"Hello, I'm Professor Luigi Di Biase from the Albert Einstein College of Medicine at Montefiore Health System in New York, and Editor in Chief of the Arrhythmia Academy. I'm here in Boston for the 31st edition of The Boston AFib Symposium — always one of the masterclass symposia for AFib ablation, bringing together innovations, technologies, trials and networking opportunities for everyone attending.

There's a lot to summarize, but let me focus on what I feel are the most important presentations and trials. We had several late-breaking clinical trials, and a few of them deserve particular mention.

First, the IDE trial from Abbott — the VOLT. VOLT achieved FDA approval with 12-month follow-up and strong results. I think the authors should be commended for the publication, the approval, and delivering another tool in our hands that will be very useful in the PFA platform. Completing a large clinical trial through to FDA approval is no small feat.

Second, and I think very important, was a presentation by Dr Natale and Mansour — of which I am a co-author — on a workflow change for the Varipulse from Johnson & Johnson involving high irrigation flow. This completely changes the risk profile for TIA and stroke, with the high flow approach showing absolutely no risk for cerebrovascular events. Very good and solid information presented here at the conference.
I would also like to highlight the presentation on Sphere 9, specifically around linear ablation. A sub-analysis of the Sphere 9 data from Affera demonstrated very good outcomes at follow-up with linear ablation — and I think everybody was impressed. This is important because with RF we never had linear data that could be reliably replicated or properly analyzed. With PFA and the combination of PFA and RF, we may now see new trials that can genuinely change our perception of linear strategy for persistent atrial fibrillation.

Another very important presentation was the long-term follow-up of the ADVENT LTO data from the Boston Scientific FaraWave catheter — very significant information with ILR data at three years of follow-up. We are now getting longer-term data with new PFA technology, and this is critical. The data presented by the Boston Scientific team really adds something meaningful to the field.

Finally, there was a great deal of activity around live cases and emerging technologies — new tools with early-stage numbers, intracardiac echo solutions in both 2D and 4D, innovations from Siemens, and artificial intelligence being applied to support intracardiac echo, improve ablation outcomes, and map atrial fibrillation. There is a lot happening here at the Boston AFib Symposium, and I would genuinely recommend everyone to attend — or to make sure they come back next time.”