Bernard Harbieh, MD, FHRS, FACC, FESC

Cardiology & Cardiac Electrophysiology KMC & LHGUMC & CHN, Lebanon Cardiac Electrophysiology Aman Hospital, Doha Qatar

[Bernard Harbieh, MD, FHRS, FACC, FESC @harbiehbernard]

Read the full study:
https://t.co/7AqgskMxUQ

[Bernard Harbieh, MD, FHRS, FACC, FESC @harbiehbernard]

The question has been debated for years: can we safely skip defibrillation threshold testing at S-ICD implant?

The PRAETORIAN DFT trial, just published, gives us a definitive answer.

Details in Comments

@BSCCardiology @BSC_EU_Heart
#SICD #DFT #NO_DFT #EP #CRM

[Bernard Harbieh, MD, FHRS, FACC, FESC @harbiehbernard]

As electrophysiologists, this trial gives us the evidence base to streamline implant procedures — and to have an honest conversation with patients about what is truly necessary.

Congratulations to the PRAETORIAN DFT investigators for this landmark contribution.

[Bernard Harbieh, MD, FHRS, FACC, FESC @harbiehbernard]

This is a robust demonstration that omitting DFT does not compromise shock efficacy in S-ICD patients, given the implant technique is good. The device's detection and therapy algorithms are reliable enough that pre-discharge induction testing adds no measurable safety benefit.

[Bernard Harbieh, MD, FHRS, FACC, FESC @harbiehbernard]

The primary endpoint — the first failed shock for spontaneous ventricular arrhythmias — showed:

▸ 1.7% first failed shock incidence in the No-DFT arm @ 3.3y

▸ 2.3% first failed shock incidence in the DFT arm @ 3.3y

▸ non-inferiority margin met (p<0.001)

[Bernard Harbieh, MD, FHRS, FACC, FESC @harbiehbernard]

In this prospective, randomized, multicenter non-inferiority trial, 965 patients were randomized 1:1 to S-ICD implantation with or without DFT testing + guidance based on the PRAETORIAN score.

[Bernard Harbieh, MD, FHRS, FACC, FESC @harbiehbernard]

Congratulations @KnopsReinoud and Co-investigators for this Amazing Trial. #SICD #PraetorianDFT #DFT #NoDFT
@HRSonline

[Circulation @CircAHA]

#Simpub #HRS2026: PRAETORIAN-DFT trial (n=965): PRAETORIAN score–guided omission of defibrillation testing after S-ICD implant was non-inferior for first-shock efficacy while reducing procedural risk. https://t.co/bFC91k3OSg

[Bernard Harbieh, MD, FHRS, FACC, FESC @harbiehbernard]

Congratulations @omwazni and co-investigator for this amazing trial!
#PFA #PersistentAfib
#AvantGuard

[NEJM @NEJM]

Presented at #HRS2026:

In patients with persistent atrial fibrillation, first-line treatment with pulsed field ablation reduced the recurrence of atrial arrhythmias at 12 months as compared with antiarrhythmic drugs. Full AVANT GUARD trial results: https://t.co/milHy26ojJ

@HRSonline

[Bernard Harbieh, MD, FHRS, FACC, FESC @harbiehbernard]

Our session was presented by Drs. Pierre Baaklini and Jimmy Abou Khalil, and moderated by Dr. Jad Skaff.

@jad_skaf

[Bernard Harbieh, MD, FHRS, FACC, FESC @harbiehbernard]

Our EP session for cardiology fellows is still ongoing! We’ve been covering increasingly complex topics with numerous interdisciplinary discussions. This month’s session focused on localizing the origin of a PAC and a PVC on an ECG.
#electrophysiology #ECG #cardiology_Fellows

[Bernard Harbieh, MD, FHRS, FACC, FESC @harbiehbernard]

The Autumn Meeting of the Lebanese Society of Cardiology that will be held on September 13-14, 2025 at Al Bustan Hotel – Bet Mery.

[Bernard Harbieh, MD, FHRS, FACC, FESC @harbiehbernard]

As a Chairman of the EP Working Group in the Lebanese Society of Cardiology, i am proud to have involved Lebanon in the international 2025 ESC-EHRA atlas on Heart rhythm disorders

#EP #ESC #EHRA
@LSC09932397

Access the publication here: https://t.co/1IcNNsEsOw

[Bernard Harbieh, MD, FHRS, FACC, FESC @harbiehbernard]

Some Fun in the lab!
Afib Pulsed Field Ablation combined with watchman appendage closure for the same patient!

[Bernard Harbieh, MD, FHRS, FACC, FESC @harbiehbernard]

When you have to do think out of the box!
30 yrs post Mechanical tricuspid valve with complete heart block. CRTP with two leads in CS, one as a back-up
@geitaoui

[Bernard Harbieh, MD, FHRS, FACC, FESC @harbiehbernard]

Being awarded Fellowship in the ACC represents a significant milestone in any cardiologist’s professional journey. I was honored to participate in a memorable convocation. What made the occasion truly special was having my 13-year-old daughter, Kelly, by my side to celebrate this

[Bernard Harbieh, MD, FHRS, FACC, FESC @harbiehbernard]

Spreading incomplete information is dangerous!
Any medication has a side effect and we can not just talk about the POSSIBLE side effect and disregard the benefits!
Patients are freaking out and stopping life threatening medication because of a reports done by @MTVLebanonNews

[Bernard Harbieh, MD, FHRS, FACC, FESC @harbiehbernard]

@MTVLebanonNews @MTVLebanon
@LSC09932397 @mophleb

Spreading medical information is very critical when dealing with any medications related to medical issues!
Last week Burinex
This week Concor
What’s next?
Who is the doctor reviewing the medical scripts?

[Lebanese Hospital Geitaoui - UMC @geitaoui]

First AVEIR leadless pacemaker implantation in Lebanon at HLG - UMC!
A groundbreaking achievement in electrophysiology. 🙌🇱🇧

#MedicalInnovation #Electrophysiology #AVEIR #Lebanon

[Bernard Harbieh, MD, FHRS, FACC, FESC @harbiehbernard]

Fellow of European Society of Cardiology
@escardio

[Bernard Harbieh, MD, FHRS, FACC, FESC @harbiehbernard]

The Lebanese Idol Dr @WilliamZoghbi at the ESC Lebanese Society of Cardiology booth! Proud_to_be_lebanese!
@escardio
#cardiology #Master_Of_Cardiology #Lebanese_Society_of_cardiology
#Lebanon #USA