Julian Chun

[EHRAPresident @EHRAPresident]

Do oesophageal temperature probes actually make left atrial ablation safer and are we still using them?
That’s the question behind the new EHRA Scientific Initiatives Committee survey on the contemporary use of oesophageal temperature probes (ETPs) during left atrial ablation and the subject of our latest #EHRA_SICsays conversation with @AriSultanEP.

232 physicians from 37 countries responded and the picture is far from uniform. ETPs are used predominantly during thermal ablation, while their use with pulsed field ablation is uncommon. Even when probes are used, temperature thresholds and the response to temperature excursions vary considerably between centres.
The key issue isn’t simply whether we monitor temperature. It’s what that monitoring actually achieves. Current randomized and observational evidence has not established that ETPs prevent oesophageal injury or atrio-oesophageal fistula, and 56% cited lack of evidence for AEF prevention as a reason for not using them. Meanwhile, the growing use of PFA is reshaping oesophageal protection strategies altogether.

🎙️ Watch the discussion with @AriSultanEP 👇
📄 Read the full manuscript: https://t.co/46SFvcd9R1

Does oesophageal temperature monitoring still have a place in your left atrial ablation workflow?

#EHRA_SICsays #EHRA_ESC #EPeeps #AtrialFibrillation #CatheterAblation #PulsedFieldAblation #Electrophysiology
@LauraPerotta @JarkkoKarvonen @jongichun @micaela_ebert @DrCherylTeresEP @HaranBurri @veramasloo @drtahasahin @AugustoMeretta @JacopoImberti @cespon_maria @jadczyk @Fede79Miglio @CarolRemme @LA_Stanciulescu @VerenaTscholl @Amar__taha @mattans5 @AmrAbdin10 @JuliaCTourigny @DrMarkMills @RachelterBekke @FraSantoroMD @Pierre_Olt @cris_lozano @LinaMarcantoni @ChristianHeeger

[Julian Chun @jongichun]

@SoSunny14 Only 2cc🥃

[Julian Chun @jongichun]

Pacing LAA….!
What happens and why..?

[Julian Chun @jongichun]

@EHRAPresident @HRSonline @LAHRSonline1
🎉🎉🎉🙌🏻🙌🏻🙌🏻♥️💪🏼🎉🎉🎉

[Julian Chun @jongichun]

BIG BIG 🙏🏻🙏🏻🙏🏻 to all authors and centers for contributing to this joint work. Born and discussed in the EHRA SIC - executed by Sergio Castrejon et al.

✅Now, we have realistic information on stroke risks linked to AF ablation!

[EHRAPresident @EHRAPresident]

Who is behind #EHRA_ESC? 👋❤️

The new EHRA Board brings together colleagues working across the many areas that make our community thrive:

🎓 Education
🔬 Science
❤️ Patient initiatives
🤖 Digital & AI
🌍 Diversity & international collaboration
🧬 Genetics
🌱 Young EP
📣 Advocacy & communication
🎤 Congress & more
And behind them? Committees, volunteers and members sharing their expertise, energy and ideas. 🤝
EHRA is much more than its President or Board — it’s a diverse, international community working together to shape the future of electrophysiology. ⚡🌍❤️

#EHRATopicWeek #EHRA_ESC #EHRAEducation #ScientificInitiatives #DigitalHealth #PatientInitiatives #YoungEP #ECommunications #EHRA2027 #Leadership #Electrophysiology

[Europace Editor-in-Chief @EuropaceEiC]

#Europace #epeeps

🎯Percutaneous left atrial appendage closure following AF ablation : outcomes stratified by bleeding risk – a sub-analysis of the OPTION study

🔗🆓https://t.co/nYqgquLuoQ

@GiulioConteMD @FraSantoroMD @marcovitoloMD @DavideMei93 @Dominik_Linz @AndyZhangMD

[Julian Chun @jongichun]

@hrs_journal @finnakerstrom Interesting👍🏻…! Ethanol effect or durable mitral isthmus block, regardless of the energy source?

[Mark Mills @DrMarkMills]

Our new publication in Europace 📖

Diversity, equity and inclusion in arrhythmia care: A European Heart Rhythm Association survey

Link: https://t.co/wRLDCqMUAS

@jongichun @ChristianHeeger @Mel_Gunawardene @LauraPerrottaEP #EHRA_SIC

[Roderick Tung @DrRoderickTung]

Great to be back in China 🇨🇳

It’s real, I’ve seen it with my own eyes. The robots are here. #CHRS2026

[Circulation @CircAHA]

In this sham-controlled trial of 60 patients with symptomatic atrial fibrillation, pulsed field ablation (PFA) was superior to sham in reducing arrhythmia recurrence & burden and improving QOL. https://t.co/iZqzeZILK7

[Boldizsar Kovacs @BoldiKovacsMD]

👀Take a look at this #EHRA survey about #Afib ablation in elderly patients. Very important topic and <5 minutes to complete!

