The Lead Podcast presented by Heart Rhythm Society

In this episode of The Lead, host Christopher Kowalewski, MD, is joined by John M. Mandrola, MD, and Nassir F. Marrouche, MD, FHRS, to discuss the journal article, The Association Between Atrial Fibrillation Burden and Quality of Life: A Substudy of the SHAM-PVI Trial. Together, they explore the relationship between atrial fibrillation burden and quality of life, reviewing findings from this substudy of the SHAM-PVI Trial and discussing their relevance to patient-centered outcomes. Learning Objectives Review the key findings from the SHAM-PVI Trial substudy examining the association between atrial fibrillation burden and quality of life. Discuss the relationship between atrial fibrillation burden and patient-reported quality-of-life outcomes. Explore the implications of assessing both arrhythmia burden and quality of life when evaluating treatment outcomes in atrial fibrillation. Host: Christopher Kowalewski, MD Guests: John M. Mandrola, MD and Nassir F. Marrouche, MD, FHRS Disclosures: Christopher Kowalewski, MD No relevant disclosures John M. Mandrola, MD No relevant disclosures Nassir F. Marrouche, MD, FHRS • Honoraria/Speaking/Consulting Fee/Speaker's Bureau: Biosense Webster, Inc., Boston Scientific, AtriCure, Inc., Abbott, Sanofi • Research: Abbott, Biosense Webster, Inc., Medtronic, Siemens, General Electric, Boston Scientific, Sanofi, Samsung

Join Digital Education Committee Member and podcast host Jason T. Jacobson, MD, FHRS, along with this week's guest contributors, Gaurav A. Upadhyay, MD, FHRS and Pugazhendhi Vijayaraman, MD, FHRS for this exciting conversation! This Heart Rhythm Journal article explores the electrophysiologic signatures that occur during left bundle branch pacing (LBBP) as lead position changes, with a focus on identifying "uninterrupted transition" patterns in recorded electrograms. The findings help clarify how subtle lead movement within the interventricular septum can alter electrogram morphology and capture behavior, improving clinicians' ability to confirm true conduction system engagement during implantation. Read the article Learning Objectives Describe the electrophysiologic basis of lead position–dependent electrogram changes observed during left bundle branch pacing. Differentiate uninterrupted transition electrogram patterns from other pacing capture transitions (e.g., septal capture vs LBB capture). Apply electrogram transition findings to improve procedural decision-making for confirming optimal lead placement during LBBP implantation. Article AuthorsJiabo Shen, MD, Longfu Jiang, MD, Hao Wu, MD, Lu Zhang, MD, Hengdong Li, MD, Lifang Pan, MD Podcast ContributorsGaurav A. Upadhyay, MD, FHRS Pugazhendhi Vijayaraman, MD, FHRS Jason T. Jacobson, MD, FHRS 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 G. Upadhyay Honoraria/Speaking/Teaching/Consulting: Boston Scientific, Abbott, Medtronic, Biontronik, Zoll Medical Corporation P. Vijayaraman Honoraria/Speaking/Consulting: Medtronic, Boston Scientific, Biotronik, Abbott Medical, Abbott Research: Medtronic Fellowship Support: Medtronic 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 Digital Education Committee Member and podcast host Deep Chandh Raja, MBBS, MD, PhD , and his guests Georgios Leventopoulos, MD, and Muthiah Subramanian, MD, CCDS, CEPS-A, for this week's Lead episode. This Heart Rhythm article investigates the Bachmann bundle as a target for pacing by using retrograde electrical mapping and correlating findings with underlying myocardial microstructure. The piece provides detailed insights into how Bachmann bundle activation pathways relate to tissue architecture, with implications for optimizing physiologic pacing strategies. These findings may help refine pacing techniques that aim to better mimic natural conduction and improve clinical responses. Learning Objectives Describe the anatomical and electrophysiologic characteristics of the Bachmann bundle and its role in atrial conduction. Explain how retrograde mapping and microstructural correlation can identify optimal pacing targets within the atrial conduction system. Evaluate the potential clinical implications of Bachmann bundle pacing for achieving more physiologic atrial activation. Article AuthorsDaniel L. Lustgarten, MD, PhD, FHRS, Nicole Habel, MD, PhD, Margaret Infeld, MD, MS, Daniel Correa de Sa, MD, Robert Lobel, MD, Peter Spector, MD, FHRS, Nathaniel Thompson, MD, Joseph Winget, MD, Neal Duong, BME, Bo Ye, MD, PhD, Paul A. Iaizzo, PhD, Markus Meyer, MD, PhD Podcast Contributors Deep Chandh Raja, MBBS, MD, PhD Georgios Leventopoulos, MD Muthiah Subramanian, MD, CCDS, CEPS-A Article Being Discussed Host and Contributor Disclosure(s): G. Leventopolous Nothing to disclose. D.C. Raja Nothing to disclose. M. Subramanian •Nothing to disclose.