EP Edge Journal Watch Issue 23 May 2026: PFA Durability, Posterior Wall Ablation, Outflow Tract PVCs, and Fitness as Substrate Modification

In EP Edge™ Journal Watch Issue 23, May 2026, Dr. Sharma reviews the latest high-impact electrophysiology and cardiology literature with a new focused format: four deep-dive studies and a rapid-fire review of the remaining trials.This episode explores whether pulsed field ablation platform design affects pulmonary vein isolation durability, how balloon-in-basket PFA may change posterior wall ablation, and whether focal PFA is ready for outflow tract PVC ablation. The episode also includes an EP-Edge™ Off-track deep dive on midlife cardiorespiratory fitness and healthy aging, highlighting fitness as upstream cardiovascular substrate modification.Rapid-fire discussions cover residual tiny pulmonary vein potentials after PFA, dronedarone versus amiodarone after AF ablation, AI versus electrophysiologist rhythm adjudication, quantitative Brugada risk stratification, smartwatch detection of Type I Brugada pattern, AV nodal left inferior extension mapping, IV lidocaine safety in AF patients treated for ventricular arrhythmias, and HEPARIN-STEMI.Topics include atrial fibrillation ablation, pulsed field ablation, posterior wall isolation, pulmonary vein durability, PVC ablation, Brugada syndrome, wearable ECG, artificial intelligence in electrophysiology, ventricular arrhythmias, STEMI systems of care, and cardiorespiratory fitness.Full references, graphics, and detailed trial analysis are available in the EP-Edge™ Journal Watch LinkedIn newsletter and on Substack at epedge.substack.com.