Dr Melanie Gunawardene joins us to examine whether integrated mapping and ablation technology is ready to redefine how we approach atrial fibrillation ablation in the modern EP lab.

The Sphere-9 catheter and Affera mapping system represent a significant step toward consolidating what has traditionally required multiple tools into a single-catheter workflow — combining high-density mapping with PFA delivery without the need to switch between systems. As adoption grows, electrophysiologists are beginning to ask not just whether this approach is feasible, but whether it fundamentally changes procedural strategy, lab efficiency, and the management of complex AF cases.

Dr Gunawardene draws on her clinical experience to assess where integrated workflows are delivering on their promise — and where questions remain.

Interview Questions:

1. How would you characterise the shift we're seeing toward integrated mapping and ablation platforms — is this evolutionary or a genuine step change in how we ablate?
2. What has your experience with the Sphere-9 and Affera system been in practice — where does the integration add the most tangible value?
3. What impact have you observed on procedure times and overall lab efficiency when moving to a single-catheter workflow?
4. Fluoroscopy reduction is a key goal in modern EP — how does this approach influence your use of imaging and radiation during a case?
5. For complex AF cases — persistent AF, posterior wall involvement, non-PV triggers — does integrated mapping change your ablation strategy, or are the benefits more confined to straightforward PVI?
6. Are there scenarios where you would still reach for a conventional multi-catheter setup, and what would need to change for single-catheter workflows to become the default?
7. What is your overall take-home message for electrophysiologists evaluating whether to adopt integrated mapping and ablation platforms?

Recorded on-site at EHRA 2026, Paris.

Editors: Jordan Rance,
Videographer: David Ben-Harosh, Oliver Miles

Support: This is an independent interview produced by Radcliffe Cardiology.