From Next-Gen Pacing to Live PFA and DOACs Dilemmas: The Future of Electrophysiology Unveiled

The symposium series in Dian Ballroom A brought together electrophysiology experts from across the region to discuss practical advances in heart rhythm management, ablation, pacing, and stroke prevention. Across three sessions, speakers shared contemporary evidence and clinical experience relevant to everyday cardiovascular practice.

Morning Symposium 1 featured a joint session of the Indonesian, Singapore, and Malaysian Heart Rhythm Societies, moderated by Muhammad Munawar, MD, PhD, and Tachapong Ngarmukos, MD. Erika Maharani, MD, opened with a discussion on conduction system pacing and its evolving role in modern pacing therapy. Seow Swee-Chong, MD, then explored Pulsed Field Ablation (PFA) as an emerging non-thermal approach to atrial fibrillation treatment, highlighting its advantages over conventional thermal ablation. The session concluded with Koh Keng Tat, MD, who discussed cardioneuroablation, including anatomical approaches, procedural objectives, and long-term outcomes, while examining its potential as an alternative to permanent pacing in selected patients.

Symposium 7, chaired by Ardian Rizal, MD, and Budi Ario Tejo, MD, focused on integrating non-thermal ablation into clinical practice. Anggia Chairuddin Lubis, MD, discussed the transition of PFA from an emerging technology toward routine clinical application. Mohammad Iqbal, MD, PhD, followed with a practical approach to repeat AF ablation in the PFA era. The session featured a live procedural demonstration by Prof. De-Yong Long, MD, PhD, and Dony Yugo Hermanto, MD, providing participants with a real-time view of the procedure and its practical considerations.

The final session, Symposium 10, chaired by Hermawan, MD, and Simon Salim, MD, addressed anticoagulation in clinical practice. I Made Putra Swi Antara, MD, discussed DOAC use in elderly patients with increased bleeding risk. Yoga Waranugraha, MD, examined anticoagulation considerations in obese patients, while Reynold Agustinus, MD, addressed perioperative anticoagulant management and the balance between bleeding and thromboembolic risks.

Together, the sessions highlighted the importance of evidence-based practice, technological innovation, and regional collaboration in advancing contemporary electrophysiology care.