EP Edge® Journal Watch 40, October 2026: AF Ablation, Anticoagulation, Stroke Risk, GLORIA-AF, Stellate Ganglion Block, and ICD Outcomes

EP Edge® Journal Watch | Issue 40 | October 2026

Beyond AF Burden: Stroke Risk, Rhythm Progression, Atrial Pacing, and Sudden Death Prevention

Should oral anticoagulation continue after successful atrial fibrillation ablation? Does AF density provide better stroke-risk information than conventional burden measurements? Can the GLORIA-AF score improve thromboembolic risk prediction? And could autonomic modulation or advances in pacing and defibrillator therapy change electrophysiology practice?

In Issue 40 of EP Edge® Journal Watch, Dr. Sharma examines eleven research papers, with detailed analysis of five major studies and concise reviews of six additional publications.

The episode explores study methodology, statistical interpretation, clinical relevance, and the distinction between promising associations and evidence sufficient to change practice.

Featured Studies

1. Anticoagulation After AF Ablation | Ren et al.

A prospective observational analysis of 13,669 patients examines continuation versus discontinuation of oral anticoagulation following catheter ablation.

Continued anticoagulation after six months was not associated with a statistically significant reduction in thromboembolism across stroke-risk categories, while major bleeding was higher in anticoagulated high-risk patients. The interpretation is complicated by nonrandom treatment selection, differences in baseline stroke risk, and incomplete quantitative AF burden assessment.

We discuss adjusted hazard ratios, absolute event rates, confidence intervals, confounding by indication, and the implications of contemporary randomized evidence, including ALONE-AF, OCEAN, and OPTION.

The accompanying editorial by Alhassan and Kwaku provides additional context for individualized anticoagulation strategies after ablation.

Ren et al. DOI: