EHRA Congress 2026 – Prof Roland Tilz (University Hospital Schleswig-Holstein, Lübeck, DE) presents the findings from the TiFFANY-AF study, a retrospective observational analysis evaluating real-world mortality outcomes associated with pulsed field ablation compared with thermal ablation techniques — radiofrequency and cryoballoon — for atrial fibrillation.

Drawing on a decade of data from the US FDA's MAUDE database, this study examined lethal complications across ablation modalities, with findings that carry significant implications for how PFA is understood and applied in clinical practice.

Key results reveal that while cardiac tamponade remains the leading cause of death across technologies, secondary fatal complications differ markedly by modality. For PFA, the predominant secondary cause of death was cardiac arrhythmia — specifically ventricular tachycardia and ventricular fibrillation — in contrast to atrioesophageal fistula for thermal ablation. Mortality rates for PFA were identified as more than twofold higher than those observed with cryoballoon ablation.

Interview Questions:

1. What were the objectives of TiFFANY-AF, and what prompted the use of the FDA MAUDE database as the primary data source?
2. Can you walk us through the study design and primary endpoints?
3. What were your key findings, and which results did you consider most significant?
4. How should these findings inform clinical decision-making when selecting ablation modality for patients with AF?
5. What further research is needed, and how might these results shape the development and application of PFA technology going forward?

Recorded on-site at EHRA Congress 2026, Vienna.
Editor: Jordan Rance
Videographer: David Ben-Harosh
Support: This is an independent interview produced by Radcliffe Cardiology.