F. Perry Wilson, MD, MSCE, breaking down the results of an AI notification study.

Cardiac Wire will be celebrating the Fourth of July! As such, we won’t be putting out an issue on Monday. See you next Thursday and if you’re in the U.S., have a wonderful long weekend.

Cheers and be well,

Vik

Artificial Intelligence

DETECT AS II and the Importance of Assertive Notifications

We already know that passive EHR alerts improve severe aortic stenosis management, but the  DETECT AS II study now suggests a more forceful “opt-out” approach could substantially increase how many patients get timely valve replacement.

• Getting eligible patients to AV replacement within 90 days of severe AS diagnosis became an ACC/AHA-endorsed quality measure in 2024.
• This guideline shift created real institutional pressure to close the care gap, something which EHR-based algorithms have tried to improve.

Moving beyond standard passive notifications, DETECT AS II’s investigators built a valve care pathway that automatically screened transthoracic echocardiograms for severe AS findings, then routed alerts to the relevant physician’s EHR inbox.

• The key difference was that physicians could accept or decline a valve clinic referral — but if they didn’t act within two weeks, the patient was automatically referred anyway.

This small adjustment made a world of referral differences…

• The proportion of patients who saw a valve specialist within 30 days or underwent AVR within 90 days jumped from 21.8% before implementation to 47.0% after.

• Valve specialist evaluation within 30 days rose from 15.8% to 39.3%.
• AVR within 90 days climbed from 15.0% to 25.6%.

Perhaps the most important finding is where the benefit landed. The pathway improved care specifically in groups that have historically been undertreated for AS like older patients, women, nonwhite, and Hispanic individuals, and those with low mean gradients.

• That pattern suggests system-level, EHR-based automation may be a scalable way to mitigate long-standing disparities in AS care, a trend also supported by the ALERT trial.

It’s also worth noting that how the physicians responded to the alerts varied sharply by specialty, exposing a cultural divide in how ownership of these patients is perceived.

• Primary care physicians accepted the referral far more often than cardiologists (38.7% vs 16.3%) and declined it far less (19.4% vs 51.2%).
• Roughly a quarter of patients were auto-referred only because no physician acted within the two-week window.
• Cardiologists showed a notable reluctance to hand off patients to an automatic referral system.

The Takeaway

DETECT AS II is the latest EHR integration study to tell us that notifications help close the care gap in aortic stenosis. What makes its results even more important is the fact that a more aggressive notification approach might be what’s needed to truly close that gap.

What Every Cardiologist Needs to Watch for in Heart Failure

Patients with preserved (HFpEF) or mildly reduced ejection fraction (HFmrEF) face a high risk of hospitalization for heart failure and cardiovascular death, even with guideline-directed medical treatment. Hear from Bayer’s Dr. Alanna Morris-Simon as she shares common heart failure signs to look out for.

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 Economics of AI-Assisted HF Diagnosis

As sonographer shortages become more common, so too are diagnostic delays and missed opportunities for early heart failure treatment. Find out how task-shifting LVEF assessment to novice operators using AI-assisted ultrasound is both clinically viable and cost-saving.

The Wire

• Catching Heart Failure in Primary Care: A new study demonstrated that Ventric Health’s Vivio System can non-invasively screen for hidden heart failure at the point of care. The system works by estimating left ventricular end-diastolic pressure (LVEDP) from a pneumatic cuff and single-lead ECG in under five minutes. Across 1.2k high-risk patients, the device achieved a 92.2% conclusive diagnostic rate using a 15-minute workflow run by trained medical assistants. Ventric frames the workflow as a scalable way to catch HF patients before structural damage occurs.

• A Partnership to Crack the U.S. Market: Australian cardiac software developer Echo IQ signed a funding and commercial partnership with imaging firm Pro Medicus worth up to $14M. The deal opens with an initial $7M investment with another $7M available if Echo IQ secures FDA approval for its EchoSolv HF echocardiography-based heart failure assessment platform. Beyond the capital, Pro Medicus’s Visage Imaging subsidiary will become a U.S. reseller of EchoSolv and embed the echo analysis software in its Visage 7 Cardiology PACS platform.

• More Money for Echo IQ: Shortly after the Pro Medicus partnership, Echo IQ raised approximately $76M by issuing 76M new shares. The funds will strengthen Echo IQ’s financial base and support its U.S. commercial expansion, continued rollout of the echocardiography-based EchoSolv platform, and ongoing development of its broader cardiovascular AI platform. This raise also follows FDA clearance for EchoSolv AS, a submitted FDA application for EchoSolv HF, and a partnership with Mayo Clinic.

• Abbott’s Structural Heart Data: Abbott shared new data on three structural heart devices at New York Valves 2026. For its TriClip tricuspid TEER system, 87% of patients saw their TR reduced to moderate or less at 30 days. Meanwhile, Navitor valve registry data showed 98.2% of small aortic annuli patients saw reduced paravalvular leak. Finally, 45-day VERITAS data for the Amulet 360 LAA occluder showed 100% implant success and complete closure rising from 84.3% in roll-in physicians to 96.1% among experienced implanters.

