2026 HRS Scientific Statement on PFA for Cardiac Arrhythmias: Interview With Professor Damijan Miklavcic
© 2026 HMP Global. All Rights Reserved.
Any views and opinions expressed are those of the author(s) and/or participants and do not necessarily reflect the views, policy, or position of EP Lab Digest or HMP Global, their employees, and affiliates.
Edited by Jodie Elrod
Professor Damijan Miklavcic joins Bradley Knight, MD, to discuss the key takeaways from the 2026 HRS/EHRA Scientific Statement on pulsed field ablation (PFA) for cardiac arrhythmias, including the technology’s rapid evolution, safety profile, and expanding clinical applications. The interview explores how the writing committee navigated differing opinions while developing practical guidance in a fast-moving field where new PFA platforms are entering the market frequently. Professor Miklavcic also addresses the major electrical engineering challenges facing next-generation PFA systems, such as energy delivery precision, tissue selectivity, and lesion durability, while offering his perspective on whether PFA would be his preferred approach if he personally required atrial fibrillation ablation.
Clinical Summary
- Atrial fibrillation (AF); pulsed field ablation (PFA); HRS Scientific Statement 2026; Chicago, US (conference setting): Document outlines fundamentals, workflow, evidence, adverse events, and emerging use beyond atrial targets; reflects rapid clinical adoption (routine use reported over ~18 months).
- Consensus process (11-member committee): Uses question-based recommendations with explicit agreement levels (e.g., 11/11 vs 8/11) and documented dissent to ensure transparency amid evolving evidence and heterogeneous device landscape.
- Device/engineering considerations (PFA platforms): Key determinants include catheter type (focal vs single-shot), waveform/duration (microsecond/sub-microsecond), and contact-dependent lesion depth; emphasis on minimizing thermal footprint, with suggested evaluation via benchtop testing (e.g., bubble formation, hemolysis) and consideration of remapping (~2–3 months) for durability assessment.
Reviewed by Jodie Elrod, Managing Editor
