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2026 AF Symposium
AF Symposium Abstracts—More Reports, Vol. 2
Volume 2 picks up where my first ten 2026 AF Symposium Abstracts summaries left off. (Here’s a link to my first report, if you haven’t read it.)
AF Symposium Abstracts are concise summaries with a wealth of the latest research. This year there were 103 abstracts. In general, abstracts are non-refereed (non-peer-reviewed) presentations and are often the work of a single medical center or hospital and may have a small number of patients/test subjects.
2.1 Analysis of Adverse Events of Sotalol and Dofetilide Reported to FDA
Sotalol and Dofetilide are Class III antiarrhythmic drugs often used to treat Atrial Fibrillation. Both may cause adverse events, although rare (<0.6%). Using the FDA database from 2004-2023, this study evaluated the difference between adverse events in A-Fib patients prescribed Sotalol vs. Dofetilide.
Cardiac adverse events and A-Fib recurrence are commonly reported to the FDA in patients taking Sotalol and Dofetilide. While Torsades de pointes (a fast heart rhythm disorder) was found to be more common in patients on sotalol, A-Fib recurrence was most common with dofetilide use.
[For A-Fib patients taking Sotalol or Dofetilide, be aware that these are not benign drugs or like taking vitamins. They carry real risks. Talk to your Electrophysiologist about alternatives (like catheter ablation).] (p. 38, Douglas Corsi, AFS2026-21, Submission Number 2297760)
2.2 Starting Antiarrhythmic Drugs Can Be Risky for A-Fib Patients— The Biomarker, Corrected QT Interval (QTc), is Strongest Predictor of Adverse Outcomes
Antiarrhythmic drugs (AAD) when first administered require hospitalization for cardiac monitoring.
When starting the antiarrhythmic drugs, sotalol and dofetilide, high-risk patients can be identified by their QTc (Corrected QT Interval on an ECG). A 10.5% change in QTc from baseline was a strongly significant independent indicator of adverse event risk. The findings offer improved risk assessment for A-Fib patients starting antiarrhythmic drugs. (p. 39, Douglas Corsi, AFS2026-22, Submission Number 2297393)
2.3 Good News for PFA Patients—Recurrence of A-Fib is Low
If you have a Pulsed Field Ablation, you’re not likely to have your Atrial Fibrillation come back, i.e., Early Recurrence. For those who do experience a return of A-Fib, it’s often associated with sleep apnea, implanted devices, and non-sinus rhythm. These findings suggest that Early Recurrence may reflect “a more advanced atrial substrate requiring tailored ablation strategies”. (p. 40, John Day, AFS2026-23, Submission Number 2296829)
2.4 How You Are Sedated When Getting a Watchman Occlusion Device May Matter
The Watchman (Boston Scientific) is an occlusion device that closes off the Left Atrial Appendage to prevent stroke.
General Anesthesia (GA) vs. lower levels of sedation like Conscious Sedation (non-GA) may matter when installing the Watchman device. Risk of embolus (blood clot) when inserting a Watchman is low (<1%) regardless of level of sedation.
Risk of cardiac arrest and ischemic stroke when inserting the Watchman were more frequent in those treated with lower levels of sedation. But the difference was not statistically significant (GA: 0.12% vs non-GA: 0.28%) and (GA: 0.05% vs. non-GA: 0.18%) respectively. (p, 43, Enrico Ferro, AFS2026-27, Submission Number 2298184)
Illustration: Abbott Integrated ViewFlex X ICE 3-D System – Mapping image
2.5 Using Integrated ViewFlex X ICE 3-D Mapping System in Concomitant A-Fib Ablation with Left Atrium Appendage (LAA) Closure—Safe and Effective
The Integrated ViewFlex X ICE 3-D System (Abbott) creates Intracardiac Echocardiography mapping models without compromising safety or effectiveness. It does this by decreasing modeling time compared to ablation alone and by allowing operators to measure the size of the Left Atrium Appendage (LAA) and check for leaks. (p. 49, Jonathan Hsu, AFS2026-33, Submission Number 2289053)
2.6 Good News! You Can Stop Blood Thinners After A-Fib Ablation—No More Anticoagulation For Life!
CHA2DS2-VASc score: assesses stroke risk by assigning points for risk factors (0-9 scale), with higher scores dictating increased anticoagulation needs.
