Dr Marco Schiavone (Centro Cardiologico Monzino IRCCS, Milan, IT) joins us to discuss the evolving landscape of cardiac mapping, exploring how advances in signal fidelity, high-density mapping systems, and integrated imaging technologies are reshaping the electrophysiologist's approach to arrhythmia characterisation and ablation planning.

Accurate interpretation of cardiac electrograms underpins every stage of catheter ablation, from substrate characterisation to lesion assessment. Rapid innovation across mapping platforms — encompassing high-density catheter arrays, electroanatomical integration with intracardiac echocardiography, AI-assisted anatomical reconstruction, and emerging real-time lesion assessment tools — is significantly expanding the precision and reproducibility of electrogram-guided procedures. These advances carry implications not only for procedural efficiency but for the durability of ablation outcomes across a range of arrhythmia substrates.

Interview Questions:

1. How has the concept of signal fidelity evolved in cardiac mapping, and why does it matter clinically?
2. What are the most significant recent advances in high-density mapping, and how are they changing substrate characterisation?
3. How is the integration of intracardiac echocardiography and AI-assisted anatomical reconstruction influencing mapping workflows?
4. What are the current limitations in electrogram interpretation, and how are emerging technologies addressing these?
5. How are real-time lesion assessment tools developing, and what is their potential role in improving ablation outcomes?
6. What does the future of cardiac mapping look like, and which advances are you most anticipating in clinical practice?

Recorded on-site at HRS Congress 2026.
Editor: Jordan Rance
Videographer:
Support: This is an independent interview produced by Radcliffe Cardiology.