EP Edge Journal Watch — January 2026 | Issue #5

Pulsed Field Ablation, Device Therapy, and the Era of Personalized EP

Welcome to EP Edge Journal Watch – Issue #5 (January 2026), your high-yield, evidence-driven electrophysiology podcast designed for practicing EPs who want more than just abstracts.

As 2026 begins, electrophysiology is entering a defining phase—where pulsed field ablation (PFA) matures beyond feasibility, device therapy is reframed by competing risk, and “one-size-fits-all” ablation strategies give way to personalization.

In this episode, Dr. Niraj Sharma MD FACC FHRS breaks down practice-changing trials, real-world registries, and mechanistic insights that are actively reshaping how we approach atrial fibrillation ablation, ICD decision-making, leadless pacing, and AF progression.

What’s covered in this issue:

• Long-term ICD outcomes in nonischemic cardiomyopathy
  Why preventing sudden death does not always translate into survival benefit—and how age and competing risk matter.
• Leadless pacing evolution
  Dual-chamber leadless pacemakers, operator learning curves, and why high acute atrial thresholds don’t predict chronic failure.
• Reducing CIED infections
  How a simple iodinated adhesive drape significantly lowers contamination and infection risk.
• AF progression as a biologic signal
  Why device-detected AF progression predicts mortality, heart failure, and stroke risk.
• Monitoring-driven AF management
  How implantable cardiac monitors change rhythm-control strategies and outcomes.
• Pulsed Field Ablation at scale
  CE-Mark data, IDE trials, and the MANIFEST-US registry defining safety, durability, and workflow in real-world PFA.
• Rare but serious delayed PFA complications
  What every electrophysiologist should know about delayed ischemia and malignant arrhythmias.
• Personalized AF ablation strategies
  LA wall thickness–guided ablation, sex-specific outcomes, and patient-factor–driven lesion optimization beyond PVI-only.

Why this episode matters:

This is not headline medicine. This is mechanism-aware, data-literate electrophysiology, focused on:

• Durability over acute success
• Precision over dogma
• Biology over empiricism

Whether you’re performing AF ablation weekly, implanting devices, or shaping EP programs, this episode provides context you can apply immediately in the lab and clinic.

Want more?

• EP Edge Journal Watch (Weekly): concise, curated EP research updates
• EP Edge Newsletter (In-Depth): deep dives into trials, mechanisms, and clinical implications

All references, figures, and infographics discussed in this episode are available in the EP Edge Journal Watch LinkedIn Newsletter.

Subscribe, follow, and stay at the edge of electrophysiology.

— Niraj Sharma, MD FACC FHRS
Cardiac Electrophysiologist | Founder, EP Edge