In this December 2025 episode of EP Edge Journal Watch, Dr. Niraj Sharma breaks down the most provocative atrial fibrillation trials of the year—studies that force us to rethink what really drives AF outcomes beyond the ablation lesion
EP EDGE JW Dec 2025 Newsletter.
We dive deep into four game-changing themes shaping modern electrophysiology:
A critical analysis of OCEAN (NEJM 2025) and ALONE-AF, exploring DOAC de-escalation, aspirin as a comparator, and whether selected AF-free patients may safely discontinue oral anticoagulation.
A deep dive into sham-controlled ablation trials, including SHAM-PVI and the landmark PFA-SHAM trial, providing definitive evidence that both thermal and pulsed-field ablation deliver true reductions in AF burden and meaningful quality-of-life benefits.
We examine emerging data on GLP-1 receptor agonists (semaglutide), metformin, and SGLT2 inhibitors after AF ablation—highlighting which therapies reduce recurrence and which fail when used purely as off-label antiarrhythmics.
A fascinating look at human sinoatrial node transcriptomics, explaining sex-specific heart-rate biology and its implications for inappropriate sinus tachycardia, sinus node dysfunction, and AF progression.
What you’ll learn
This episode moves electrophysiology beyond lesion sets toward precision, whole-patient AF care—integrating stroke prevention, substrate modification, and biologic reality.
Full trial graphics, references, and detailed breakdowns are available in the EP Edge Journal Watch – December 2025 Issue on LinkedIn.
Questions or feedback? Email epedgecast@gmail.com
This is EP Edge Journal Watch — where data meets clinical judgment.