Joshua Lampert, MD, on the latest trajectory of EP practice at HRS 2026.

The Cardiac Wire Show captured key insights into the latest electrophysiology breakthroughs, business, and research at this year’s HRS 2026 in interviews with…

• AccurKardia’s COO, Sadeq Ali, and Specialized Medical’s CEO, Steve Burns on their new partnership to expand access to AccurKardia’s ECG-AI algorithms.
• Medtech Investor and industry leader, Ken Nelson, on the trends he’s seeing in EP business.
• Mount Sinai’s Medical Director of Machine Learning, Joshua Lampert, MD on where AI and EP research are headed.
• Kenneth Civello, MD, MPH, on what role wearables play in remote cardiac monitoring.
• Saurabh Kumar, MBBS, PhD, on his late-breaking results from the CAAD-VT trial.
• Boyoung Joung, MD, PhD, on the clinical relevance of ALONE-AF’s late-breaking results.
• Lucas Boersma, MD, on the real-world results from the Enlighten Study.
• Robert Schaller, DO, on the LBBAP safety and efficacy results from the ASCEND CSP trial.

Cardiology

Cardiac Wire’s Top Six of HRS 2026

The Heart Rhythm Society’s Annual Meeting for 2026 electrified Chicago with talks of the latest EP tech, rhythm management debates, and insights into where remote patient monitoring is headed. Here are Cardiac Wire’s top-six takeaways from electrophysiology’s biggest weekend of the year.

HRS Grows Steadily – This year’s HRS attendance numbers hit just over 10k, similar to last year’s, but where HRS reached new heights was in research. Nearly 3.7k scientific abstracts were submitted, 20 late-breakers were presented, and 150+ exhibitors showed up, signaling the growing fervor for EP science, and a blooming conference.

PFA is Here to Stay – Judging by the biggest booths and the loudest buzz, pulsed field ablation has earned its place in the EP mainstream. The medtech giants all brought their own PFA devices to the table, but there’s still plenty of room for smaller contenders like Pulse Biosciences and Arga Medtech if their tech proves superior.

What Makes a PFA Device Unique – Some PFA device makers argue their ablation catheter leads to the best results, others say its their unique wave form, or nanosecond energy frequency, but one thing is clear, innovation is at the heart of PFA design and outcomes.

EP is an Imaging-Guided Specialty – Cardiology in general is relying more and more on image guidance for better procedures and outcomes, but that’s especially true for EP. Whether it’s 4D ICE ultrasound for LAAO, or electrical mapping for ablation targets, EPs rely on imaging. 

Education Holds Back RPM – Despite favorable data and viable reimbursement, conversations on the show floor suggested that a lack of education on remote patient monitoring’s benefits prevent the technology from reaching its full potential in primary care and general cardiology.

The LAAO, Ablation, and Drug Debate – Finally, one trend is clear in arrhythmia care – docs are debating the merits of old-school anti-arrhythmic drugs in the face of advanced catheter-based therapies like LAAO and ablation. This theme remains consistent across late-breakers, conversations on the floor, and debates online in EP, with some physicians becoming more wary of non-inferiority trials and what justifies an LAAO or ablation.

Heart Failure Hospitalization Doubles Risk of Cardiovascular Death

21% of patients with symptomatic heart failure escalate to hospitalization for heart failure or cardiovascular death, and 25% of those who experience hospitalization are readmitted due to heart failure within one year of discharge. Watch Bayer’s Dr. Alanna Morris-Simon discuss heart failure hospitalizations and when to assess care plans.

PIA’s Post-Processing Solution

Advanced cardiac imaging often calls for a time-consuming post-processing step, requiring costly software, hardware, and training. See how PIA provides this post-processing at lower cost, improved consistency, and greater efficiency.

CA Diagnosis Using Echo AI

Diagnosing cardiac amyloidosis using echo can be challenging due to the imaging overlap between CA and more prevalent causes of cardiomyopathy. Read more about how Us2.ai’s echocardiographic score and fully automated deep-learning model overcome this challenge to enable better diagnosis.

