The Lead Podcast presented by Heart Rhythm Society

In this episode of The Lead, host Deepak Pasupula, MD, MPH, FHRS, is joined by Zaniar Ghazizadeh, MD, and Pugazhendhi Vijayaraman, MD, FHRS, to discuss the journal article, The Long-Term Outcomes of Left Bundle-Branch Pacing vs Biventricular Pacing in Heart Failure (The HeartSync-LBBP Randomized Clinical Trial). Together, they review the long-term outcomes of left bundle-branch pacing compared with biventricular pacing in patients with heart failure and discuss the findings of the HeartSync-LBBP randomized clinical trial. Learning Objectives Review the long-term outcomes of left bundle-branch pacing compared with biventricular pacing in patients with heart failure. Discuss the findings of the HeartSync-LBBP randomized clinical trial. Examine the clinical implications of comparing left bundle-branch pacing with biventricular pacing in heart failure. Host: Deepak Pasupula, MD, MPH, FHRS Guests: Zaniar Ghazizadeh, MD and Pugazhendhi Vijayaraman, MD, FHRS Disclosures: D. Pasupula No relevant disclosures Z. Ghazizadeh No relevant disclosures P. Vijayaraman Honoraria/Speaking/Consulting Fee: Biotronik, Boston Scientific, Abbott, Medtronic Research: Medtronic Fellowship Support: Medtronic

In this episode of The Lead recorded at HRS2026, host Danesh Kella, MBBS, FHRS is joined by Jeffrey S. Healey, MD, FHRS and Fred M. Kusumoto, MD, FHRS to discuss the journal article, Left Atrial Appendage Closure or Medical Therapy in Atrial Fibrillation (The CLOSURE-AF Trial). Together, they review the study findings comparing left atrial appendage closure with medical therapy in patients with atrial fibrillation and discuss the potential implications for clinical practice. Learning Objectives Review the design and key findings of the CLOSURE-AF Trial comparing left atrial appendage closure with medical therapy in patients with atrial fibrillation. Discuss the comparative considerations of left atrial appendage closure and medical therapy for the management of atrial fibrillation. Examine the potential clinical implications of the CLOSURE-AF Trial for treatment decision-making in patients with atrial fibrillation. Host: Danesh Kella, MBBS, FHRS Guests: Jeffrey S. Healey, MD, FHRS and Fred M. Kusumoto, MD, FHRS Disclosures: D. Kella Honoraria/Speaking/Consulting Fee: Zoll Medical Corporation, MBW Spectrum J. Healey Honoraria/Speaking/Consulting Fee: Boston Scientific, Servier Research: Pfizer, Boston Scientific, Medtronic, Inc. Speakers' Bureau: Bristol-Myers Squibb F. Kusumoto No relevant disclosures

Recorded at EHRA 2026, this episode of The Lead features host Melissa Middeldorp, MPH, PhD, FHRS, in conversation with Sana Al-Khatib, MD, MHS, FHRS, and Wei Hua, MD, FHRS, about the journal article, Conduction System vs Biventricular Pacing in Heart Failure: The PhysioSync-HF Randomized Clinical Trial. Together, they discuss the findings of the PhysioSync-HF randomized clinical trial, comparing conduction system pacing with biventricular pacing in patients with heart failure and exploring the potential implications for clinical practice. Learning Objectives: Review the design and key findings of the PhysioSync-HF randomized clinical trial comparing conduction system pacing and biventricular pacing in patients with heart failure. Discuss the differences between conduction system pacing and biventricular pacing as evaluated in the PhysioSync-HF trial. Examine the potential clinical implications of the trial findings for pacing strategies in patients with heart failure. Host: Melissa Middeldorp, MPH, PhD, FHRS Guests: Sana Al-Khatib, MD, MHS, FHRS and Wei Hua, MD, FHRS Disclosures: M. Middeldorp · No relevant disclosures S. Al-Khatib · Other Financial Relationship: American Heart Association W. Hua · No relevant disclosures

Recorded at EHRA 2026, this episode of The Lead features host Christopher Kowalewski, MD, in conversation with Christian Sohns, MD, and Pierre Jaïs, MD, about the journal article, 20 Years: Clinical Outcome After Pulmonary Vein Isolation in Patients With Symptomatic Drug-Refractory Paroxysmal Atrial Fibrillation. Together, they discuss the study's long-term clinical outcomes following pulmonary vein isolation in patients with symptomatic drug-refractory paroxysmal atrial fibrillation and explore the implications of two decades of follow-up. Learning Objectives: Review the long-term clinical outcomes reported after pulmonary vein isolation in patients with symptomatic drug-refractory paroxysmal atrial fibrillation. Discuss the implications of 20-year follow-up data for the treatment of patients undergoing pulmonary vein isolation. Examine how long-term outcome data may inform clinical decision-making for catheter ablation in paroxysmal atrial fibrillation. Host: Christopher Kowalewski, MD Guests: Christian Sohns, MD and Pierre Jaïs, MD Disclosures: C. Kowalewski No relevant disclosures C. Sohns No relevant disclosures P. Jaïs Ownership/Partnership/Prinicipal: inHEART Honoraria/Speaking/Consulting Fee: Biosense Webster, Inc., Boston Scientific, Medtronic

Welcome to the third in this week's series of Lead episodes covering late breaking clinical trials from Heart Rhythm 2026 in Chicago. Join host Michael Lloyd, MD, FHRS, and his guests Christopher Kowalewski, MD and Karin Benali, MD, PhD for this discussion. This first-in-human, prospective study presented at Heart Rhythm 2026 evaluated noninvasive proton beam cardiac radioablation for patients with refractory ventricular tachycardia who had failed prior ablation and medical therapy. In a small, high-risk cohort, proton therapy was feasible and demonstrated substantial reductions in VT burden (approximately 80%) with no significant treatment-related toxicity observed during follow-up. These early findings highlight proton beam radioablation as a promising, highly targeted, noninvasive treatment option, though larger studies are needed to confirm long-term safety and durability. Learning Objectives: Describe the principles of cardiac radioablation and the advantages of proton beam therapy compared with photon-based approaches for treating ventricular tachycardia. Evaluate early feasibility, safety, and efficacy outcomes of proton beam therapy in patients with refractory ventricular tachycardia. Assess the potential role of noninvasive cardiac radioablation in the treatment algorithm for patients with drug- and ablation-refractory ventricular tachycardia. Podcast Contributors Michael S. Lloyd, MD, FHRS Christopher Kowalewski, MD Karin Benali, MD, PhD Host and Contributor Disclosure(s): M. Lloyd •Honoraria/Speaking/Teaching/Consulting: Medtronic •Membership on Advisory Committees: Boston Scientific K. Bemali Nothing to disclose. D. Chew Nothing to disclose.