EHRA 2026 — Dr Ioanna Koniari (University Hospital of Patras, Rio-Patras, Greece) joins us for a forward-looking discussion on the expanding role of pulsed field ablation beyond its established indications, with a focus on ventricular tachycardia and the frontier applications that are beginning to redefine the boundaries of PFA in clinical practice.

As operator experience with PFA deepens and early real-world data accumulates, Dr Koniari explores what the evidence — and the clinical rationale — currently supports for off-label use, and where the field may be headed as this technology continues to mature.

Interview Questions:

1. What is the biological and biophysical rationale for applying PFA to ventricular tissue?
2. What do we know so far about PFA for VT ablation?
3. How does PFA compare to radiofrequency energy for VT in terms of lesion characteristics, safety, and procedural considerations?
4. Beyond VT, what other emerging indications are generating the most interest — and which do you think have the strongest clinical rationale?
5. What are the key safety considerations when using PFA in off-label settings, and how should operators be approaching risk mitigation?
6. What does the field need — in terms of trial design, registry data, or regulatory pathways — to move these indications from exploratory to mainstream?
7. What are your key take-home messages for electrophysiologists curious about or already exploring PFA beyond its current approved use?

Recorded at EHRA 2026, Paris.

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

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