{"type":"rich","version":"1.0","provider_name":"Transistor","provider_url":"https://transistor.fm","author_name":"EP Edge Journal Watch","title":"EP Edge™ Journal Watch Breaking News Special Edition: CHAMPION-AF, PRAGUE-17, and CLOSURE-AF — LAAC vs DOACs in Atrial Fibrillation","html":"","width":"100%","height":180,"duration":1633,"description":"In this EP Edge™ Journal Watch Breaking News Special Edition, Dr. Niraj Sharma delivers an in-depth analysis of the CHAMPION-AF trial and places its findings in direct comparative context with PRAGUE-17 and CLOSURE-AF, three pivotal randomized studies shaping the modern debate around left atrial appendage closure (LAAC/LAAO) versus direct oral anticoagulants (DOACs) for stroke prevention in atrial fibrillation.This episode goes well beyond a simple trial summary. It examines whether percutaneous left atrial appendage closure can truly challenge contemporary DOAC-first management in patients with nonvalvular atrial fibrillation, and whether the latest evidence justifies broader expansion of LAAC in routine electrophysiology practice. The discussion focuses on the real clinical questions facing electrophysiologists, cardiologists, and stroke prevention specialists in 2026: Which patients remain best served by oral anticoagulation? Where does LAAC still have a meaningful role? And how should clinicians interpret noninferiority claims when ischemic events, bleeding definitions, and procedural risk tell a more complicated story?The episode begins with a detailed breakdown of CHAMPION-AF, including trial design, patient selection, baseline stroke and bleeding risk, endpoint construction, and the interpretation of the primary efficacy and safety results. Particular attention is given to the noninferiority framework, the absolute margin used in the study, the numerical ischemic stroke signal in the device arm, the distinction between procedure-related and non–procedure-related bleeding, and the critical question of whether the reported bleeding advantage is robust enough to offset the upfront risk of device implantation. The discussion also explores why the lack of drug-specific DOAC breakdown matters when interpreting a comparator arm labeled broadly as “NOAC therapy.”The episode then turns to PRAGUE-17, a landmark randomized comparison of LAAC versus DOAC therapy in...","thumbnail_url":"https://img.transistorcdn.com/C7iPWVsHlGRm13syn3X4eXGLcqOXyzcuH5XmVutqgHc/rs:fill:0:0:1/w:400/h:400/q:60/mb:500000/aHR0cHM6Ly9pbWct/dXBsb2FkLXByb2R1/Y3Rpb24udHJhbnNp/c3Rvci5mbS9jMzFi/ZTYxOTI1M2U4NGRj/OGZmZjBhMDFlMjFm/NDQwMC5wbmc.webp","thumbnail_width":300,"thumbnail_height":300}