{"type":"rich","version":"1.0","provider_name":"Transistor","provider_url":"https://transistor.fm","author_name":"EP Edge Journal Watch: Cardiac Electrophysiology Research","title":"EP Edge® Journal Watch Issue 35: ESC 2026 Munich Special Edition | SINGLE-AF, CMR GUIDE, New HF Guidelines & Fifth Universal Definition of MI","html":"","width":"100%","height":180,"duration":1263,"description":"In this special edition of EP Edge® Journal Watch, Dr. Sharma reviews the major breaking cardiovascular and electrophysiology science presented at the European Society of Cardiology Congress 2026 in Munich.\nThe episode begins with two important electrophysiology trials that challenge familiar clinical thresholds.\nFirst is SINGLE-AF, led by Daehoon Kim and colleagues and published in the New England Journal of Medicine in August 2026. The trial provides the first randomized evidence evaluating direct oral anticoagulation versus no anticoagulation in patients with atrial fibrillation at intermediate stroke risk. Dr. Sharma explains why this population has remained a clinical gray zone, how the trial was designed, what the 69% relative reduction in the primary net clinical endpoint actually means, why the absolute event rate remains important, and whether these findings should change anticoagulation decisions in everyday AF practice.\nNext is CMR GUIDE, led by Joseph B. Selvanayagam and colleagues and published in JAMA in August 2026. This provocative randomized trial tested whether myocardial scar identified by late gadolinium enhancement cardiac MRI could help identify patients with LVEF 36% to 50% who may benefit from a primary-prevention ICD. Although the primary endpoint was neutral, the reduction in sudden cardiac death and the striking signal among patients younger than 70 years raise a much larger question for electrophysiologists: Is LVEF alone still an adequate way to determine sudden cardiac death risk and ICD candidacy?\nThe episode then moves into a rapid review of additional major developments from ESC 2026.\nThe 2026 ESC Heart Failure Guidelines, led by Lars Køber, Marianna Adamo and colleagues and published in the European Heart Journal, eliminate the traditional HFmrEF category, redefine HFrEF as LVEF below 50%, introduce a Stage A through D heart failure framework, and reorganize therapy into foundational, additional, and guideline-directed...","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}