LAAO vs Anticoagulation Explained: WATCHMAN FLX, AF Ablation Recurrence, Post-TAVR Heart Block & ICU AF, Hormones and TdP – EP Edge Journal Watch
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EP Edge Journal Watch Podcast — Issue 6 (January 2026)
Left Atrial Appendage Occlusion, AF Ablation Insights, Post-TAVR Conduction, ICU Anticoagulation & Translational EP Signals
EP Edge Journal Watch is your high-yield, evidence-driven electrophysiology podcast—designed for busy clinicians who want clinical relevance, mechanistic insight, and practice-changing nuance without wading through every paper.
In Issue 6 (January 2026), we anchor the episode around Left Atrial Appendage Occlusion (LAAO)—examining long-term randomized outcomes, implant mechanics that truly matter, and frontier strategies for the most complex patients—then expand into essential EP topics you’ll actually use on rounds.
What’s covered in this episode?
1. LAAO vs Oral Anticoagulation — Long-Term Outcomes
We break down a contemporary randomized trial meta-analysis (including OPTION) examining:
- Stroke and systemic embolism
- Hemorrhagic vs non-procedural bleeding
- A provocative mortality signal favoring LAAO
Practical implications for counseling ablation patients and high-bleeding-risk populations.
2. WATCHMAN FLX Mechanics — Why Compression Matters
A deep dive into device sizing and compression:
- Over-compression thresholds
- Impact on peridevice leak (PDL)
- How this data should influence real-world implant decisions.
3. Persistent LAA Thrombus — Is There a Salvage Path?
We discuss a multicenter experience using:
- Percutaneous aspiration thrombectomy
- Embolic protection strategies
- Same-session, no-touch LAA closure
A feasibility signal—not for routine practice, but critical for expert centers facing clinical dead-ends.
OPTION Sub-Analysis — Does LAAO Worsen AF Recurrence?
Using the largest randomized dataset available:
- Concomitant vs staged LAAO with ablation
- AF recurrence, cardioversion, redo ablation
- Why “no AF recurrence” ≠ “no stroke risk”.
4. Post-TAVR Conduction Disturbances
A physiology-forward look at:
- Intraprocedural vs delayed high-grade AV block
- HV interval and PR prolongation as rule-out tools
- Practical EP risk stratification after TAVR.
5. Early Recurrence After Persistent AF Ablation
Insights from CAPLA challenge the traditional blanking period:
- Timing and burden of early recurrence
- Why late blanking-period events matter most
- How this should reshape post-ablation follow-up.
6. Septic Shock + AF — ICU Anticoagulation Reality
A clinically uncomfortable but crucial topic:
- Therapeutic anticoagulation in septic shock
- Mortality vs bleeding tradeoffs
- Why EP input matters even in the ICU.
7. Sex Hormones & Torsades de Pointes — A Translational EP Signal
A paradigm-shifting study linking:
- Hypogonadism, hyperestrogenism, and QT prolongation
- Cellular electrophysiology and real-world TdP severity
- A new biologic layer in arrhythmic risk.
Want more?
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EP Edge Journal Watch (Weekly): https://lnkd.in/e-Wa4diC
A concise, high-yield weekly digest of the most important EP studies—curated, contextualized, and clinically translated so you don’t have to read everything to understand what matters.
The EP Edge Newsletter (In-Depth Issues): https://lnkd.in/ep3NdZUz
Our flagship, deep-dive editions, where we go far beyond abstracts—breaking down:
- Technology and mechanisms
- Trial design and statistical nuance
- Efficacy, durability, and complications
- What truly differentiates one approach from another
The upcoming EP Edge deep-dive issue on Pulsed Field Ablation will do exactly that—offering a comprehensive, evidence-driven analysis of PFA platforms, mechanisms, outcomes, safety, and where the field is headed next.