• FDA Greenlights Aortic Stent: The FDA approved Artivion’s AMDS Hybrid Prosthesis grafting stent for Debakey Type I aortic dissection. The company estimates it can help approximately 60% of the 6k U.S. patients who suffer these deadly dissections each year. AMDS’ approval stems from the PERSEVERE U.S. IDE trial which demonstrated a reduction in all-cause mortality (-72%) and major adverse events (-54%) at 30 days.

• Feds Issue Fraud Warning: Federal agencies warned consumers of screening schemes that exploit cardiac arrest fears after a cardiologist was charged with falsely ordering ECGs for college athletes. Students, parents, and schools were told to be wary of aggressively marketed, low-cost screening events that don’t require a doctor’s order or offer a chance to discuss results with a provider. These could indicate a scam to bill insurers for unnecessary or false claims. Suspected fraud can be reported here.

• HF Framework Updated: An AHA/ACC and ESC coalition released the Second Universal Definition of Heart Failure to improve prevention, early detection, and management of HF worldwide. The document proposes a standardized list of HF causes and rejects the current hard LVEF cutoffs for staging the condition. It also establishes three positive HF trajectories — improvement, remission, and recovery — and acknowledges geographic variation in disease risk and outcomes. The work builds on the 2021 universal definition document.

• AI for TTE Quality Control: Researchers have developed an AI tool that performs real-time quality assessments of TTEs with near-total accuracy. In a JASE study, the system agreed with experts on image quality in 95% of test cases (n=1,801) and roughly 92% of the time across three public datasets (n=1,821). Average inference time came in at just 303 ms per video, meaning the technology could improve clinical efficiency and standardize image acquisition, ultimately improving sonographer training.

• DragonFly Spreads Its Wings: Valgen Medtech’s DragonFly TMVR system received another EU approval, this time for use in treating functional mitral regurgitation. This second CE mark comes a year after the tool’s approval for management of degenerative MR, making it the third device of its kind to receive dual clearance. DragonFly has also won clinical victories with one trial reporting an 88% success rate, and more data is sure to come as its functional MR use expands.

• Action Steps for Aortic Stenosis: A new Circulation report on the AHA’s aortic stenosis registry clarifies wins and shortcomings in treating the disease. Among 8k patients, rates of timely diagnosis improved from 54% in 2023 to 61% in 2024. Still, clinical recommendations were given in <10% of cases and timely surveillance was only performed 60% of the time. While there’s still a long way to go in managing AS, having accessible data via the AS registry may help optimize care.

• More Apples, Less Apple Juice: A recent Circulation study revealed that fruits and fruit juices aren’t created equal, and neither are their effects on hypertension. Data from a longitudinal analysis of 25.7k individuals showed that those with the highest intake of fruit juices and sugar-sweetened beverages had a 1.5x higher risk of hypertension than those with low intake. However, whole fruit and total fructose consumption showed no such correlation, highlighting the need to limit sugary drinks for kids, even those with natural sugars.

Relieving The Burden of Post-Processing

With the advent of advanced imaging technologies like CCTA come added burdens to technologists and diagnostic imaging centers. See how PIA can relieve the burden of post-processing, saving you time while helping your bottom line.

A Cardiovascular Ultrasound Platform You Can Trust

Being able to provide premium diagnostic information for your pediatric patients every day, all day, is vital. Find out why cardiac imagers trust Fujifilm’s Lisendo 880, and how its premium imaging quality, efficiency tools, and reliability you can trust, have helped change workflows for clinicians and technologists alike.

Redefining Cardiac Analytics

More data doesn’t equal deeper insight. There’s a fundamental difference between measuring the timing of heart beats and understanding how the heart recovers electrically after each beat. Monebo is using that distinction to define the next frontier of cardiac analytics.

The Resource Wire

• 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 ACUSON Origin customer, Tony Gallagher about how Siemens Healthineers’ cardiovascular ultrasound system is improving exam efficiency and showing positive impact on ROI.

• Merge Cardio 12.5 is Officially Available! From AI-generated echo measurements to upgraded UI and reports, Merge Cardio 12.5 brings a long list of new innovations to the table. Find out more about how Merge Cardio’s latest version streamlines workflows to make your cardiovascular service line more cost-effective and patient-centered. 

• How AI Expands the Role of CMR Experts: If you’re an MRI technologist, AI could be the best thing that ever happened to your career. Read here to learn about the benefits of AI for CMR experts and how it can accelerate both your training and career.

• 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%.

• State-of-the-Art Cardiac Monitoring at Scale: Cleared for 13 different heart rhythm interpretations, AccurKardia’s AccurECG 2.0 shortens the time from an arrhythmia incident to clinical intervention. Watch here to find out how AccurKardia and Specialized Medical are teaming up to bring the AccurECG 2.0 technology to clinicians across the U.S.

The Industry Wire

1. Steve Walsh becomes American Hospital Association CEO.
2. Court dismisses PBMs’ lawsuit against FTC.
3. Marburg outbreak reported in Uganda.
4. ACA enrollment declines by nearly 3M.
5. Wall Street isn’t clear about AI’s insurance payoff.
6. Peptide hype is at an all-time high.
7. 26 states sue CMS over Medicaid work requirements.
8. Coffee may lower liver disease risk.
9. Zelis launches AI solution for NSA disputes.
10. Queue lands $12.6M for robotic pharmacy kiosks.