Kevin Brady

📢 Focus Issue on PFA interaction with CIED @hrs_journal @HRSonline #EPeeps ➡️ PFA offers myocardial selectivity, procedural efficiency, and an encouraging early safety profile; ➡️PFA interaction with existing intracardiac hardware—remains incompletely understood. *⃣The May 2026 issue brings together several important real-world observations demonstrating that PFA energy fields can interact with leads, coils, and device circuitry in clinically meaningful ways, underscoring the need for heightened procedural awareness. 🧵below

(1) We have cases where PVCs are not produced on the table, particularly after sedation. @drrakeshg1 and I were able to prove a theory I have held for years regarding the MOA of outflow tract PVCs. Our workflow allows for identification of the trigger site when PVCs are absent.

🔵 LBBAP without a terminal r′/R′-wave in V1 🔵

Fresh from #HRS2026 by @drrakeshg1 using Peak-frequency SR mapping to localize PVCs. We applied it on an RVOT PVC today #EnSiteX. Pic 1: LAT map of PVC (L), Peak Freq map in SR (R) Pic 2: Successful RF site (teal tag) Pic 3: Reference poster @GoArmyChris @Coops_Squigles

The #VoltPFA insights keep coming! Late-breaking results on Volt PFA System PVI durability and patterns help answer the question: does the pulse field ablation system matter? Explore the data straight from #HRS2026 ⬇️ Safety Info: bit.ly/4vHc0tl

Kerfed Tip Enhances Catheter Stability During Accessory Pathways Ablation in Children heartrhythmjournal.com/article/S1547-…

Bipolar radiofrequency catheter ablation of incessant ventricular tachycardia originating from anterolateral papillary muscle heartrhythmcasereports.com/article/S2214-…

Repeating PF twice created the optimal combination of greatest depth and least variation compared with all single and sequential PF/RF strategies in a swine model @DrKeitaW @VivekReddyMD @jskoruth #Epeeps ahajrnls.org/48m2wtC

Here we go #HRS2026 On the highly touted AVANT GAURD RCT of Boston scientific Farapulse PFA vs AAD. nejm.org/doi/full/10.10… The Topline results are positive. Look at that KM curve But let's look under the hood so as not to be bamboozled A thread coming and it's quite surprising

Design matters. At #EHRA2026, VOLT 12‑month data reinforce that biophysics, contact, and lesion durability are critical to long‑term success in pulsed field ablation.
✅ Outcomes driven by catheter and waveform design #EPeeps #AFib #PFA #abbott #MedTech

Likely SOO? #EPeeps

@syamkumarmd Posteroseptal RVOT

@syamkumarmd @narrowQRS Ahh interesting, not as pronounced of a pattern break in sinus since V3 is R/S vs QS in the PVC, but still there!

@Hapa_EP @narrowQRS It was just below the RB. One interesting thing I noticed in the ECG is conducted rhythm also shows the same pattern break.

Where is the likely SOO? #EPeeps

facebook.com/share/v/18bcGN… AV nodal delay (≈0.09 s) is the heart’s precision timing mechanism. It forces the impulse to pause from 0.03 s (entry) to 0.12 s (exit), allowing complete atrial contraction and ventricular filling before systole. #CardiacElectrophysiology #AVNode

#CardioNuggets Phase 3 vs phase 4 blocks: ⚡️ Phase 3 (tachy-dependent): impulse arrives too early during repolarization → tissue still refractory → block 🐢 Phase 4 (brady-dependent): slow rates → spontaneous depolarization → ↓Na channel availability → block #CardioNuggets #MedEd #EPeeps #CardioTwitter

16 yom High burden PVC. No, it is not RVOT. What do you think is SOO ?

@ALFIEEP1 Parahisian

case no. 4: where is the focus of these PVC’s? #Epeeps