The 2026 Heart Rhythm Society (HRS) annual meeting recently concluded in Chicago, Illinois. The four-day event was packed with educational sessions, research presentations, and networking opportunities for the global cardiac electrophysiology community.

Today, we’re taking a look at a curated selection of abstracts on arrhythmia topics. Some descriptions and conclusions were edited for brevity and clarity. To view the abstracts presented during the HRS 2026 annual meeting, visit the Heart Rhythm publication website and view the April 2026 issue supplement.

Arrhythmia Abstracts from HRS 2026 Annual Meeting

Interpretable AI-Based Models For Arrhythmia Risk Assessment In Patients With KCNH2 Mutations, And Comparison With Healthy Relatives

  • Description: KCNH2 (hERG) mutations, a major cause of Long QT Syndrome, increase susceptibility to malignant ventricular arrhythmias. Risk stratification is difficult, often leading to unnecessary treatment of low-risk carriers and missed protection in high-risk patients. Heart rate variability (HRV) may provide a non-invasive indicator of autonomic instability and arrhythmic vulnerability.
  • Conclusion: An HRV-based framework effectively stratified individuals into healthy relatives, KCNH2 carriers, and VT/VF survivors. Using only 15-minute ECG segments and HRV-derived features, the study demonstrates strong clinical feasibility, with potential extension to PPG-based monitoring for a low-cost, low-burden alternative. The model achieved 100% recall for high-risk patients, showing that even with safety-first prioritization, mid- and low-risk classification retains clinical value.

Ventricular Arrhythmias in Patients with Early Onset Atrial Fibrillation and Titin Truncating Variants

  • Description: Patients with early-onset atrial fibrillation (EoAF) are enriched for pathogenic truncating variants in the sarcomeric gene titin (TTNtv). Patients with TTNtv are also at risk for sustained ventricular tachycardia and ventricular fibrillation (VT/VF), but there are no genotype-specific recommendations for arrhythmia risk stratification.
  • Conclusion: Over 25% of EoAF patients with TTNtv incurred sustained ventricular arrhythmias, for which premature ventricular contraction burden and complexity appear to be risk factors. These findings warrant further study to improve VT/VF risk stratification in patients with EoAF.

Correlation of Anatomic and Substrate Characteristics of Mitral Valve Prolapse with Ventricular Arrhythmias

  • Description: Mitral valve prolapse (MVP) has been associated with the development of malignant ventricular arrhythmias (VAs). The origin of VAs in patients with MVP are poorly understood.
  • Conclusion: The presence of bileaflet prolapse, mitral annulus disjunction, and basal inferior scar were associated with increased VA severity in patients with MVP. Significant mitral regurgitation, but not bileaflet MVP or mitral annulus disjunction, was related with VAs originating from mitral apparatus. Many patients with arrhythmic MVP have non-mitral valve-associated VA sites of origin, and whether this is due to altered hemodynamics remains to be determined.

Incidence, Predictors, and Racial Disparities of Arrhythmias in Peripartum Cardiomyopathy: Machine Learning–Based Risk Stratification

  • Description: Peripartum cardiomyopathy (PPCM) is a rare but potentially fatal pregnancy-associated cardiac condition. Arrhythmias occur frequently in PPCM leading to serious complications, including sudden cardiac death. Yet, the overall arrhythmia burden, related mortality, and disparities in this underrepresented population remain poorly defined.
  • Conclusion: PPCM is associated with a high arrhythmic burden and mortality which disproportionately affects Black women. Machine learning models can facilitate early arrhythmia risk stratification in this vulnerable population, informing targeted monitoring and intervention strategies.

Venous Ethanol Ablation for Ventricular Arrhythmias Arising from the Left Ventricular Inferoseptal Process

  • Description: Ventricular arrhythmias (VA) from the left ventricular inferoseptal process (LV-ISP) pose challenges for radiofrequency ablation (RFA) due to complex catheter maneuverability, common intramural origins, and proximity to the atrioventricular node, His-Purkinje system, and coronary arteries. Endocardial, epicardial (via coronary sinus or tributaries) and right atrial approaches have been described, but effective RFA often requires a multichamber strategy. The value of venous ethanol ablation (VEA) for LV-ISP VA has not been systematically assessed.
  • Conclusion: VEA of the LV-ISP was feasible and provided consistent acute success and meaningful arrhythmia reduction at follow-up with a low complication rate. These findings support VEA as a valuable adjunct to treat VAs arising from this anatomically challenging region.

External Validation of the Dsp-Risk Score for Prediction of Clinically Significant Ventricular Arrhythmias in Patients with Desmoplakin Cardiomyopathy Associated Genetic Variants

  • Description: Patients harboring pathogenic / likely pathogenic (P/LP) variants in the desmoplakin (DSP) gene are at increased risk of ventricular arrhythmias (VAs). A risk prediction model estimating the 5-year risk of VAs in patient with P/LP DSP has been recently developed.
  • Conclusion: In a large independent cohort of DSP patients, this study showed external reliability of the DSP Risk Score. These findings support the use of the DSP Risk Score to facilitate shared decision making regarding implantable cardioverter-defibrillator implantation in the primary prevention of VAs in patients harboring DSP P/LP variants.

Type and Timing of Arrhythmia Recurrence During Blanking Period Strongly Predict Recurrence After Atrial Fibrillation Ablation

  • Description: Catheter ablation is a first-line therapy in the treatment of symptomatic atrial fibrillation. The prognostic significance of the timing and type of arrhythmia recurrence during the conventional 90-day blanking period remains unclear.
  • Conclusion: Atrial fibrillation recurrence at any point during the blanking period is a powerful predictor of long-term failure. Early recurrences (≤30 days) — predominantly atrial flutter — do not predict poor outcome, whereas any recurrence after 30 days is strongly associated with late failure. These findings challenge the uniform 90-day blanking period and support individualized post-ablation management based on timing and type of early recurrence.

Single-Procedure All-Arrhythmia Benefit of a Tailored Dispersion-Based Ablation on Truly-Persistent Atrial Fibrillation Patients: A TAILORED-AF Sub-Analysis

  • Description: In the TAILORED-AF trial (NCT04702451), de novo catheter ablation targeting artificial intelligence (AI)-guided spatiotemporal dispersion was superior to pulmonary vein isolation (PVI) alone in patients with drug-resistant persistent atrial fibrillation (AF) for more than 3 months. Spontaneous sinus rhythm conversion after 3 months of persistent AF is very unlikely. Still, 12% of the patients presented spontaneously in sinus rhythm at the onset of the procedure without prior cardioversion.
  • Conclusion: Truly-persistent AF patients — defined as patients in AF at the procedure onset or with prior cardioversion — have a significantly better single-procedure freedom from AF outcome when undergoing a patient-tailored, dispersion-based ablation vs. PVI-alone.

Intraprocedural Drug-Induced Arrhythmias Predict 12-Month Recurrence After AF Ablation: Insights From the Real-AF Registry

  • Description: Adenosine and isoproterenol may be given during atrial fibrillation (AF) ablation to unmask dormant pulmonary vein (PV) conduction or trigger non-PV atrial arrhythmias. The prognostic significance and value of performing additional ablation remains unclear.
  • Conclusion: In a large multicenter, prospective registry, drug-induced arrhythmias were independently associated with higher 12-mos arrhythmia recurrence and clinical events. However, PV reconnection inducement was not prognostic. Performing additional radiofrequency ablation of induced arrhythmias did not impact outcome, which may suggest that drug testing may identify a vulnerable atrial substrate rather than modifiable triggers.

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