Spotlight on EHRA 2026: illuminating arrhythmia management

‘Illuminating Arrhythmia Management’ was the central theme of the hybrid conference of the European Heart Rhythm Association (EHRA) 2026 in Paris. This annual event was attended by a total of 7108 delegates. The faculty consisted of 419 delegates from 41 countries. The international character of EHRA 2026 was reflected by joint sessions with the Asian Pacific Heart Rhythm Society, Canadian Heart Rhythm Society, Heart Rhythm Society, Latin America Heart Rhythm Society, Japanese Heart Rhythm Society, Brazilian Cardiac Arrhythmia Society, and the World Society of Arrhythmias. Additionally, the multidisciplinary character of arrhythmia management is reflected by joint sessions with the International Society for Holter and Noninvasive Electrocardiology, Heart Failure Association, European Association for Cardio-Thoracic Surgery, and the European Association of Percutaneous Cardiovascular Interventions. The various components of EHRA 2026 are illustrated in Figure 1. The scientific programme featured 109 sessions, alongside 168 abstract and clinical case presentations, and 80 Simulation Village workshops. These hands-on sessions offered practical experience in advanced left atrial mapping, epicardial ablation techniques, echo-guided transseptal puncture, venous access closure devices, intravascular lead extraction, and conduction system pacing lead implantation. Additional workshops focused on cardiac anatomy and entrainment techniques, further enriching the interactive learning experience. Five sessions also included a patient perspective. Established highlights of the EHRA conference include the ever-popular ECG competition, as well as the engaging ECG, EP, and device-tracing sessions. Total number of delegates over the past years This year’s EHRA honorary lectures were delivered by Akihiko Nogami (Japan) and Katja Zeppenfeld (the Netherlands). Prof. Nogami revisited the evolving understanding of Purkinje-related arrhythmias, offering insights into their mechanisms and management. Prof. Zeppenfeld lectured on ventricular tachycardia, bridging invasive mapping with non-invasive risk prediction to highlight the importance of timely, targeted therapy in congenital heart disease. During EHRA 2026, four important consensus documents were presented, reflecting the field’s continued drive towards standardization and innovation. The statement ‘on same-day discharge after electrophysiological and cardiac implantable electronic device procedures’ outlines key considerations including patient selection, peri-procedural management, early complication monitoring, discharge criteria, and structured post-discharge follow-ups. The document on ‘intracardiac echocardiography (ICE) during invasive electrophysiological procedures’ provides a comprehensive overview of ICE fundamentals, including standardized imaging views and their applications in transseptal puncture and ablation of both supraventricular and ventricular arrhythmias. It also underscores the value in reducing radiation exposure, enabling early detection and management of complications, identifying infective endocarditis, and supporting procedures such as endomyocardial biopsy and left atrial appendage occlusion. ‘The Digitally Assisted Learning in Cardiac Electrophysiology and Cardiac Implantable Electronic Devices’ consensus highlights the growing importance of digital tools in modern training, emphasizing their role in enhancing education, standardizing competencies, and improving patient safety in an increasingly complex field. Finally, the consensus on ‘pulsed field ablation for the interventional treatment of atrial fibrillation’ offers practical guidance for clinical implementation and operator training while also identifying current evidence gaps and setting priorities for future research and technological development. This year, a remarkable 103 proposals were submitted for the Late-Breaking Science (LBS) Sessions. Following a rigorous selection process, four sessions were curated, focusing on paroxysmal atrial fibrillation (AF) ablation, persistent AF ablation, ablation and drug therapy, and cardiac implantable electronic devices. In the paroxysmal AF ablation session, PERFECT-AF demonstrated noninferior efficacy of pulsed field ablation compared with cryoballoon ablation in patients with drug-refractory paroxysmal AF, while the overall safety outcomes were similar between treatment groups. In patients with persistent AF and low voltage areas, the SOLVE-AF trial showed that circumferential pulmonary vein isolation plus ablation of low voltage and abnormal electrograms identified during sinus rhythm improves AF freedom rates at the 12-month follow-up. In the Cornerstone AF trial, the addition of empirical left atrial posterior wall isolation to pulmonary vein isolation did not significantly improve freedom from atrial arrhythmia at 18 months compared with pulmonary vein isolation only in patients with non-paroxysmal AF undergoing a first-time AF ablation procedure. In the device sessions, the SAFEPED EVICD Registry demonstrated that implantation of extravascular implantable cardioverter defibrillator (EVICD) in paediatric patients has a high procedural success rate, minimal complications, and stable electrical performance during short-term follow-up. Biventricular pacing and left bundle branch area pacing in patients with heart failure and reduced left ventricular ejection fraction (<40%) and a left bundle branch block were compared in the LEft bundle branch area pacing for CArdiac Resynchronization Therapy (LECART) trial. This trial demonstrated that patients with left bundle branch area pacing had a lower incidence of the primary composite outcome of death, heart failure hospitalization, and device-related complications. A highlight in the ablation and drug therapy session was the LINEAR study. In this study, the lattice-tip catheter was superior in acute efficacy and procedural efficiency compared with the standard focal irrigated tip for radiofrequency ablation of the cavotricuspid isthmus. The EHRA 2026 once again demonstrated why it remains a cornerstone event in the field of cardiac electrophysiology. From cutting-edge late-breaking trials to hands-on innovation in the Simulation Village and from consensus statements to inspiring lectures by a diversity of scientists from all over the world, the meeting truly lived up to its theme of ‘Illuminating Arrhythmia Management.’ The scientific sessions, global collaboration, and knowledge exchanges highlighted not only how far the field has progressed but also the exciting momentum driving it forward. As new technologies, strategies, and evidence continue to reshape clinical practice, the EHRA 2026 leaves a clear message: the future of arrhythmia care is increasingly precise, collaborative, and patient-centred. All authors declare no disclosure of interest for this contribution. Nothing to declare.