Stefan Simović

Head of Electrophysiology, UCC Kragujevac | Medical Faculty, Kragujevac | R&D BioIRC l Chair of #EHRA_ESC E-comm committee | #EHJCaseReports l @CybenceOrg

[DAS-CAM @DASCAMaastricht]

🌟Unlock your leadership potential in cardiac arrhythmia management 🩺
Join our #DASCAM 2026 programme (#EHRA level 3).
🔗 https://t.co/iR42Ur5X35
👉 EXTENDED DEADLINE until 22 June 2026, DO NOT MISS it !

[EHRAPresident @EHRAPresident]

🫀 #EHRATopicWeek Focal or reentrant? Modern insights into atrial tachycardia

What we once called “focal” AT is often far more complex.

Traditionally, focal AT (FAT) was defined as activation spreading centrifugally from a discrete site. Today, high-resolution mapping has revealed that many apparently focal tachycardias are actually tiny localized reentrant circuits — micro-reentrant ATs (MiRATs).

📌 True focal AT is mainly driven by:
• enhanced automaticity
• triggered activity
Meanwhile, localized reentrant ATs (LRATs) commonly occur in scarred atria or after previous ablation procedures and are characterized by slow conduction and long fractionated electrograms.

⚡ Modern EP increasingly relies on:
• high-density mapping
• entrainment mapping
• electrogram interpretation
• detailed anatomical understanding

Common AT locations include the crista terminalis, pulmonary veins, left atrial ridge, septal regions, and prior ablation scars.

💡 The more we map atrial tachycardias, the more we understand that “focal” does not always mean focal.

📖 Read more in the #EHRA_ESC Consensus document on Atrial Tachycardias 👉https://t.co/T5EGaHI51q
@escardio @EuropaceEiC

[EHRAPresident @EHRAPresident]

⚡ #EHRATopicWeek on Atrial Tachycardias

Catheter ablation has become the preferred treatment strategy for most symptomatic or recurrent ATs, while antiarrhythmic drug therapy often shows limited long-term efficacy.

📌 Key concepts from the latest evidence:
• Beta-blockers and calcium channel blockers remain important for rate control
• Catheter ablation is now first-line in many patients
• High-resolution electroanatomical mapping has transformed our understanding of AT circuits
• Entrainment and activation mapping remain essential tools for distinguishing focal vs reentrant mechanisms
• Pulsed-field ablation and ultra-high-resolution mapping are opening a new era in AT treatment

💡 Success in AT ablation depends on identifying the “critical isthmus” — the key region maintaining the arrhythmia — while durable bidirectional block is increasingly recognized as a crucial procedural endpoint.

Importantly, recurrence remains a major challenge, especially in patients with structural heart disease, prior AF ablation, or extensive atrial scarring

Find out more in the #EHRA_ESC Consensus document on Atrial Tachycardias 👉https://t.co/T5EGaHI51q
@escardio @EuropaceEiC

[EHRAPresident @EHRAPresident]

🔍 #EHRATopicWeek on Atrial Tachycardias
Atrial Tachycardia is more complex than we once thought

Traditionally, rapid regular atrial arrhythmias were divided into “atrial tachycardia” and “atrial flutter” based mainly on ECG appearance. Today, high-resolution mapping shows these distinctions are often oversimplified.

📌 Current concepts classify all regular atrial rhythms >100 bpm as AT:
• Non-reentrant AT
• Reentrant AT (localized or macro-reentrant)

Importantly, many arrhythmias previously labeled as “flutter” may actually represent different AT mechanisms.

⚡ Differentiating AT from organized AF can be challenging, especially in scarred atria or after ablation. ECGs, EP studies, intracardiac mapping, and even wearable devices all play an important role in diagnosis.

💡 Precise classification matters — for diagnosis, treatment strategy, and improving ablation outcomes.

Find out more in the #EHRA_ESC Consensus document on Management of patients with atrial tachycardia 🔗https://t.co/T5EGaHI51q
@escardio @EuropaceEiC

[EHRAPresident @EHRAPresident]

🎙️ New EHRA CardioTalk podcast episode is out!

This month we are tackling one of the most clinically demanding scenarios in electrophysiology — Re-Do atrial fibrillation procedures.

When does a patient need a second (or third) ablation? What are the key considerations, pitfalls, and strategies? 🤔

Join @sozi81 @simovicst @JacopoImberti sharing their expertise

👉 Listen here: https://t.co/PU4Z8zPNlt

#EHRAtopicweek @escardio

[EHRAPresident @EHRAPresident]

⚠️ Arrhythmic mitral valve prolapse. One of the most complex challenges in modern EP

Risk stratification. Sudden cardiac death prevention. High stakes — and not always clear-cut answers.
#EHRA_ESC has provided a consensus framework. But how is it actually being applied in real-world clinical practice?
We want to hear from you 🫵

If you manage patients with AMVP, your insights matter. This short survey is gathering frontline perspectives on how these recommendations translate from guidelines to the bedside.

📋 Take the survey 👇 🔗 https://t.co/m5etSizBFS

[EHRAPresident @EHRAPresident]

🌟 The future of electrophysiology is bright — and it has names.

Meet Corentin Chaumont, Tine Prolič Kalinšek, and @ManningerMartin — three Young Ambassadors shaping the next chapter of the EP community through EHRA.