This is the most important abstract for us patients! The ALONE-AF trial showed that, after a catheter ablation and without recurrent A-Fib, there were no significant differences between stopping or continuing to take oral anticoagulants (OAC). Researchers found, at 2 years, A-Fib patients who had an ablation had a lower risk of stroke, systemic embolism, and major bleeding compared with patients who continued to take anticoagulants.
In the ALONE-AF trial, patients were stratified into low and high-risk groups according to their CHA2DS2-VASc score, then assigned to discontinuation or continuation subgroups. No major bleeding events occurred in either discontinuation group while 5 major bleeding events, including 2 hemorrhagic strokes, occurred in the continuation groups. (p, 54, Boyoung Joung, AFS2026-38, Submission Number 2271905)
2.7 Who Knew That Persistent A-Fib is Induced or Driven by Gangliated Plexi (GP) Autonomic Neurons?—Ablating Them Stops Persistent A-Fib
Identifying non-pulmonary vein triggers of persistent A-Fib is difficult and challenging.
The Tau20-RETRO mapping system identifies Ectopy-Triggering Ganglionated Plexi (ET-GP) sites that produce premature or extra heartbeats.
Once these trigger sites (over 80) were ablated and nonfunctional, there was a 70% freedom from persistent A-Fib. This is great news for patients with persistent A-Fib when other treatment strategies have failed. One caveat: Ablating ganglionated plexi sites may affect other areas of the heart and body. (p. 56, Prapa Kanagaratnam, AFS2026-40, Submission Number 2296417)
Sansa (Huxley Medical) Sleep apnea diagnostic patch
2.8 You Don’t Need to Undergo a Sleep Apnea Study Anymore—a Patch Worn on the Chest Does the Same Thing
Patients with Atrial Fibrillation often have sleep apnea, as well, where breathing stops and starts repeatedly during sleep, causing low blood oxygen and fragmented sleep. Treating sleep apnea reduces A-Fib hospitalizations, and mortality. Traditional home sleep testing require lab provided equipment (pick up and return) and an uncomfortable face mask.
The SANSA device (Huxley Medical) is an FDA-cleared diagnostic patch worn on the chest while sleeping. It is a single-point-of-skin-contact diagnostic device that does not require additional attachments, wires, belts or hoses. It records sleep data, then via an embedded modem transmits that data to a sleep specialist. In addition, this SANSA patch monitor detects Atrial Fibrillation as well. It has an accuracy rate of about 88%. It’s available by prescription only.
[Note: The SANSA device doesn’t provide the many complex findings as an in-lab sleep study, but it does tell you if you have sleep apnea. Now, there is now no reasonable excuse for not getting tested for sleep apnea.] (p. 63, David Kenigsberg, AFS2006-47, Submission Number 2292539)
2.9 You May Have a Lot of Cardiac Fibrosis—But Fibrosis Can Be Isolated/Ablated
Kardium 122-electrode spherical array catheter
Fibrosis is scarred, basically dead tissue that makes the heart stiff and less flexible, it’s often irreversible and is a structural driver of atrial fibrillation.
Recently, a 122-electrode spherical array catheter (Globe® System, Kardium Inc.) has been FDA approved for Pulmonary Vein Isolation using Box Isolation of fibrotic areas.
It‘s used first to perform a normal PVI. Then, using high-density voltage mapping, the spherical array catheter can precisely delineate and ablate (using Box Isolation) areas of dense fibrosis in an effort to return patients to normal sinus rhythm. (GLOBAL-PF study). (p. 65, Hans Kottkamp, AFS2026-49, Submission Number 2298260)
Illustration: Abbott Amplatzer Amulet LAA Occluder
2.10 Doing a Catheter Ablation in Patients with an Amulet Occluder Is Challenging—But It Can Be Done
The Abbott Amplatzer™ Amulet™ is an occlusion device inserted to close the heart’s Left Atrial Appendage (LAA) to prevent blood clots from entering the bloodstream and causing a stroke.
The ADVANCE LAA clinical trial studied patients undergoing Catheter Ablation who previously had an Abbott Amplatzer™Amulet device inserted to close off their LAA. The Amulet uses a lobe and disc design with the lobe inside the heart. Operators have to be careful not to hit it with their catheter(s). Researchers found the procedure was feasible and safe with no reported device procedure related complications. (p. 71, Akash Makkar, AFS2026-55, Submission Number 2274713)
Abstracts Not Online: While printed in the 2026 AF Symposium Program, these abstracts are not published online. But if they become available, I’ll update this page with links.
More reports to come: I have a few more Abstract summaries underway. So, look for more of my summaries.
