EP Edge Journal Watch Issue 32 August 2026: AF Ablation Anticoagulation, Flecainide After CAST, AI-ECG & PFA Mapping

Can anticoagulation be safely discontinued after successful atrial fibrillation ablation? Is the traditional prohibition against flecainide in structural heart disease too broad or does CAST remain an essential warning? And can AI-enabled ECGs, unipolar voltage mapping, and cardiac MRI improve how we detect AF and characterize arrhythmic substrate?In EP Edge® Journal Watch Issue 32, Dr. Niraj Sharma examines important electrophysiology research published in Heart Rhythm and JACC: Clinical Electrophysiology, translating the methodology, statistical findings, limitations, and clinical implications into practical insights for electrophysiologists and cardiovascular clinicians.Topics include:Discontinuing oral anticoagulation after AF ablationThe clinical and economic consequences of delayed AF ablationEstimating AF burden after several AF-free monitoring daysMulticenter validation of an AI-enabled ECG model for predicting AFUnipolar voltage mapping and lesion durability after pulsed field ablationHigh-density electroanatomic mapping versus cardiac MRI in nonischemic cardiomyopathyHow CAST changed the direction of flecainide researchClass Ic antiarrhythmic therapy after PCIReconsidering flecainide in selected structural heart disease phenotypesAmiodarone-associated thyrotoxicosis in patients with pre-existing hypothyroidismThe episode separates statistical association from causal evidence and asks what these findings should and should not change in current practice. It also outlines the prospective trials needed to determine whether anticoagulation withdrawal, AI-guided AF screening, voltage-guided PFA, and phenotype-based flecainide prescribing can improve clinically meaningful outcomes.Dr. Sharma also previews the next collaborative EP Edge® Journal Watch issue with the Heart Rhythm Society, the forthcoming EP Edge® app, and the new epedge.org platform—bringing podcasts, newsletters, EP Edge Rx, EP Edge Academy, and additional clinical and patient-focused resources into one accessible ecosystem.References, graphics, and the complete written analysis are available through EP Edge® Journal Watch on LinkedIn and Substack:https://epedge.substack.comQuestions, suggestions, or concerns: epedge.cast@gmail.com