The Wire

• Ablation vs. Drugs Across Cardiomyopathies: The CAAD-VT trial, presented at Heart Rhythm 2026, confirmed that catheter ablation is more effective than antiarrhythmic drugs for both ischemic and non-ischemic cardiomyopathy. Among the study’s 100 patients, ablation significantly reduced the composite of VT recurrence, VT storm, or death over 36 months (51% vs. 71%). While mortality rates were similar between the two treatment groups, the study provides real-world randomized evidence for underrepresented non-ischemic patients. You can watch Cardiac Wire’s interview with CAAD-VT’s Dr. Saurabh Kumar here. 

• Ablation vs. Anticoagulation for Cognitive Recovery: Presented as an HRS late-breaker, an ALONE-AF trial substudy showed that stopping oral anticoagulation (OAC) one year after successful ablation doesn’t impair a patient’s cognition. Across the study’s 646 patients, scores on the Montreal Cognitive Assessment improved in both groups, so long as patients remained AFib-free. The study’s authors suggest this supports discontinuing OAC to reduce bleeding risk without sacrificing a patient’s mental clarity. Cardiac Wire interviewed Dr. Boyoung Joung to learn more about ALONE-AF.

• PFA Beats Drugs for Persistent AFib: In what is somewhat of a clinical trial comeback, the AVANT GUARD trial demonstrated that Boston Scientific’s FARAPULSE pulsed-field ablation can be a first-line option for persistent AFib. Compared to anti-arrhythmic drugs, PFA slashed treatment failure by 54%, achieving a 56% success rate versus 30%. Despite a temporary safety pause for neurologic events, protocol refinements kept the procedure viable. The study’s authors argue that PFA offers a more effective path to sinus rhythm, so we could eventually see a change in future clinical guidelines. 

• COMPASS Improves Early AFib Care: When it came to the broader impacts of EP research, a new study showed that HRS’s COMPASS program improved care for early AFib across three U.S. centers. Early rhythm control rose from 29% to 33%, primarily through increased catheter ablation. The initiative also boosted oral anticoagulation use and specialist referrals. While gains fell short of the study’s 10% target, experts claimed the framework reduces therapeutic inertia. While identifying patients in primary care remains a hurdle for the initiative, its scalable model could help overcome this.

• ULTA Effectively Freezes Out VT: Results from the FULCRUM-VT trial at HRS 2026 showed that ultra-low temperature ablation remains a powerful tool for ventricular tachycardia. Using nitrogen at -196°C, the procedure rendered 98% of targeted VTs non-inducible with a low 2.5% major complication rate. By penetrating deep scar tissue better than conventional thermal methods, researchers believe ULTA provides a new option for managing high-risk arrhythmias in cardiomyopathy patients who fail standard therapies. 

• AI Unlocks Pacemaker Data: An AI substudy of the NOAH-AFNET 6 trial, presented at Heart Rhythm 2026, used natural language processing to extract AFib burden from pacemaker reports with 98% accuracy. The analysis revealed that higher AFib burden did not increase stroke risk in this device-detected population. Anticoagulation (edoxaban) consistently increased bleeding risks without reducing strokes, regardless of AFib duration. These findings suggest that subclinical, low-burden AFib may not necessitate routine anticoagulation therapy.

• iCardio Closes $4.5M Funding: Echocardiography AI developer iCardio.ai raised $4.5M to further commercialize its technology for automating cardiac ultrasound scans. The company has two FDA clearances – CardioVision for detecting aortic stenosis and EchoMeasure for supporting echo interpretation and preliminary reporting – with several more pending, and its corporate partners range from Butterfly Network to Abbott. The funding round was led by Cedars-Sinai Technology Ventures, and iCardio completed an agreement giving it access to Cedars-Sinai’s cardiac imaging dataset. 

• Refining BAC Cardiovascular Predictions: A new JACC study refined predictions of cardiovascular risk using AI-based calculations of breast arterial calcification by adjusting them to the patient’s age. Researchers used a research version of CureMetrix’s cmAngio software to analyze screening mammograms of 21.5k women and develop age-adjusted BAC calculations correlated to major adverse cardiovascular events. Over a mean follow-up of 4.7 years, every 10-percentile increase in BAC was associated with a 17% increase in MACE risk. 

