In this episode of EP Edge Journal Watch, we review several developments that directly impact modern electrophysiology practice — from pulsed field ablation safety to operator health. We begin with the real-world Varipulse experience, where early neurovascular events dropped dramatically after workflow modification and reduction of lesion stacking, highlighting that PFA success depends as much on procedural execution as on device design. We then discuss the first-in-human ElectroPulse mapping-ablation platform and what its early durability signals suggest about integrated catheter systems and standardized ablation protocols.

We next turn to right-sided ablation safety. The episode examines cavotricuspid isthmus pulsed field ablation, the mechanism of coronary vasospasm, and the high-dose nitroglycerin protection strategy used in studies. We also review emerging intracoronary imaging findings suggesting possible delayed coronary arterial remodeling after PFA. Device and structural therapy updates follow, including Amulet 360 left atrial appendage occlusion sealing performance and long-term outcomes of a small-diameter ICD lead platform designed to improve lead durability.

Finally, we discuss practical EP laboratory implications: a simplified pacing maneuver to distinguish AV nodal from septal accessory pathway conduction, the first reported infection involving an atrial leadless pacemaker, and new data on occupational hazards in electrophysiology — including radiation exposure, cataracts, orthopedic injury, and pregnancy-related workforce considerations. The central message is clear: electrophysiology outcomes increasingly depend on workflow discipline, protection strategies, and operator sustainability.

Full references, figures, and detailed graphics are available in the LinkedIn Newsletter: EP Edge Journal Watch — Issue 11 (February 2026) and on Substack at epedge.substack.com.
Questions or feedback: epedgecast@gmail.com.