Kevin S. Shah, MD.

Artificial Intelligence

Google’s AMIE Shows Promise for Cardiology Care

AI scribes and LLMs’ potential impact on cardiology just became a lot clearer after a Stanford RCT published in Nature Medicine demonstrated that Google’s AMIE system helped general cardiologists better diagnose and plan treatment for rare heart conditions.

• The WHO predicts an 18M healthcare provider deficit by 2030, with the shortage hitting hardest in subspecialties like those across cardiology.
• Large language models might help alleviate this shortage, but rigorous LLM RCTs are rare across medical specialties with zero RCTs evaluating LLMs in cardiology until now.
• Among the healthcare LLMs is Google’s AMIE, which focuses on gathering conversational information and interpreting medical scans like lab tests and ECGs.

Researchers enrolled nine general cardiologists to evaluate 107 patients with suspected genetic cardiovascular disease. Each case was then reviewed by two cardiologists (one with access to AMIE and one without) and three subspecialists later confirmed the diagnoses.

• AMIE-assisted assessments were more often supported by the subspecialists (46.7% vs 32.7%).
• As were the resulting management plans (45.8% vs 29.9%), 
• And diagnostic recommendations (43.9% vs 30.8%).

When it came to catching mistakes…

• Clinical errors occurred in 13% of AI-assisted versus 24% of unassisted assessments.
• Meanwhile general cardiologists reported AMIE improved their assessments in 57% of cases, increased confidence in 52%, and saved time in 50%.

But AMIE also made some mistakes of its own, with hallucinations occurring in 6.5% of cases.

• The hallucinations were mild (such as assuming patient gender or fabricating minor imaging findings), and they often self-correcting when challenged by cardiologists.

What is perhaps most remarkable about the study is that AMIE adapted to this level of subspecialist cardiology with considerable data efficiency, requiring feedback from experts on just nine cases.

Taking it all into consideration in their discussion, the study’s authors suggest that AMIE is still better at improving treatment planning than initial diagnostic reasoning, with that part still best left to expert physicians.

The Takeaway

This study is notable in the cardiology community as the first RCT to truly evaluate how an LLM can support general cardiologists with handling complex CV conditions that usually belong to subspecialists. The results suggest it’s a strong starting point that could help improve treatment planning and management, while the verdict is still out on diagnostics.

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The Wire

• Crouching MedTech, Hidden Dragon: In what’s becoming a deeper story around corporate MedTech espionage, the House of Representatives alerted the U.S. Treasury Department to China-based Grand Pharmaceutical Group’s predatory practices. First covered by the WSJ, Grand’s subsidiary, Sirtex, allegedly invested in and manipulated IVL startup, FastWave Medical. Once gaining two FastWave board seats, Sirtex allegedly refused to sign NDAs for data access, “ransomed” its Series B financing, and didn’t cooperate with required CFIUS filing. The House letter now alleges that Grand Pharmaceutical is systematically targeting multiple American MedTech startups beyond FastWave.

• J&J’s PFA Milestones: Johnson & Johnson unveiled 12-month pilot data for its OMNYPULSE Platform at the 2026 AF Symposium, showing a 90% freedom from AFib with zero procedure-related adverse events. The 12 month data suggests that J&J’s approach of combining contact-force sensing with bipolar, biphasic pulse delivery is both safe and effective at one year. The company also released new data for the VARIPULSE Platform across over 6,800 patients that confirms the PFA device has an especially safe neurovascular event rate of 0.22% when paired with optimized irrigation and advanced mapping.

• HeartLung’s AI-CVD Predicts Heart Failure: The AI-CVD algorithm from HeartLung Technologies predicted heart failure more accurately than clinical criteria in a new study. Researchers used AI-CVD to extract additional data from CT-derived coronary artery calcium scans of 6.7k people without symptoms. Compared to the PREVENT-HF clinical criteria, AI-CVD had higher AUC over 10 years (0.83 vs. 0.79) and the algorithm performed consistently across age, sex, and race/ethnicity. AI-CVD got FDA clearance in December.

• CCTA Plaque Measures Predict MACE: Measures of plaque burden and volume from coronary CT angiography exams helped predict MACE in a sub-analysis from the PROMISE trial published in JAMA Cardiology. Among 4.3k patients who got CCTA exams, risk of MACE was nearly double in people with total plaque volume ≥ 87 mm3, total plaque burden ≥ 35%, and noncalcified plaque burden ≥ 20% (aHR = 2.07, 1.96, and 1.77, respectively). The findings reinforce CCTA’s value in predicting adverse cardiovascular events.

• nPulse Nanosecond PFA: Pulse Biosciences presented data at the 2026 AF Symposium showing that its nanosecond Pulsed Field Ablation technology achieved 96% procedural success at one year in 150 patients. The system significantly reduced procedure times, with a left atrial dwell time of 21 minutes and a 1.3% serious adverse event rate. These results suggest that nsPFA provides precise, durable pulmonary vein isolation with a highly efficient workflow, leading to an upcoming pivotal IDE study.

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• ADVENT-LTO’s Results: Long-term follow-up data from the ADVENT-LTO study found that Boston Scientific’s FARAPULSE PFA maintains preserved effectiveness over 3.65 years post ablation. In 364 paroxysmal AFib patients, FARAPULSE showed a 72.8% treatment success rate compared to 64.1% for thermal ablation. Notably, Boston Scientific’s PFA platform significantly reduced the need for repeat ablations (10.4% vs. 17.7%) and showed a favorable trend in preventing progression to persistent AFib.

• GE HealthCare ReadyFix Launch: GE HealthCare introduced ReadyFix, a remote fleet management solution designed to improve device uptime, launching first for use with MAC VU360 resting ECG workstations. The system allows biomedical engineering teams to perform remote diagnostics, repair, and proactive troubleshooting using real-time data to minimize interruptions in cardiac care.

• Dietary Quality and CHD Risk: A study of 198k+ people over 30 years found that both low-carbohydrate and low-fat diets are associated with a lower risk of coronary heart disease when they prioritize high-quality, plant-based foods. Conversely, diets high in animal proteins, saturated fats, and refined carbohydrates increased heart disease risk. The results emphasize that the quality of food matters more than the specific macronutrient composition, as healthy versions of both dietary patterns showed improved metabolomic profiles and reduced inflammation.

• FDA Updates Breakthrough Device List: The FDA issued an update last week to its list of medical devices granted breakthrough designation. The agency in 2025 issued 164 breakthrough designations, down by one compared to 165 in 2024. Cardiology earned 251 of the 1,246 designations (20%) since the program’s start in 2015. Breakthrough cardiac technologies that went on to get marketing authorization in 2025 include Abbott’s Tendyne TMVR, and Edwards’ Sapien M3 for TMVR, among others.

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The Resource Wire

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The Industry Wire

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3. MultiCare sues Optum, Change Healthcare over outstanding claims.
4. Kaiser strike expands as 3,000 more workers walk out.
5. KLAS ranks the best EHRs globally, by region.
6. Epstein files reveal deeper ties to scientists than previously known.
7. Mark Cuban says “Meh” to FTC, Express Scripts settlement.
8. Public trust in CDC plummets after vaccine changes.
9. Public health workers are quitting over assignments to Guantánamo.
10. HHS to drop 340B rebate pilot after court rulings.