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2026 AF Symposium
How The AF Symposium Began: 30 Years and Beyond
By Steve S. Ryan, PhD.
Learn how the AF Symposium began over 30 years ago including its development, purpose, and achievements by viewing three short videos (4 min, 8 min and 15 min respectively).
Dr. Jeremy Ruskin, the founding director of the AF Symposium is interviewed by Dr. Luigi Di Biase, Editor-in-Chief of the Arrhythmia Academy. They discuss:
• Starting the AF Symposium (1995) when there were no realistic solutions for patients; Anticipating the burgeoning Atrial Fibrillation (AF) problem;
• Evolution in A-Fib research; Top dramatic changes in AF Treatment; Mentoring of young electrophysiologists;
• The logistics of broadcasting live patient procedure cases; Maximizing the learning experience at a large-scale cardiology event.
Watch or Read: To watch each video, just click on in the video title or the image, then a new browser window will open. Or you can just read the following summary.
Dr. Luigi Di Biase is Director of Arrhythmia Services, Albert Einstein College of Medicine, Bronx, New York; Dr. Jeremy Ruskin is Professor of Medicine at Harvard Medical School and Founder and Director Emeritus of the Cardiac Arrhythmia Service at Massachusetts General Hospital.
Video 1: Drs. Keane and Ruskin Start the AF Symposium—But Not Much Hope at First
Drs. David Keane and Jeremy Ruskin started the AF Symposium in 1995 in Boston, MA, at Massachusetts General Hospital. The first meeting was only 12 hours long.
At that time there were no realistic solutions to the burgeoning Atrial Fibrillation (AF) problem. The first years of meetings were intense and grim, because there was virtually nothing Electrophysiologists (EPs) at that time could do besides anticoagulation. There wasn’t even a lot to talk about.
Tsunami of Atrial Fibrillation: In the 1990s, EPs had little interest in AF because they couldn’t do much except to anticoagulate patients to try to prevent strokes. But it was obvious to the AF Symposium participants that AF was a major health issue, that there was a “tsunami of AF coming at us”. It was clear to Dr. Ruskin and his colleagues that AF would become a major health problem.
Video 2: A-Fib Research and the Role of Mentors in the Development of Young Electrophysiologists—Key Developments in AF Management
Dr. Di Biase described how he was mentored as a student at the 2006 AF Symposium, and then how he became a mentor/faculty member himself in 2012.
Dr. Ruskin described his own mentors such as Dr. Anthony Damato and the colleagues who supported him, such as Dr. Vivek Reddy (then working at Mass General), and Dr. Pierre Jais from Bordeaux.
Top Dramatic Changes in AF Treatment: Dr. Di Biase asked Dr. Ruskin what he considered the major pillars or top dramatic changes in the evolution of AF treatment over the last 30 years.
1. Electrically isolating the pulmonary veins. The evolution of research into AF expanded dramatically with the work of Drs. Haïssaguerre, Jais and their colleagues in Bordeaux, France. They discovered that by electrically isolating the pulmonary veins, they could “cure” AF. [I was their first US patient in 1998.]
They used a catheter to apply RF energy to the pulmonary vein openings thereby preventing AF electrical pulses from entering and affecting the heart. Since then, Pulmonary Vein Isolation (PVI) has become the primary focus of electrophysiology intervention.
2. Direct Oral Anticoagulants. Another pillar in the evolution of AF treatment was the development of the drug therapy, Direct Oral Anticoagulants (DOACs). For decades, warfarin was the only anticoagulation option. But it was a difficult drug to manage both for patients and their EPs. DOACs are as, or more effective than warfarin, and much easier to use.
3. Left Atrium Appendage Closure. A third pillar was the development of left atrium appendage closure (LAA). It was a long regulatory route to get FDA approval. But now left atrium appendage closure is acknowledged as safe and effective and on a par with prescribing DOACs to prevent stroke.
4. Pulsed Field Ablation for A-Fib. While the technology has been around for 50 years, using Pulsed Field Ablation (PFA) to isolate the pulmonary veins was a major medical breakthrough. It’s fast, efficient, and safe with results similar to RF ablation. PFA is even used now in outpatient treatment.
In a Final Thought: Dr. Ruskin thought that the new GLP-1 and SGLT2 drugs to manage type 2 diabetes might become important in the treatment of A-Fib.
Video 3: What Makes the AF Symposium So Successful: The AF Symposium’s Unique Format
Dr. Di Biase discussed with Dr. Ruskin why the AF Symposium works so well and has such great attendance (even though it’s held in Boston during the chilly winter months).
All Presentations in One Room Available to All Attendees: All the AF Symposium meetings are held in one huge room with multiple big screens visible to all attendees. The presenters come to the attendees, rather than the other way around. Most national meetings are often spread out with attendees having to move from one meeting room or ballroom location to another to hear speakers.
[I personally experienced this problem at another regional AF conference when I tried to attend a talk by Dr. Michel Haissaguerre but couldn’t get in because the room was too small and crowded.]
Single Topic, Single Room with Multiple Presenters: For example, one topic at the 2025 AF Symposium was “Pulsed Field Ablation—Safety, Efficiency and Workflow.” There were two moderators (leaders in the field), followed by five lectures of 7 minutes each by well-known researchers (but also by new doctors with innovative insights). This was followed by a 25 minute panel discussion with the moderators, speakers, and attendees. All this happened in one location.
Year-Long Research into Topics and Speakers: Dr. Moussa Mansour of Mass General revealed how much work goes into researching and selecting topics and speakers for the AF Symposium.
He and Dr. Ruskin meet every week for a year doing intense research. In Dr. Mansour’s own words “very few people are crazy enough to put so much time into it.” Every single topic is important to the treatment of A-Fib and usually provides new insights to the attendees.
The Symposium speakers are world class and leaders in their field. Over the years Drs. Ruskin and Mansour have developed relationships with the best and most talented in the field. Faculty presenters are enthusiastic, as well as loyal and committed to the AF Symposium.
Incredible Video and Live Procedures! Over the 3-day AF Symposium, attendees can see 20+ live broadcasts or prerecorded videos of doctors performing cases (such as live Pulsed Field Ablations). These cases are not just from the U.S. but from around the world.
[At the 2025 AF Symposium there were twenty live and prerecorded cases. The prerecorded cases were carefully planned, making excellent and detailed teaching tools.]
For many attendees this is an incredible learning experience—to see the best doctors/operators doing difficult cases [with no guarantee that things will always go well].
Conclusion: What This Means for A-Fib Patients
As patients, we have received the benefits of the decades long demanding work of doctors and researchers in the treatment of Atrial Fibrillation. For 30 years, the AF Symposium has been a showcase for sharing these advancements resulting in many patients who no longer live with the burden of A-Fib.
Back in 1995, when the AF Symposium began, there were no realistic solutions and there didn’t seem to be much hope of curing Atrial Fibrillation. Nonetheless, Drs. Keane and Ruskin and other pioneers in the field knew they had to start somewhere; thus, the AF Symposium began. As patients, we should be grateful to them for their courage and vision.
As someone who has been attending the AF Symposium for over 20 years, I can attest to how well the AF Symposium is organized and run. Each year seems better than the last.
