Electrophysiology, we believe, is a field that contains a gamut of disorders of rate and rhythm defects, congenital or acquired, right from the SA node to the Purkinje fibers.The core principle of EP is interwined with LV function and preventing all preventable electrical SCD , should be be our primary aim. Unfortunately, nowadays if you open any EP journal, you will wonder whether electrophysiology is all about atrial fibrillation and pulmonary vein ablations.
Here is a table comparing the space allotted to AF and various ablation techniques in major EP journals between the years 2025 and 2026. It is clear that EP science is heavily biased towards AF. Meanwhile, PFA may be a genuine innovation in tissue ablation, but its overwhelming dominance in the EP literature is not acceptable and not in the best interest of patients.(Cryo and RF should not succumb to this inflated superiority of PFA) *The PACE journal should be appreciated as it seems to resist the peer pressure to promote pulsed field ablation (PFA).The editors deserve some complements.
Final message
Cardiac arrhythmias in ischemic structural heart disease are more critical than the more benign and nuisance arrhythmia of atrial fibrillation (AF), which can be effectively managed in 90% of the population with simple drugs and anti-arrhythmiclifestyle modifications.
An appeal to all stakeholders: Let us take a pause and bring back the original charm of electrophysiology (EP). Let us be inclusive.There are many more areas of crucial importance. Keep an upper limit for AF-related articles—maybe a maximum of 20% (even this appears liberal).
Read further
The various PFA catheters fighting for supremacy.
