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Originally published June 29, 2026
Last updated June 29, 2026
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Every year, electrophysiologists from all over the world gather at Heart Rhythm to discuss the latest research and clinical practices changing the field. Junaid A. Zaman, MD, PhD, a cardiac electrophysiologist with the USC Cardiac and Vascular Institute, part of Keck Medicine of USC, has always enjoyed staying on the forefront of cardiac electrophysiology. Zaman was recently renewed to serve on the Heart Rhythm Society Board of Trustees, a 17-member board representing leaders from around the world who help guide the future direction of electrophysiology. His appointment reflects a professional journey that began during his PhD training in London in 2012 and evolved through years of leadership roles within the organization.
“The Heart Rhythm Society has always been the most important professional community for me,” Zaman says. “It brings together physicians, researchers, allied health professionals and patients to shape where the field is going.”
The main conversations at the latest annual meeting of the Heart Rhythm Society in April this year centered around the fact that atrial fibrillation management is changing quickly, and some long-held assumptions may no longer apply. Below, Zaman discusses the three biggest takeaways from the society’s meeting about the future of atrial fibrillation care.
Two years ago, pulsed field ablation (PFA) was largely viewed as a promising technology. Today, the question of whether pulsed field ablation represents the future of atrial fibrillation treatment has largely been answered.
“It’s absolutely the next big thing,” Zaman says, pointing to both the clinical trials presented at the Heart Rhythm Society meeting as well as Keck Medicine’s own internal data and experience over the last two years of clinical use. “We’re the only center in Los Angeles that offers all three PFA devices available on the market, which gives us the ability to choose the right tool for the right patient, depending on their unique history, for a more personalized treatment.”
This is especially useful for differentiating between first-time patients and patients needing multiple follow-up ablations.
“We see a highly complicated patient population at Keck Medicine, with many patients with prior failed ablations needing only a very precise focal ablation,” he says. “But pulsed field ablation is still not the answer to everything. Patients with complex arrhythmias often require a more customized strategy using both PFA and radiofrequency energy.”
One of the strongest themes emerging from evolving evidence is treatment timing.
Historically, many patients with atrial fibrillation first underwent trials of antiarrhythmic medications before referral for ablation. But updated evidence and newer guideline recommendations increasingly support earlier intervention.
“The best outcomes occur when patients are seen early,” Zaman says. Current data suggest that patients undergoing ablation within six months of an atrial fibrillation diagnosis experience substantially better outcomes than those treated later in the disease course.
For general practitioners and cardiologists, this represents an important shift in thinking:
The difference in outcomes can be substantial. “In patients who are treated within six months, success rates are now frequently above 90% for clinically meaningful recurrences,” Zaman says. Ablation is still not a cure, he explains, but it is a highly effective method for significantly reducing disease burden, stopping atrial fibrillation disease progression and improving quality of life.
One of the most common questions patients ask after successful atrial fibrillation treatment is: “Can I stop taking my blood thinners?”
Today, the answer often remains no, because anticoagulation decisions are based on stroke risk factors rather than rhythm status alone, Zaman says. But that might not always be the case. Ongoing research seeks to determine if wearable device trackers might be able to help determine when anticoagulation is necessary based on an individual’s biomarkers.
Zaman is the principal investigator from Keck Medicine for the multicenter REACT-AF trial, which is actively enrolling patients to evaluate whether wearable technology can safely guide anticoagulation use. The trial randomizes approximately 5,000 patients to either standard therapy or a smartwatch-guided strategy that uses enhanced atrial fibrillation–detection algorithms (which are more advanced than the devices offered to the general public) to determine when anticoagulation is actually necessary.
The concept is straightforward. Rather than taking blood thinners continuously, patients would take them only during periods when atrial fibrillation is detected. “This may be where anticoagulation management is heading, especially with the tech-savvy patient population we have in Los Angeles,” Zaman says.
While the results have not been finalized or published yet, the REACT-AF study reflects a larger movement toward personalized and patient-directed disease management.
Atrial fibrillation care is evolving rapidly toward earlier intervention, more personalized treatment and greater integration of advanced technology, Zaman explains.
Moving forward, Zaman hopes that general practitioners and cardiologists are aware that previous assumptions about atrial fibrillation may no longer reflect current practice.
“Atrial fibrillation is treatable with ablation and much more effective and safer due to new technology,” Zaman says. “The earlier patients are seen, the better their outcomes can be.”
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