In "Rising Stars of EHRA: Young EP Trailblazers", they open up about what it means to be an early-career electrophysiologist today — the challenges, the opportunities, and the power of being part of a global network that has your back.

Whether you're just starting your EP journey or looking to get more involved in the #EHRA_ESC community, this one's for you.

🎥 Watch now 👇
🔗 https://t.co/BtDq80OntL

[Stefan Simović @simovicst]

@OCanoPerez @micaela_ebert @HaranBurri @ZacharyWhinnett @escardio Thank you Oscad for accepting the invitation! @micaela_ebert

[Stefan Simović @simovicst]

What a great success of the 1st #EHRA_ESC Journal club discussing the LEFT-BUNDLE CRT trial with @micaela_ebert @HaranBurri @OCanoPerez @ZacharyWhinnett

More episodes to come soon!
@escardio

[EHRAPresident @EHRAPresident]

📖 EHRA Journal Club - Late-Breaking Trial: left bundle CRT

📅 6 May | 18:00–18:45 CEST

LBBAP vs BiV-CRT — practice-changing or not? ⚡

Join top EP experts 🇨🇭 🇩🇪 🇪🇸 🇬🇧 for a fast, critical take on the latest randomized data & what it means for your patients.

👉 Register & watch on #ESC365

https://t.co/Xg4w3f1p3S

#EHRA #JournalClub #CRT #EP

[Stefan Simović @simovicst]

The 1st #EHRA_ESC Journal Club is scheduled for the 6th of May! Register 👇🏻and discuss the LEFT-BUNDLE CRT trial

[EHRAPresident @EHRAPresident]

📖 EHRA Journal Club - Late-Breaking Trial: left bundle CRT

📅 6 May | 18:00–18:45 CEST

LBBAP vs BiV-CRT — practice-changing or not? ⚡

Join top EP experts 🇨🇭 🇩🇪 🇪🇸 🇬🇧 for a fast, critical take on the latest randomized data & what it means for your patients.

👉 Register & watch on #ESC365

https://t.co/Xg4w3f1p3S

#EHRA #JournalClub #CRT #EP

[Heart Rhythm TV @HeartRhythmTV]

Immediately following the #LBCT presentation at #HRS2026, Heart Rhythm TV host @MehakDhande, sat down with @sean_pokorney, and Roopinder K. Sandhu, MD, MPH, FHRS, to discuss Centers of Excellence Optimal Management Pathways for Atrial Fibrillation Specialty Services Early Rhythm Control Treatment Care Pathway: Primary Results of the COMPASS Heart Rhythm Society Quality Improvement Initiative.

See the full discussion here #EPeeps ➡️ https://t.co/Slx6WjDFwB

[Stefan Simović @simovicst]

#EHRAroundTheGlobe from #HRS2026

[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 👇

[Stefan Simović @simovicst]

@HaranBurri and @arbelo_e go head-to-head on the most compelling cases from the Innovative Devices Rapid Firesession — one of the most electrifying formats at this year's meeting from #HRS2026

The future of pacing? Very bright indeed. 💡
📺 Watch below 👇

[JK Han MD @netta_doc]

👩🏻‍⚖️Passing the gavel from one woman in EP to another!!

Congrats Dr Mina Chung (@EP_mom1) on a great year as @HRSonline President!

Welcome to Dr @SanaAlkhatib9, our new #HRS2026 - #HRS2027 #MadamePresident!!

#WomeninEP
#EPeeps

[JK Han MD @netta_doc]

Case-based Innovations & Procedural Strategy in #AF, #VT, & Conduction system #pacing!

Led by
@Drdevignair
@Mel_Gunawardene
@EP_mom1

Come to the grand Ballroom now s100!

#HRS2026

[Stefan Simović @simovicst]

#EHRAroundTheGlobe #HRS2026

[EHRAPresident @EHRAPresident]

🌍 Introducing a brand-new #EHRA_ESC format: #EHRAroundTheGlobe

We're hitting the road — traveling to our sister society meetings to bring you the most important scientific breakthroughs in heart rhythm, straight from the source

🇺🇸 First stop: #HRS2026 in Chicago
@simovicst sat down with @purerfellner to break down the highlights from the #HRS2026 this year.

What's making waves at #HRS2026? Find out 👇

[Stefan Simović @simovicst]

10/10
The takeaway from this session:
💉 Microcurrents can reverse HF remodeling — subcutaneously
🗺️ Mapping and PFA can now be done with a single focal catheter
👁️ Seeing tissue contact during balloon PFA can improve durability
⚡ Extravascular defibrillation is moving beyond the subcutaneous ICD
The future of EP is being written now. 🚀 #HRS2026

[Stefan Simović @simovicst]

🧵 First-in-Human Trials & Innovative Techniques at #HRS2026 — 4 studies, 4 frontiers 🫀⚡
@HRSonline

[Stefan Simović @simovicst]

9/10
ASCEND EV results (n=18-19, Croatia/New Zealand/Paraguay):
⚡ Defibrillation: 94% at implant → 100% at 3 months
📡 Sensing: 100% with 4 different ICD manufacturers
🩺 No P/T wave oversensing, no pericardial effusion, no myocardial damage
⚠️ 2 inappropriate shocks from household EMI (microwave, washing machine) — being addressed in programming guidance
➡️ ALARION EV Pivotal Study enrollment planned 2026