What an absolute pleasure it was to meet so many people from across the electrophysiology community at EHRA 2026. From familiar faces to new introductions, the congress was a reminder that progress in our sector is driven as much by people and shared ideas as it is by technology.
Thank you to the European Society of Cardiology and the wider EHRA team for bringing together such an engaging congress. Hopefully, this was the first of many EHRA meetings still to come.
Beyond the Exhibition Floor
EHRA offered the usual mix of scientific discussion, hands-on technology and conversations about where cardiac rhythm management is moving next. The exhibition floor reflected a sector evolving quickly across ablation, mapping, cardiac implantable electronic devices, remote monitoring and data interpretation.
What stood out was not simply the volume of innovation on display, but the way technologies are becoming increasingly connected. Mapping platforms are becoming more intelligent. Monitoring is becoming more continuous. Clinical data is becoming easier to access and interpret. The direction of travel is clear: better procedural decisions, better follow-up and a more complete view of the patient journey.
The conversations around pulse field ablation, mapping intelligence and connected monitoring were particularly strong. Yet one point from the scientific programme stayed with me because it challenges how we interpret the evidence behind these technologies.
The therapy may be the same. The lens used to measure it may not be.
The Overlooked Variable in AF Ablation Outcomes
One of the most overlooked variables in atrial fibrillation ablation outcomes is not necessarily the energy source. It is the monitoring strategy used after the procedure.
Radiofrequency, cryoablation and pulse field ablation are often compared through headline success rates. On the surface, those figures can appear directly comparable. In reality, they may have been produced using very different methods of follow-up.
| MONITORING DURATION | MONITORING MODALITY | DEFINITION OF RECURRENCE |
| How long patients are followed and how frequently rhythm data is collected. | Whether recurrence is assessed through intermittent Holter monitoring, wearable technology or continuous implantable monitoring. |
The duration, burden and timing of arrhythmia required before an event is counted as recurrence. |
More intensive and longer-term monitoring will usually detect more atrial fibrillation. A trial relying on a 24 to 72 hour Holter monitor may report a lower recurrence rate than a study using an implantable loop recorder, simply because intermittent monitoring can miss episodes occurring outside the recording window.
An implantable monitor does not change the treatment. It changes the visibility of what happens afterwards. As more recurrence is detected, the reported success rate may fall. That does not automatically mean the therapy is less effective. It may mean the study is observing the patient more thoroughly.
Looking Beyond the Headline Number
This matters because the industry is entering a period in which multiple ablation technologies are competing for clinical attention, investment and adoption. A single freedom-from-AF figure can be persuasive, but without understanding the monitoring protocol behind it, that number tells only part of the story.
Meaningful comparison requires context. When reviewing clinical evidence, we should ask not only which technology achieved the highest success rate, but how recurrence was searched for, how consistently patients were monitored and what threshold was used to define failure.
There is also a broader lesson here. Better diagnostics and more continuous monitoring can initially make outcomes look worse because they reveal events that previously went undetected. That should not discourage better monitoring. It should encourage more transparent interpretation and more consistent study design.
As monitoring becomes more sophisticated, the benchmark for success must become more sophisticated with it.
EHRA 2026 reinforced just how much momentum there is across electrophysiology. The science is advancing, the technology is becoming more connected and the conversations are becoming more nuanced. For me, the most valuable part of attending was being able to combine all three: seeing the innovation, listening to the evidence and speaking with the people helping to move the field forward.
A sincere thank you to everyone who took the time to meet, share ideas and make the congress such an enjoyable experience. I look forward to continuing those conversations and, hopefully, to many more EHRA congresses in the years ahead.