# EP Edge Journal Watch Issue 24 June 2026: AF Ablation in Heart Failure, VT Pulsed Field Ablation, Subcutaneous-ICD Shocks, Wearable Expansion, CABG AF, Genetics and GLP-1 Agonists

Page: https://stenobird.com/podcast/ep-edge-journal-watch-7561379/ep-edge-journal-watch-issue-24-june-2026-af-ablation-in-heart-failure-vt-pulsed-field-ablation-subcutaneous-icd-shocks-wearable-expansion-cabg-af-genetics-and-glp-1-agonists
Text version: https://stenobird.com/podcast/ep-edge-journal-watch-7561379/ep-edge-journal-watch-issue-24-june-2026-af-ablation-in-heart-failure-vt-pulsed-field-ablation-subcutaneous-icd-shocks-wearable-expansion-cabg-af-genetics-and-glp-1-agonists.md
Podcast: [EP Edge Journal Watch](https://stenobird.com/podcast/ep-edge-journal-watch-7561379)
Published: 2026-06-08T09:30:00+00:00
Episode link: https://share.transistor.fm/s/06f0cf4a
Audio file: https://media.transistor.fm/06f0cf4a/64e48f9b.mp3
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JSON: https://stenobird.com/v1/public/podcasts/ep-edge-journal-watch-7561379/episodes/ep-edge-journal-watch-issue-24-june-2026-af-ablation-in-heart-failure-vt-pulsed-field-ablation-subcutaneous-icd-shocks-wearable-expansion-cabg-af-genetics-and-glp-1-agonists
Duration seconds: 1581

## Resource

In this episode of EP Edge Journal Watch , Dr. Sharma reviews major electrophysiology and cardiology studies from Issue 24: Substrate, Sensing, Wearables, Surgery, and the Precision Turn . The central theme is precision EP: selecting the right patient, targeting the right substrate, interpreting the right signal, choosing the right antithrombotic strategy, and designing the right follow-up plan. This episode begins with a randomized trial of persistent atrial fibrillation ablation in patients with heart failure , comparing anatomic-guided ablation, electrogram-guided ablation, and an extensive electrogram-anatomic strategy. The discussion focuses on why pulmonary vein isolation alone may be insufficient in selected patients with persistent AF, atrial myopathy, and heart failure, and how meaningful AF burden reduction may translate into fewer heart-failure hospitalizations and better functional outcomes. Next, Dr. Sharma reviews early experience with high-voltage pulsed field ablation for redo ventricular tachycardia in nonischemic cardiomyopathy . This paper highlights the promise of deeper lesion formation for intramural VT substrate, while also emphasizing major operational challenges, including electromagnetic interference with ICDs, CRT-Ds, and electroanatomic mapping systems. The device EP section covers quantitative vector screening for subcutaneous ICD implantation . Instead of asking only whether an S-ICD vector “passes,” this study asks whether the patient has enough sensing reserve to reduce inappropriate shocks over time. The episode explains how stronger pre-implant vector selection may reduce inappropriate shocks, but also exclude some patients from S-ICD candidacy. The wearable technology discussion reviews a European Heart Journal state-of-the-art paper…

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