Barry Manilow in a 2011 speech to the U.S. Congress (yes, that Barry Manilow).

Atrial Fibrillation

AFib Might Be Far More Common Than We Think

A JACC study suggests that atrial fibrillation is far more prevalent than many previously thought, estimating that nearly one in 20 American adults have been diagnosed with the disease.

UCSF researchers analyzed medical records from 29M adults who received hospital-based care in California from 2005 to 2019 (51yr avg. age, 54% women, 50% White), finding that a whopping 2M (6.8%) of them had been diagnosed with AFib.

• AFib rates increased dramatically during the study period, from 4.49% in 2005-2009 to 6.82% in 2015-2019.
• That increase was greatest among younger patients, males, minorities, and patients with hypertension and diabetes. 

When these results are applied across the U.S., the researchers estimate that at least 10.55M Americans are currently diagnosed with AFib, representing 4.48% the U.S. adult population.

• That’s far higher than previous estimates, including a pair of JAMA and Circulation studies that estimated nationwide AFib rates of 2.26M and 5.1M back in 2000, and forecasted that 3.33M and 7.5M adults would have AFib by 2020.

Since all of these studies only looked at patients who were already diagnosed, true AFib prevalence is likely far higher, with the authors noting that wearable-based arrhythmia detection might drive far more significant diagnosis increases in the future.

The Takeaway

Although few readers are likely surprised that AFib diagnosis is on the rise, this study’s 51% growth rate and 4.48% prevalence estimate truly are shocking, and suggest that we might see a wave of AFib-related care in the future.

Incidental CAC Predicts Long-Term Risks

What if you could identify which of your asymptomatic patients have high risks of future cardiac events? Stanford-led researchers used Bunkerhill Health’s Incidental CAC algorithm to do just that, finding that patients with ≥100 incidental CAC scores had a 24% 10-year risk of developing ASCVD and far higher risks of major adverse events.

TeraRecon’s Structural Heart Enhancements

Detecting and addressing mitral valve and LAA conditions can be challenging. Check out TeraRecon’s Structural Heart white paper and discover how improving workflow and pretreatment planning can streamline these processes and potentially improve patient outcomes.

Improve Clinical Efficiency with Structured Reporting

Structured cardiovascular reporting enhances clinical efficiency, improves diagnostics, and streamlines billing. See how it might impact your team in this Optum report.

The Wire

• The Case for Early Cholesterol Control: The SWEDEHEART study showed that achieving early and sustained low non-HDL cholesterol levels after a heart attack leads to better outcomes. Participants who hit the study’s cholesterol target within two months (<2.2 mmol/L) had a 20% lower risk of MACE compared to those who didn’t, suggesting that current stepwise cholesterol-lowering strategies may actually harm post-MI patients.

• SpectraWAVE Series B: Intravascular imaging innovator SpectraWAVE landed $50M in Series B funding from Johnson & Johnson and a lineup of major VCs to advance its HyperVue Imaging System’s commercial expansion and support future product additions. The HyperVue system combines SpectraWAVE’s DeepOCT and NIRS spectroscopy technology within a no-flush catheter, supporting both image acquisition and AI-based image review to help physicians optimize coronary stent placement in the cath lab.

• Plozasiran’s Chylomicronemia Impact: A phase 3 trial found that Arrowhead Pharmaceuticals’ plozasiran significantly reduces triglycerides and acute pancreatitis risk in patients with persistent chylomicronemia. Over 12 months, patients on plozasiran saw a 79% average drop in triglycerides, compared to 17% with placebo. The odds of pancreatitis were also lower (OR 0.17), while the two groups experienced similar side effects.

• Plozasiran’s Breakthrough Status: Plozasiran’s hot streak continued, receiving FDA Breakthrough Therapy Designation for reducing triglycerides in adults with familial chylomicronemia syndrome (FCS). FCS is a rare genetic disease characterized by extremely high triglyceride levels that can cause life-threatening pancreatitis, and currently doesn’t have any FDA-approved treatments. The designation should expedite plozasiran’s development, with Arrowhead planning to submit a New Drug Application by the end of 2024.

• Brightflow SAS Series A: French startup Brightflow SAS secured $18.2M in Series A funding to develop its minimally invasive percutaneous mechanical circulatory support device, intended for patients with end-stage heart failure and severe RV dysfunction. The Brightflow device is implanted through a minimally invasive procedure, allowing long-term RV circulatory support without open-heart surgery. The new capital should fund Brightflow through 2026, as it completes product development and performs its first implantations.

• Acoramidis’ Serum TTR Increases: New analysis from the Phase 3 ATTRibute-CM study and its open-label extension further highlighted the efficacy of BridgeBio Pharma’s ATTR-CM treatment acoramidis. Among 611 ATTR-CM patients, those who switched from Pfizer’s tafamidis and a placebo to acoramidis after 30 months saw increases in serum TTR levels one and six months later (avg. +3.0mg +3.4/dL). Increases in serum TTR were associated with significantly lower risk of mortality and cardiovascular hospitalization.

• STEEERing Toward Better AFib Care: The STEEER-AF trial showed that giving healthcare professionals focused educational interventions can improve their AFib guideline adherence. Centers receiving extra training saw a jump in rhythm control adherence from 21% to 34%, while stroke prevention remained unchanged mainly due to already high baseline anticoagulation use (89%).

• First Hypertension DTx: In a first for cardiovascular medicine, DeepWell DTx landed FDA clearance for its biofeedback software development kit that uses digital therapeutics to treat stress and hypertension. The digital therapeutic technology would be integrated into immersive and interactive media, providing biostimulation that activates patients’ vagus nerve, releasing dopamine that improves resilience and reduces stress and hypertension. The software would be used in over-the-counter mental health digital therapeutic products, which will be available with CMS reimbursements starting next year.

