A Vienna Symphony of Advances in Arrhythmia Care: insights from the European Heart Rhythm Association 2025

The European Heart Rhythm Association (EHRA) Congress 2025 was held under the fitting theme ‘A Vienna Symphony of Advances in Arrhythmia Care’. This annual meeting brought together thousands of delegates from across the world, all united by a shared mission to improve outcomes in arrhythmia care through science, education, and innovation. Reflecting its informal identity as the annual ‘EP Family Reunion’, the event fostered a welcoming atmosphere of learning, discussing, connecting, and professional growth. The hybrid format of EHRA 2025 accommodated a total of 6063 delegates, including 5454 onsite and 609 online. Collaboration and extroversion are defining features of EHRA reflected by its intensified efforts to build bridges with heart rhythm communities around the globe and to organize joint scientific sessions with prominent societies. They include the Asian Pacific Heart Rhythm Society, Latin America Heart Rhythm Society, Heart Rhythm Society, Canadian Heart Rhythm Society, Japanese Heart Rhythm Society, Chinese Society of Pacing and Electrophysiology, Chinese Heart Rhythm Society, and Indian Heart Rhythm Society. This growing engagement with other societies is reflected by more than 657 delegates originating from countries outside Europe. Additionally, several sessions were held in collaboration with the International Society for Holter and Noninvasive Electrocardiology, Heart Failure Association, European Association for Cardio-Thoracic Surgery, and World Society of Arrhythmias—further emphasizing EHRA’s commitment to international engagement. Importantly, these collaborative sessions fostered meaningful dialogues between experts from diverse backgrounds and facilitated the exchange of ideas on a global scale. One of the major highlights was the presentation of late-breaking clinical trials (LBCTs) where new data from pivotal studies were revealed for the first time. These sessions were met with great anticipation and delivered findings that are likely to influence clinical practice in the near future. Highlights from these sessions are as follows: (i) SINGLE SHOT CHAMPION, a multicentre randomized clinical trial which compared the efficacy and safety of pulsed field ablation vs cryoablation in patients with symptomatic paroxysmal atrial fibrillation1 and (ii) the HeartSync left bundle branch pacing trial, which was the first trial randomizing a large cohort of patients with heart failure, severe systolic dysfunction (left ventricular ejection fraction < 35%), and left bundle branch block to either biventricular pacing or left bundle branch pacing—assessing the impact on all-cause mortality and heart failure hospitalizations. Another defining feature of EHRA 2025 was the release of five novel scientific documents which provided timely, evidence-based guidance on key clinical topics. The scientific documents are entitled: the Clinical Consensus Statement on Conduction System Pacing; the Practical Guide on Epicardial Ventricular Arrhythmia Ablation; the Diagnostic Role of Pharmacological Provocation Testing in Cardiac Electrophysiology Consensus Document; the Practical Compendium of Antiarrhythmic Drugs; and the Artificial Intelligence in Clinical Electrophysiology in 2025 Scientific Statement. These documents are expected to shape practice across Europe and beyond, offering clinicians structured recommendations based on the latest research and expert consensus. The development and dissemination of such documents are integral to EHRA’s mission of standardizing and improving arrhythmia care worldwide. It should be noted that all these scientific documents, as well as several of the LBCTs, were simultaneously published in the official journal of our association EP Europace – EHJ Arrhythmias and Electrophysiology. The interactive live case sessions allowed delegates to observe complex procedures being performed and discussed in real time by experienced operators and thought leaders. This year, a wide range of innovative procedures were demonstrated, including conduction system pacing, leadless pacemaker implantation via the jugular vein, extravascular ICD implantation, ablation of ventricular fibrillation, and ventricular tachycardia ablation in patients with left ventricular assist devices. These sessions bridged the gap between theoretical knowledge and clinical application, making them valuable educational components of the congress. The European Heart Rhythm Association is renowned for pioneering innovative educational formats, and this year’s congress continued that tradition with the Simulation Village, an immersive training environment that replicated real-world procedural settings. The simulations provided invaluable hands-on experience using the latest technologies. The Simulation Village offered 12 different workshops, covering various skills related to cardiac implantable electronic devices, pulmonary vein isolation, and usage of intracardiac echocardiography, transseptal puncture, and echo-guided femoral venous puncture. The atrial and ventricular tachycardia entrainment workshops and cardiac anatomy sessions deepened the understanding of delegates about arrhythmia mechanisms. Equally engaging were the EHRA tracing workshops covering interpretation of cardiac implantable electronic devices (CIEDs), electrocardiogram (ECG), and intracardiac electrograms while providing practical, case-based learning opportunities. Participants also benefited from ‘How To…Sessions’ which focused on specific diagnostic and procedural challenges such as differentiating between supraventricular and wide complex tachycardias while helping clinicians refine their clinical reasoning. The annual ECG competition was another highlight, drawing enthusiastic participation and showcasing the analytical skills of EP professionals in a spirited, collegial environment. Career development and mentorship also received significant attention at EHRA 2025. The European Heart Rhythm Association aims to actively engage the next generation of leaders in cardiac electrophysiology by organizing activities such as speed mentoring that enables early career professionals to receive direct guidance from experienced leaders in short, focused exchanges. The Women in EP sessions created a supportive space to address gender disparities and to promote visibility, leadership, and inclusivity within the specialty. The EHRA 2025 honorary lectures were given by Madelene Carina Blomstrom-Lundqvist and Jonathan Kalman who, respectively, presented on ‘Evolving concepts in atrial fibrillation: classification, burden, and key trial endpoints’ and ‘Mechanisms and ablation strategies for atrial tachycardias: from focal to macro—three decades of progress’. Finally, aligning with the EHRA Board’s vision, the Scientific Document Committee enhanced the active involvement of patients through several sessions featuring those central figures integrated into the scientific program. It provided a platform for those patients to share their perspectives, concerns and critical factors impacting their well-being and quality of life. Such unique insights are crucial for understanding what truly matters to our patients because, ultimately, all our efforts are for their benefit. While EHRA 2025 was firmly rooted in science and education, it also served as a vital platform for building relationships and fostering collaboration. Whether during formal sessions or casual encounters between meetings, the spirit of community and openness was palpable throughout the congress. The EHRA 2025 in Vienna was a resounding success and proved once again that when science and community come together, the result is nothing short of a symphony. All authors declare no disclosure of interest for this contribution.

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