My name is Dominik Linz here from EHRA 2025 in Vienna and I would just like to summarise a little bit what were my highlights during this conference until now.

EHRA Ablation Innovation Summit

So everything started off already one day before the real start of EHRA 2025 with the Ablation Innovation Summit. And this was quite interesting because a lot of news on how to treat atrial fibrillation and how to treat VT by ablation. There were two components. One component mainly focusing on atrial fibrillation, a lot of emphasis on pulsed field ablation, but also actually the management around, so for example, how to perform sedation, how to perform anaesthesia in those patients undergoing pulsed field ablation.

And in addition to this, also a little bit of what kind of imaging we actually need. Is it ICE, is it now integration of the ablation catheter into electroanatomical mapping systems. So this was really a nice discussion.

The second part was on VT ablation. When it comes to VT ablation, still mapping is super central. And there was one part focusing on new strategies, how to identify for example the more tricky part of the substrate, the substrate which might be benefit to be modulated. And this was very interesting. Also pulsed field ablation arrived in the ventricle. And this was also mainly focusing, for example, on the effect of pulsed field ablation concerning lesion depths, for example how deep we can get and how far we are able to use this new energy source to modify the complex arrhythmogenic substrate in the ventricle.

The third part was also alternative treatments for VT because it's not just ablation, it's not just mapping, it's not just other things, but also for example then radiation, for example, also new strategies like stellate ganglion block, et cetera. I think those Summits are super, super helpful to get an overview and also to just get new ideas about what is important in this field.

MORE-CRT MPP

Then there was also one of the late-breakers. And one of the late-breakers which I found super interesting was the MORE-CRT MPP trial. This was presented by Dr Leclercq. And what they actually did is they focused on a very, very tricky population who is treated with CRT. And those are actually the CRT non-responders which we all experience in our practice.

And they actually might have found a solution to at least help some of those patients. They identified a population of 1,677 patients being CRT non- responders and they randomized them either to CRT and continued the treating or multipoint pacing.

So that's actually a new strategy also already available at the moment to see which of those two strategies actually benefit our patients. And they could show that there was a 36% relative risk reduction if you use multiple-point pacing compared to CRT alone, which I think is really something to consider in the future if you have a CRT non-responder.

Pulse Day Survey

Another highlight of this conference of EHRA 2025 was also the release of the Pulse Day Survey. So the Pulse Day Survey, a lot of us worked on this, particularly also not just we physicians, but also patients and people in the general public helped us to collect data on the relevance of arrhythmias in general.

So we got more than 4,000 respondents. 50% of those respondents were known with arrhythmias, but 50% were also not known with arrhythmias. And we actually asked several questions about what do you think are arrhythmias and are arrhythmias relevant? And how far do arrhythmias actually impact your life?

What we learned out of this was that a lot of participants are afraid of arrhythmia. So arrhythmias are really something which is relevant to our patients and we should not just play them, but also talk about it to directly get a better link to our patients and to focus on their anxieties, on their things where they are busy with.

What we also learned is that not everybody at the moment feels comfortable to perform CPR. And I think this is also really a gap at the moment. So we need to more educate everybody in the population and not just our patients, but really on a more general level to really fill this gap which is relevant, I think.

So the survey actually helped us to identify several knowledge gaps. And this was also one of the triggers to have initiatives like for example, first the Pulse Day, where of course a lot of centres, a lot of countries participated, but also the Pulse Run, which was also one of the events just this morning at 7am where a lot of physicians actually just did this Pulse Run to make awareness around the topic pulse, around the topic arrhythmias, to get this more into the mind of people and to educate everybody about this.

So those are a little bit my takeaways from EHRA 2025 until now. This conference is not over yet, but I think this was really worth coming here to Vienna.