Season 4 - Ep5: SPECIAL Atrial Fibrillation: AF burden: clinical relevance - Pulsed Field Ablation - Treatment following Afib ablation

Mar 19, 2026

Guest

Konstantinos Koskinas

Guest

Konstantinos Koskinas, cardiologist and news summarizer; Michiel Rienstra, academic AF guideline coordinator; Arian Sultan, interventional electrophysiologist specialized in ablation techniques; Jason Andrade, electrophysiologist expert in AF monitoring. They discuss AF burden and how to measure it. They explore pulsed field ablation: benefits, limits and wider uses. They cover post-ablation drug and anticoagulation strategies.

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INSIGHT

Burden Explains AF Clinical States

AF burden correlates with clinical states: low burden maps to paroxysmal AF and high burden to persistent/permanent AF.
Jason Andrade highlights burden links to quality of life and adverse outcomes like heart failure and death.

INSIGHT

Measure Ablation Success By Burden Reduction

Reframe ablation success from binary recurrence metrics to magnitude of burden reduction.
Jason Andrade cites cases with >99% burden reduction that would be labeled treatment failures by a single 30-second recurrence rule.

ADVICE

Use Extended External Monitoring

Use extended external monitoring to estimate AF burden when implantable devices aren't available.
Jason Andrade recommends 7–14 day monitors every 3–6 months or 21–28 day cumulative monitoring to approximate implantable device data.

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This Special Episode on Atrial Fibrillation covers:

Cardiology this Week: A concise summary of recent studies
Atrial fibrillation burden: clinical relevance of a new outcome
Pulsed field ablation: game changer?
Drug treatment following atrial fibrillation ablation
Spotlight: Holiday Heart Syndrome

Host: Rick Grobbee

Guests: Rick Grobbee, Konstantinos Koskinas, Jason Andrade, Arian Sultan, Michiel Rienstra

Want to watch that special episode? Go to: https://esc365.escardio.org/event/2549

Disclaimer:

ESC TV Today is supported by Novartis through an independent funding. The programme has not been influenced in any way by its funding partner.

This programme is intended for health care professionals only and is to be used for educational purposes. The European Society of Cardiology (ESC) does not aim to promote medicinal products nor devices.

Any views or opinions expressed are the presenters' own and do not reflect the views of the ESC. All declarations of interest are listed at the end of the episode.

The ESC is not liable for any translated content of this video. The English language always prevails.

Declarations of interests: Stephan Achenbach, Jason Andrade, Yasmina Bououdina, Rick Grobbee and Nicolle Kraenkel have declared to have no potential conflicts of interest to report.

Carlos Aguiar has declared to have potential conflicts of interest to report: personal fees for consultancy and/or speaker fees from Abbott, AbbVie, Alnylam, Amgen, AstraZeneca, Bayer, BiAL, Boehringer-Ingelheim, Daiichi-Sankyo, Ferrer, Gilead, GSK, Lilly, Novartis, Pfizer, Sanofi, Servier, Takeda, Tecnimede.

John-Paul Carpenter has declared to have potential conflicts of interest to report: stockholder MyCardium AI.

Davide Capodanno has declared to have potential conflicts of interest to report: Abbott Vascular, Bristol Myers Squibb, Daiichi Sankyo, Edwards Lifesciences, Novo Nordisk, Sanofi Aventis, Terumo.

Konstantinos Koskinas has declared to have potential conflicts of interest to report: honoraria from MSD, Daiichi Sankyo, Sanofi.

Felix Mahfoud has declared to have potential conflicts of interest to report: research grants from Deutsche Forschungsgemeinschaft (SFB TRR219), Deutsche Gesellschaft für Kardiologie (DGK), Deutsche Herzstiftung, Ablative Solutions, ReCor Medical. Consulting fees, payment honoraria lectures, presentations, speaker, support travel costs: Ablative Solutions, Astra-Zeneca, Novartis, Inari, Recor Medical, Medtronic, Philips, Merck.

Steffen Petersen has declared to have potential conflicts of interest to report: consultancy for Circle Cardiovascular Imaging Inc. Calgary, Alberta, Canada.

Michiel Rienstra has declared to have potential conflicts of interest to report: consultancy fees from Bayer (OCEANIC-AF national PI) , InCarda Therapeutics (RESTORE-SR national PI), Novartis to the institution. Speaker fee from Daiichi-Sankyo, Pfizer to the institution. Unrestricted research grant from the Dutch Heart Foundation and is conducted in collaboration with and supported by the Dutch CardioVascular Alliance, 01-002-2022-0118 EmbRACE. Unrestricted research grant from ZonMW and the Dutch Heart Foundation; DECISION project 848090001. Unrestricted research grants from the Netherlands Cardiovascular Research Initiative: an initiative with support of the Dutch Heart Foundation; RACE V (CVON 2014–9), RED-CVD (CVON2017-11). Unrestricted research grant from Top Sector Life Sciences & Health to the Dutch Heart Foundation (PPP Allowance; CVON-AI (2018B017). Unrestricted research grant from the European Union's Horizon 2020 research and innovation programme under grant agreement; EHRA-PATHS (945260). This research is funded by the Dutch Heart Foundation and is conducted in collaboration with and supported by the Dutch CardioVascular Alliance, 01 -002 -2022 -0118 EmbRACE.

Emma Svennberg has declared to have potential conflicts