Interventional electrophysiology in Bulgaria in 2025: data from the electronic registry BG-EPHY

This study presents data from the national electronic registry BG-EPHY on electrophysiologic (EP) studies and catheter ablations performed in 2025. Material and methods: A full one-year dataset from the BG-EPHY registry was retrospectively analyzed. We evaluated patient age and sex distribution, number of ablations, use of electroanatomic mapping (EAM), ablation energy source, distribution of arrhythmia types, acute procedural success, and complications. Results: In 2025, ten EP centers performed 2898 ablations in 1831 men (63.2%) and 1067 women, including 18 procedures in pediatric patients (0.62%). EAM was used in 1607 procedures (55.5%). An irrigated-tip catheter was used in 1526 cases (52.7%), a cryocatheter in 662 (22.8%), and a pulsed fi eld ablation catheter in 114 (3.9%). Intracardiac echocardiography was used in 386 procedures (13.3%). Pulmonary vein isolation was the most frequently performed primary ablation (55.5%), followed by ablation for typical atrial fl utter (13%) and AV nodal reentrant tachycardia (13%). Acute procedural success exceeded 99%, while intraprocedural complications occurred in fewer than 1% of the cases. Conclusion: The national electrophysiology registry systematically and continuously collects data on all catheter ablations performed in Bulgaria. In 2025, the total number of ablations increased compared with 2024, although at a slower pace. The distribution of procedure types remained similar to previous years. Acute success rates were high, and intraprocedural complications were rare.