Hello, I’m Serge Boveda. I work at Clinique Pasteur in Toulouse, France.
We’re reporting live from EHRA 2026 here in Paris. It’s a great meeting on a beautiful sunny day, and we’ve seen some very important late-breaking randomized trials presented — many of them are likely to change our clinical practice.

On the first day, several randomized trials focused on paroxysmal atrial fibrillation ablation, comparing pulsed field ablation (PFA) and cryoballoon ablation for pulmonary vein isolation. Two European studies — one from France and one from Belgium — together included around 500 patients. If we pool both trials, which is reasonable as they convey the same message, we see that PFA is non-inferior to cryoballoon ablation for paroxysmal AF. The first trial is PERFECT-PAF, from Brussels University, and the second is FACIL-AF, from Grenoble University Hospital. In both studies, there is also a trend toward fewer complications with PFA compared with cryoablation.

We had another important trial on the second day, CEPAF, which compared antiarrhythmic drug treatment with first-line cryoballoon ablation in patients with persistent atrial fibrillation. This trial from China, including about 500 patients, showed that first-line cryoballoon ablation performed better than antiarrhythmic drugs as an initial strategy for persistent AF.

We also saw two very important device trials, LEFT-BUNDLE-CRT and LECART, comparing left bundle branch pacing with conventional CRT. In both trials, with a similar number of patients randomized between CRT and LBB pacing — one coming from Belgium and the other from Valencia in Spain — the results suggested superiority of left bundle branch pacing in terms of clinical outcomes. This will likely be very important in favor of adopting LBB pacing in our daily practice.

I will finish with a trial that may be particularly relevant for our routine procedures: the ULYSSES trial from Germany. This was a multicentre study conducted in German centres, including 1,700 patients undergoing AF ablation, randomized to venous puncture with ultrasound-guided puncture versus a standard approach without ultrasound. The results clearly showed that ultrasound-guided puncture is associated with fewer complications. This will definitely support the systematic use of ultrasound-guided puncture for AF ablation in order to reduce the risk of complications.

These are the main late-breaking science highlights I wanted to share from EHRA 2026 in Paris. Thank you very much.