Challenges in Arrhythmia Management: A Comparison Between Ablation Therapy and Conservative Therapy

The first forum, held in the afternoon as part of the 13th Annual Scientific Meeting of InaHRS 2026, was titled “Clinical EP Forum: Ablation or Medical Therapy? Making the Right Call in Tachyarrhythmias.” Simon Salim, MD, served as moderator for this session alongside experts in the field.

The forum opened with a presentation by Irnizarifka, MD, on the topic “Paroxysmal SVT: Should Ablation Be the First-Line Therapy?” She presented the results of a comparison between 24-hour Holter-monitored ECGs and 14-day Continuous ECG Patch recordings. The results showed that the Continuous Patch had a higher detection rate for paroxysmal arrhythmias. Additionally, long-term ECG monitoring is necessary to obtain more objective data.

The next session was led by Muhammad Rafdi Amadis, MD, on the topic “Idiopathic VT: Curative Ablation or Conservative Management?”. He explained the key questions physicians must address as clinical guidelines and considerations before implementing management strategies for patients with ventricular arrhythmias. A case study was also presented, comparing the effectiveness of RFA and AAD in patients with symptomatic PV/SVT.

The final session of the first forum addressed the topic “Cost-Effectiveness and Quality of Life: Choosing Between Ablation and Medical Therapy,” presented by Agung Fabian Chandranegara, MD. He discussed the burden borne by AF patients, ranging from high treatment costs to indirect medical costs such as loss of work productivity, hospitalizations, and therapy monitoring.

The next agenda item was a forum called “Ventricular Tachycardia Forum: VT Summit—Modern Strategies in Ventricular Arrhythmia Management.” This session was moderated by Ardian Rizal, MD.

This was followed by the topic “Understanding VT Mechanisms: From Substrate to Trigger” by Budi Baktijasa Dharmajati, MD, PhD, regarding the management of idiopathic PVCs/CTs in structurally normal hearts, and the topic “ECG Pearls in Ventricular Tachycardia: What Every Clinician Should Know” by Muhammad Muqsith, MD, who explained that numerous tools for diagnosing ventricular tachycardia are now available.

The event concluded with Sunu Budhi Raharjo, MD, PhD, on “When to Ablate? Contemporary Indications for VT Ablation.” He explained the three causes of arrhythmia: substrate, trigger, and modulator. Additionally, the discussion covered several elements of the re-entry circuit.