From Physiological Pacing to Advanced ICD Therapy: Exploring the Frontiers of Contemporary Electrophysiology

The scientific program featured Lunch Symposium 1: Live Demo Conduction System Pacing, focusing on the practical application of conduction system pacing (CSP) in contemporary electrophysiology approaches. The session provided participants with an opportunity to explore the evolving role of CSP while gaining practical perspectives on procedural live demo. The combination of insightful scientific discussion with moderator Dicky Armein Hanafy, MD, PhD and Rerdin Julario, MD with an active live demonstration presented by Muhammad Munawar, MD, PhD is providing the audience a holistic explanation on connecting theoretical concepts with real procedural practice. The session emphasized the critical role of CSP on selectively capturing the heart’s intrinsic conduction system (His–Purkinje system) to achieve more physiological ventricular activation. Through the live demonstration, participants were able to observe key procedural considerations and gain a better understanding of the technical aspects involved in CSP. The session also highlighted the importance of procedural proficiency and appropriate technique in achieving successful pacing outcomes. Overall, the symposium provided a valuable platform for translating advances in conduction system pacing into clinical practice, emphasizing how technological development and procedural expertise can work together to optimize patient care.

This agenda was continued by interesting discussion provided by Symposium 13 : The Fainting Puzzle: Insights into Syncope and Autonomic Disorders, which was moderated by Budi Baktijasa Dharmajati, MD, PhD, and Dian Andina Munawar, MD, PhD. The session addressed contemporary perspectives on syncope, beginning with Unexplained Syncope and Autonomic Dysfunction: Understanding the Clinical Connection presented by Benny Mulyanto Setiadi, MD. The presentation highlights the difference between orthostatic syncope, vasovagal syncope, and cardiac syncope with the clear stepwise clinical approach to the therapy. The second presentation, Postural Orthostatic Tachycardia Syndrome (POTS): From Recognition to Management, was delivered by Prof. Dennis Lau, MD, PhD which discusses the recognition of POTS terms and its holistic management, including many special tests. The session concluded with Technical Approaches in Cardioneuroablation for Vasovagal Syncope: Mapping and Targeting Ganglionated Plexi presented by Ignatius Yansen, MD. This presentation focuses on practical approaches to cardioneuroablation. Overall, the symposium showcased an integrated perspective on diagnosis, management, and emerging interventional strategies for syncope.

The final agenda, Symposium 16: New Updates in ICD Therapy: Transvenous, Subcutaneous, or Extravascular—Choosing the Right System in 2026 was moderated by Muhammad Yamin, MD, PhD, and Ragil Nur Rosyadi, MD. The symposium examined contemporary developments in implantable cardioverter-defibrillator (ICD) therapy and the considerations involved in selecting among transvenous, subcutaneous, and extravascular systems. The first presentation, Implant Techniques and Learning Curve: TV vs S-ICD vs EV-ICD, was delivered by Seow Swee-Chong, MD, addressing procedural techniques and the learning curve associated with different ICD systems. Rerdin Julario, MD, subsequently presented Transvenous vs Subcutaneous ICD: What Do Long-Term Outcomes Show?, examining long-term outcomes and comparative considerations. The final presentation, Pushing the Boundaries of ICD: Advances and Future, was delivered by Ardian Rizal, MD, highlighting emerging developments and future directions in ICD therapy. Overall, the symposium emphasized individualized device selection based on clinical needs, procedural considerations, and evolving evidence.