• Echo AI Misses CAD, Helps Some Users: The PROTEUS study showed that some echo AI solutions might have limited benefits for helping clinicians assess stress echocardiograms and diagnose CAD. In the study of 2,341 patients in 20 UK hospitals, clinicians using Ultromics’ EchoGo Pro referred patients for coronary angiography less accurately than clinicians following standard of care (69% vs. 75% were appropriate referrals). However, there were signs that AI decision support could help providers with less echo experience and/or with more complex cases.

• CardiaTec’s Drug Discovery Funding: Cardiovascular drug discovery startup CardiaTec raised $6.5M in seed funding to further advance its multi-omics platform and bring its proprietary drug targets to the preclinical stage. The University of Cambridge spin-out is building the “world’s largest multi-omics dataset from human cardiac tissues,” using that platform to better understand the complex biology behind cardiovascular diseases and identify novel heart drugs.

• AI’s Mixed MI Results: In the RAPIDx study of 14,131 patients seen in Australian emergency rooms for suspected MI, composite endpoint event rates (CV death, MI, unplanned readmissions) were similar for clinicians using real-time AI-based decision support compared to clinicians following standard care (26% vs. 26.4%). However, AI-assisted clinicians were less likely to make inappropriate coronary angiography referrals (5% vs. 9.4%) and more likely to appropriately prescribe statins (82% vs. 68%).

HeartFlow FFRCT Avoids Invasive Cath

Despite being conscious about his heart health, 60-year old Mike Gartman suddenly experienced classic symptoms of CAD. See how Mike’s HeartFlow FFRCT Analysis results allowed him to avoid the invasive procedure altogether and gain peace of mind about his disease.

Meet Your EP Decision Support Digital Assistant

Time is of the essence when it comes to managing Afib, and there’s ways to be more efficient. Tune in to this GE HealthCare Cardiology Coffee Break (September 18 at 12:00pm EDT) exploring how clinical decision support with CardioVisio can help you make faster decisions and accelerate the diagnostic process.

Forging the Future of Cardiovascular Care

Cardiology is changing, and for the better. Get a view into Lee Health Heart Institute’s medical director Richard Chazal, MD’s vision for a new era in cardiology, driven by imaging, AI and personalized medicine.

The Resource Wire

• Experience the future of learning: Medtronic Academy 2.0 is here! Unlock your ultimate destination for structural heart medical education with the newly redesigned Medtronic Academy 2.0. Gain access to expert-led courses, webinars, and a wealth of resources to stay ahead in cardiovascular care. Visit now!

• Your Cardiology Data is Valuable. Put it To Work. See how one major Midwest health system’s decision to implement Merge Cardio transformed physician and staff workflows, improved data entry speed and accuracy, and increased cost savings.

• Accurate and Efficient Remote Cardiac Patient Monitoring: The expansion of remote cardiac patient monitoring is creating more care opportunities, but also new operational challenges for cardiology teams. Check out this Cardiac Wire Show, where ARTELLA Solutions’ Jacinta Fitzsimons shares how the right combination of technology and service can help physicians get the most out of their cardiac RPM programs – today and into the future.

• Making the Leap to Outsource Post-Processing: Interested in how to outsource cardiac image post-processing, but not sure where to start? PIA walks you through how to assess and compare vendors, understand pricing models and payment options, and outline your requirements to identify vendors who meet your clinical needs.

• AI-Driven Novice Heart Failure Screening: We hear a lot about AI’s potential to expand echocardiography to far more users and clinical settings, and a study using Us2.ai’s AI-automated echo analysis and reporting solution showed that echo AI might make novice-led heart failure screening possible.

• AI Algorithms in Cardiology: Navigating the Path from Research to Practice: Join Tempus on Tuesday, September 24 for an in-depth webinar exploring the transformative power of cardiology AI algorithms. Learn from leading experts, including Cedars Sinai’s Dr. David Ouyang and Tempus’ senior cardiology team Dr. Brandon Fornwalt and Dr. John Pfeifer, about how cardiology AI algorithms are unlocking new possibilities for diagnosis, treatment, and patient outcomes. Secure your spot now to be part of this pivotal discussion.

• New Horizons in Structural Heart: TAVR and TMVR rates are rising rapidly, placing more pressure on interventional planning. Tune into this Circle CVI and Radcliffe Cardiology breakout detailing how to leverage modern CT workflows to produce efficient and accurate pre-procedural plans.

• The Post-Acute Stroke Game Changer: See how Viz Connect solution can optimize your post-acute stroke pathway. The Viz.ai solution allows the cardiology team to promptly receive Neurology referrals to evaluate patients with suspected AFib for cardiac monitoring and reduce their risk of secondary stroke.

The Industry Wire

1. MGB unveils unified cancer care strategy.
2. Apple adds sleep apnea to Apple Watch, hearing aid to AirPods Pro.
3. NYU Langone performs first fully robotic lung transplant. 
4. Over 1k U.S. counties have no birthing facilities or obstetricians.
5. Allegheny Health serves as backdrop for TV drama, The Pitt.
6. UVA faculty demands removal of CEO and dean, leaders push back.
7. Researchers propose replacing BMI with body roundness index.
8. One-fifth of COVID deaths attributed to strained hospital caseloads.
9. Modesto’s Stanislaus Surgical Hospital to close after Medicare removal.
10. Nearly 50M people have been insured through the ACA exchanges.