• FDA Clears Abbott AI-Powered OCT Platform: The FDA cleared the latest version of Abbott’s optical coherence tomography platform, Ultreon 3.0, for high-resolution imaging of coronary plaque. Ultreon 3.0 includes AI-powered enhancements and sports a one-second OCT pullback that can capture cross-sectional views of coronary arteries with higher resolution than intravascular ultrasound with low or zero contrast. It also provides better information on the size, shape, and location of coronary blockages, improving the ability to place stents and plan procedures. 

• Cardiology Loses a Legend: Dr. Eugene Braunwald, often referred to as the “father of modern cardiology,” passed away at 96. Born in Austria, and a refugee of WWII, he ultimately revolutionized heart care around the world by pioneering the “time is muscle” concept, which is today the foundation of modern heart attack treatment. He also founded the TIMI Study Group, served as an editor for many of cardiology’s definitive textbooks, and authored 1,600+ papers. A mentor to some of the most important voices in cardiology today, his brilliance and determination surely changed cardiology, and the world, forever.

• Eliquis Joins Cuban’s Cost Plus Drugs: The BMS-Pfizer Alliance announced that Eliquis (apixaban) is now available on CostPlusDrugs.com as of April 27, 2026. Cash-paying patients can now purchase a 30-day supply of the widely prescribed anticoagulant for $345 (the monthly cost of leasing a 2026 Toyota Camry). This partnership could help bypass certain supply chain layers to improve price transparency while becoming one of the largest brand-name additions to the platform. As a result, there’s now a direct-to-patient alternative for those managing AFib, DVT, and pulmonary embolism.

The Power of AI in Cardiovascular Imaging

Cardiac labs are under more pressure than ever to deliver more with greater speed and precision. Hear from Tony Gallagher, Director of Noninvasive Cardiology at Baptist Health Lexington about how Siemens Healthineers’ ACUSON Origin is reshaping daily practice and transforming the future of echocardiography.

Fujifilm’s Ultrasound for every Cardiovascular Ultrasound Environment

From academia to clinical diagnostics, versatility in cardiac ultrasound is essential. Discover why clinicians are choosing Fujifilm’s LISENDO 880 for exceptional image quality, comprehensive strain analysis, stress imaging, and innovative Virtual Contrast technology — all while delivering outstanding value.

Vista AI Grows CMR Volume

Are your patients waiting weeks or months for cardiac MRIs? See Brigham and Women’s Hospital’s real-world results showing how Vista AI’s software for automated MRI scanning led to 50% more scan slots, without adding more scanners or staff.

The Resource Wire

• Discover The Monebo Advantage: Need complex ECG monitoring algorithms for use in a variety of applications? Here are just a few reasons why companies across the healthcare spectrum rely on Monebo to power their ECG monitoring and analysis.

• cvi42’s Real World Results: Consistency of measurements over time is of utmost importance for clinical interpretation and follow-up. Read about how cardiac imagers are using Circle Cardiovascular Imaging’s cvi42 platform to dramatically reduce manual segmentation by up to 60%.

• 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.

• Tempus Receives FDA 510(k) Clearance for Tempus ECG-Low EF: Tempus announces the expansion of its Tempus ECG-AI portfolio with Tempus ECG-Low EF, software intended for use to analyze 12-lead ECG recordings and detect signs associated with having a low left ventricular ejection fraction (LVEF less than or equal to 40%) in patients 40 years of age or older at risk of heart failure. It is not intended as a stand-alone diagnostic and positive results may suggest the need for further clinical evaluation. For Full Indications for Use, visit here.

The Industry Wire

1. FDA launches “real-time clinical trials” for faster drug review.
2. GLP-1 drug improves motivation in trial with depressed patients.
3. New survey tracks rise in health system CEO pay. 
4. Congressional hearing criticizes CEOs for high healthcare costs.
5. OxyContin maker Purdue to dissolve as criminal trial concludes.
6. Utah medical board wants to suspend AI prescription program.
7. Nebraska first to implement Medicaid work mandates next month,
8. Health companies jockey for share of $50B rural health fund.
9. FDA testing confirms safety of infant formula. 
10. CDC says backyard poultrymay raise salmonella risk.