Electrophysiologist, prof of cardiology (cardiology dpt) at the Medical University of Silesia, Silesian Cntr for Heart Disease, Zabrze, Poland
Zabrze, Poland, Europe
Joined December 2011
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Radosław Lenarczyk retweeted
Another sobering study in AF ablation. Melbourne group reports on 121 patients who have recurrent AF despite durable PVI. All have posterior wall isolation. [Because we can.]
The results are similar to the trials. Not good.
doi.org/10.1016/j.jacep.2026…
@peterkistler3
Radosław Lenarczyk retweeted
Credit to the EP team in Bern for this excellent remapping study after either RF or PFA. Mandated remapping is much better than remapping for symptoms jacc.org/doi/10.1016/j.jacep…
A) PFA no better than RF for durable PVI
B) Recapitulates GAP study showing that AF still occurs in one-third of durably isolated PVs and 72% of those with reconnected veins DID NOT have AF at one year
This is the crux of our problem in EP: we don't understand the pathophysiology of the condition. PVs get isolated because we can. @TobiasReichlin
Radosław Lenarczyk retweeted
Interesting case of 2 times failed left sided AP; endocardially! nice double signals during VP; no early signal endo. but inside CS ; it was great and AP easily gone here👇! #Epeeps
Radosław Lenarczyk retweeted
Conduction System Recovery After Pulsed Field Ablation of a Para-Hisian PVC #OpenAccess
@DrMatthewHyman @PennEPFellows
heartrhythmjournal.com/artic…
Radosław Lenarczyk retweeted
Wow. BREAKING.
Critical appraisal springs to life from Top People when they do not like the results
Read this scathing critique of PVI-SHAM-AF trial heartrhythmjournal.com/artic…
From many of the makers of endpoints like "non-procedural bleeding" and noninferiority without relative risk margins
My friends, put down those stones, you are going to break something in that glass house
Grin. Double Grin. Stay tuned to TWIC.
In HF patients with refractory AF undergoing atrioventricular node ablation, CSP with left bundle branch area pacing was non-inferior to BVP for LVEF improvement at 6 months, providing comparable clinical outcomes and a favourable procedural profile ➡️the CONDUCT-AF trial👇 academic.oup.com/eurheartj/a…
Radosław Lenarczyk retweeted
Para-His periaortic VT ablation with focal pulsed-field energy #OpenAccess
@PranavBhagirath @IVRoca
heartrhythmjournal.com/artic…
Radosław Lenarczyk retweeted
In patients with #AFib and intermediate stroke risk, direct oral anticoagulation led to a lower risk of stroke, systemic embolism, major bleeding, or death from cardiovascular causes than no anticoagulation. Full SINGLE-AF trial results and Research Summary: nej.md/4ii61XB
#ESCCongress
ALT This image contains an excerpt from the Research Summary "Anticoagulation for Atrial Fibrillation with Intermediate Stroke Risk" published in the New England Journal of Medicine. It includes a visual representation of a patient with atrial fibrillation and an intermediate risk of stroke. Patient demographics are detailed as 1803 adults, average age of 60 years. The bottom half contains illustrations of the two treatment options: direct oral anticoagulant (DOAC) therapy or no anticoagulation. A prompt to read the full Research Summary at NEJM.org sits at the bottom.
Radosław Lenarczyk retweeted
2026 HRS/EHRA scientific statement on pulsed field ablation for cardiac arrhythmias
heartrhythmjournal.com/artic…
Radosław Lenarczyk retweeted
The legal implications of medical AI, a review of 31 cases involving AI tools
nature.com/articles/s44360-0…
A novel ECG algorithm for accurate localization of manifest accessory pathways in both children and adults: SMART-WPW-4 me, important features to differentiate right free wall vs right septal APs👇 heartrhythmjournal.com/artic…
Radosław Lenarczyk retweeted
Our meta-analysis of 7 RCTs (7,353 patients) found that pLAAO was associated with significantly more ischemic stroke or systemic embolism than OAC, without reducing major bleeding. Bayesian analysis also failed to establish noninferiority. Proponents of pLAAO will not like this paper.
@MRuzieh @drjohnm @AndrewFoy82
sciencedirect.com/science/ar…
Radosław Lenarczyk retweeted
These letters are the tip of the iceberg of the prob w CHAMPION (and OPTION, btw)
CHAMPION will be used in EBM classes as an eg of biased design and interpretation
A colossal embarrassment for the academics involved
Note what BSX stock did the Monday after the *positive* trial was presented
cc @kaulcsmc
Published in the NEJM, three letters raise important points about CHAMPION-AF:
1) The primary endpoint includes cardiovascular death (42% of events), which is a “dilutive” component that does not characterize either treatment arm and favors a finding of noninferiority.
2) Focusing on ischemic stroke reveals a hazard ratio of 1.61 (95% CI, 1.00–2.59), with no difference in hemorrhagic stroke. This is somewhat the opposite of what one would expect from percutaneous LAAC.
3) The number of events was so much lower than anticipated that, while maintaining the same noninferiority margin, the trial effectively allowed a doubling of events while still declaring noninferiority.
4) It is inappropriate to consider the risk of intracranial hemorrhage solely as a function of oral anticoagulant exposure, while ignoring predisposing structural conditions such as cerebral amyloid angiopathy.
nejm.org/doi/full/10.1056/NE…
Radosław Lenarczyk retweeted
What makes a meta-analysis believable?
In our latest issue, a new Viewpoint outlines how to identify meta-analyses that merit clinical confidence.
Explore the full issue: spkl.io/60197rxth
ALT Cover of The Lancet September 19, 2026 issue. Quote reads: Meta-analyses are not definitive truths, but rather structured efforts to interpret incomplete, evolving, and sometimes inconsistent evidence.
Radosław Lenarczyk retweeted
Premature ventricular contractions on healthy and diseased hearts: Differential acute effect of coupling interval and location
heartrhythmjournal.com/artic…
Radosław Lenarczyk retweeted
Incidence and predictors of major arrhythmic events after acute myocarditis complicated by ventricular arrhythmias: A systematic review and meta-analysis
@GuenanciaC
heartrhythmjournal.com/artic…
Radosław Lenarczyk retweeted
LEAP2: A first-in-human evaluation of a chronically implanted novel leadless pacemaker for conduction system pacing #OpenAccess
heartrhythmjournal.com/artic…
Periodic repolarization dynamics (#PRD) combined with supraventricular premature complexes/hour showed better discrimination than the CHASE‐LESS score alone in predicting new #AF after stroke
ahajournals.org/doi/10.1161/…
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