This session, led by Vivek Reddy (New York, US), presents Beyond Ablation: Integrating Smart Monitoring, Mapping and Neuromodulation, warning that pulse field ablation risks overablation and advocating smarter, source-guided strategies, including dispersion mapping, electrographic flow, ultra-high density arrays and digital twin simulations that localise a small number of driving sites rather than destroying large atrial regions, alongside adjuncts like risk-factor programmes, GLP-1 agents, renal denervation and non-invasive neuromodulation targeting the tragus or median nerve. In discussion, Juan Carlos Zerpa Acosta (São Paulo, Brazil), Shephal Doshi (Santa Monica, US) and Rahul Doshi (Scottsdale, US) explore how these tools might refine endpoints beyond simple PVI, caution that promising mapping and autonomic approaches still need robust data, and predict that scalable, AI-driven continuous monitoring will increasingly direct who needs mapping, ablation or neuromodulation, while moderator Devi Nair (Jonesboro, US) closes the programme by highlighting the shift from purely anatomical ablation to integrated, data-guided rhythm management.