@ManningerMartin @Dominik_Linz @simovicst @jongichun @kvernooy

https://t.co/8JKuDwXlRq

[Heart Rhythm Society @HRSonline]

Hear from #HRS2026 #SciComms correspondent Andres Castillo, MD as he discusses late-breaking trial "Safety and Effectiveness of a Dual-Energy Focal Ablation Catheter to Treat Paroxysmal Atrial Fibrillation: 6-Month Results of the FlexPulse IDE Study" with @jongichun.

Learn more about the LBCTs here: https://t.co/U1q8Xj90AH

[Heart Rhythm Society @HRSonline]

Hear from #HRS2026 #SciComms correspondent @veramasloo as she interviews @jongichun about late-breaking clinical trial "A Prospective Randomized Multicenter Global Study Comparing Pulsed Field Ablation versus Anti-Arrhythmic Drug Therapy as a First Line Treatment for Persistent AFib" (AVANT GUARD).

Learn more about the LBCTs here: https://t.co/U1q8Xj90AH

[EHRAPresident @EHRAPresident]

#EHRAroundTheGlobe is still at #HRS2026 in Chicago 🇺🇸

@jongichun joins us for a conversation on one of the hottest topics in EP right now — the PFA Summit and the newly released PFA consensus document.

Pulsed field ablation is reshaping how we approach AF ablation. Here's where the science and the guidelines stand today 👇

[Jason Andrade @DrJasonAndrade]

More than 10 years ago Oussama and I started our journey of investigation, trying to the define the optimal first treatment for patients with atrial fibrillation. 

Separately we pursed randomised studies in populations with treatment-naive paroxysmal AF. 

Five years ago we presented our RCTs in the paroxysmal AF population, which ended up sitting side by side in the same issue of the New England Journal of Medicine. 

https://t.co/DWgHQ2VhiJ

https://t.co/z346xqq0jg

Since then we have been working together to examine the same question of optimal initial therapy, but instead looking at patients with more advanced forms of atrial fibrillation. 

Today Oussama presented the results of the AVANT-GUARD study, which definitively demonstrated the value of initial catheter ablation in the treatment naive persistent AF population.

Like EARLY-AF, AVAT GUARD used implantable cardiac monitors to evaluate arrhythmia endpoints  

Like EARLY-AF - initial catheter ablation reduced recurrences in AVANT GUARD by about 50%, which was about 25% in absolute terms. To put this another way, only 4 patients need to be treated with ablation to prevent a recurrence of arrhythmia. 

However, binary recurrence doesn’t tell the whole story. Because we had loop recorders we were able to assess the time spent in AF (or AF burden). In this regard significantly more patients had none or negligible burden after ablation (<0.1%), with significantly more AAD treated patients having a very high burden (>5%). This is important as AF burden is associated with clinical outcomes such as hospitalisation.

In terms of risk - the rates of any adverse event or serious adverse event were comparable between randomised arms. Highlighting that persistent AF patients with high CHADS-VASc score are high risk irrespective of treatment provided. This is important as we reflect on treatment options as part of shared decision-making.

Congratulations to Oussama for the presentation and leadership, to the co-investigators and study sites for their participation and dedication, and a huge thank you to the Boston Scientific team for their support and commitment to advancing science. 

To end, I want to acknowledge and thank Oussama for this shared journey, I’m grateful for our collaboration and friendship, and look forward to what we will do next.

[Kristie Coleman @kcole_12]

📍Happening now in Rhythm Theater 1
Advancing Single Shot Technology
@HRSonline @KeepInRhythm #HRS2026 #SciComms

[EHRAPresident @EHRAPresident]

Early risers at #EHRA2026 — the Pulse Day Run delivered! Great atmosphere, great company, and a morning reminder of why we do what we do. 💓
Check out the video 👇

@escardio @jongichun @SergeBoveda

[John Mandrola, MD @drjohnm]

One of the most important trials of #ehra2026

Next do it for ICE in AF ablation

[EHRAPresident @EHRAPresident]

The EHRA Board met today — and the energy in the room said it all. #EHRA26 is here! ✨

This congress carries the fingerprints of so many dedicated Committee Chairs and members who have poured their time and expertise into making it extraordinary. We have some exciting surprises lined up — stay tuned.

To every Chair and Committee member: thank you. This is your moment too. 🙏