibrillation recurrence, AF burden, quality of life, and psychological well-being.
3. Assess the trial's limitations, potential placebo effects, and applicability to the management of patients with symptomatic atrial fibrillation.
Host: Cinzia Monaco, MD, PhD

Guests: Kinan Kneizeh, MD and Konstantinos Vlachos, MD, PhD
Disclosures:
C. Monaco
 • No relevant disclosures
K. Kneizeh
 • No relevant disclosures
K. Vlachos, MD, PhD
 • No relevant disclosures