HRS Congress 2026 – Dr Christopher Porterfield (Aurora Denver Cardiology, Aurora, CO, US) discusses findings from the REAL-AF Registry, examining the safety and effectiveness of variable loop circular catheter pulsed field ablation across a broad range of patient and procedural characteristics in real-world clinical settings.

The REAL-AF Registry is a prospective, multicentre, observational study enrolling adults with symptomatic paroxysmal or persistent atrial fibrillation who are candidates for catheter ablation. The registry captures data at multiple time points — including pre-ablation baseline, procedure, 10–12 weeks, and 12 months post-ablation — with primary endpoints of freedom from atrial arrhythmia recurrence and long-term safety assessed through adverse event surveillance.

Interview Questions:

1. What is the rationale for evaluating pulsed field ablation in a real-world registry setting, and what gap does this address relative to controlled trial data?
2. Can you describe the patient population and procedural characteristics captured in this analysis from the REAL-AF Registry?
3. What complication rates were observed, and how do these compare with existing benchmarks for radiofrequency and other ablation modalities?
4. Were there particular patient subgroups or procedural variables where safety outcomes differed, and what do those findings suggest?
5. How did effectiveness outcomes hold up across the population?
6. What are the clinical implications of these findings for centres adopting or expanding their PFA programmes?
7. What are your key take-home messages for electrophysiologists evaluating PFA as part of their AF ablation practice?

Recorded on-site at HRS Congress 2026, Chicago.
Editor: Jordan Rance
Videographer:
Support: This is an independent interview produced by Radcliffe Cardiology.