EP Edge® Journal Watch: Issue 43 November 2026: VT Ablation, Idiopathic VF, His-Bundle Pacing and Endocarditis

EP Edge® Journal Watch 43 | November 2026: VT Ablation, Idiopathic VF, His-Bundle Pacing and Endocarditis How should we judge new ventricular ablation technologies, reassess survivors of apparently idiopathic ventricular fibrillation, and weigh the long-term consequences of pacing and infection-management decisions? In Issue 43 of EP Edge Journal Watch, Dr. Sharma examines ventricular arrhythmias, cardiac resynchronization, implanted-device safety, and infective endocarditis. Four featured discussions cover CLEAR-VT with its companion device analysis, long-term outcomes after idiopathic ventricular fibrillation, His-Alternative I, and the American Heart Association’s endocarditis scientific statement, including the POET trial. Shorter reviews address focal pulsed field ablation, arrhythmogenic cardiomyopathy, Brugada syndrome, pacing-induced ventricular dysfunction, device-related infection risk, and cardiovascular nutrition. The episode is designed for cardiac electrophysiologists, cardiologists, fellows, and allied professionals seeking critical appraisal and practical clinical interpretation. Articles are listed below in newsletter order. Dasa: CLEAR-VT and Dual-Energy Lattice-Tip Ablation of Ventricular Arrhythmias. Featured discussion. Early US experience demonstrates procedural feasibility in a selected, challenging population. We examine acute noninducibility, recurrent ventricular tachycardia, mixed radiofrequency and pulsed field delivery, short follow-up, and complications that limit conclusions about durability and comparative safety. Article DOI . Accompanying Nakamura and Tandri editorial . Mahmoodi: Effects of Dual-Energy Ventricular Ablation on Cardiac Implantable Electronic Device Performance. Included in the CLEAR-VT feature. This companion analysis examines device interactions and the importance of lead proximity, interrogation, and contingency planning. Overlapping registry patients are not treated as an independent replication of the main study. Article DOI . Reyes: Initial US Experience With Focal Pulsed Field Ablation for Refractory VT. A small case series provides early feasibility data, but recurrence during follow-up and the limited sample leave durability and uncommon complications unresolved. Article DOI . Martini: Ring-Like Late Gadolinium Enhancement in Left-Dominant and Biventricular Arrhythmogenic Cardiomyopathy. We examine the association between scar distribution and arrhythmic outcomes, and why an imaging risk marker should be interpreted alongside genotype and clinical history rather than used as a stand-alone treatment threshold. Article DOI . Accompanying Ghannam and Bogun editorial . Milman: START-BrS and Spontaneous Ventricular Tachyarrhythmia Initiation in Brugada Syndrome. Stored onset recordings provide insight into arrhythmia mechanisms. We discuss selection, repeated episodes, exploratory comparisons, and why retrospective initiation patterns do not establish preventive ablation or device-selection rules. Article DOI . Accompanying Lambiase editorial . Haïssaguerre: Long-Term Outcomes After Idiopathic Ventricular Fibrillation and Emerging Etiologies. Featured discussion. Longitudinal reassessment can reveal diagnostic clues after an initially unexplained cardiac arrest. We distinguish established diagnoses from proposed mechanisms and consider the implications for surveillanc