Andrew J. Sauer, MD

Cardiac Wire has been cooking lately, and we’re proud to say there’s something for everyone on the way. For our ultrasound lovers, I recently spoke with Connie Casey about the exciting new innovations Fujifilm is making in CVUS.

Then for our fans of cardiac CT, we’ve got a star-studded webinar on the way with Dr. Matthew Budoff and Dr. Jonathon Leipsic, covering how much the modality matters for valve disease and beyond (August 19th at 1:00pm ET).

And finally, if you love the deeper bioscience behind cardiology, Cardiac Wire has a new sister publication called The Bio Wire, written by the jaw-droppingly talented Jack Troy.

Thank you, as always, for reading,

Vik

Cardiology Business

iRhythm Expands MCT Footprint with VitalConnect Acquisition

iRhythm, best known for its Zio cardiac monitoring wearables, is moving to expand well beyond its 14-day-patch roots by acquiring wearable biosensor company VitalConnect for $287.5M.

• The deal breaks down into roughly $237.5M in cash with about $50M in iRhythm stock and is expected to close by the end of 2026.
• It’s one of the bigger monitoring acquisitions in recent years, with RPM having grown into a multi-billion dollar market since the first CPT codes in 2019.

iRhythm’s strategic logic is about widening what it can monitor and where. VitalConnect’s FDA-cleared monitoring platform already spans several cardiac modalities plus multi-vitals capabilities built for hospital and remote-care settings.

• This, in turn, extends iRhythm’s reach across the continuum of care by adding mobile cardiac telemetry (MCT), a large and growing RPM category, to Zio’s portfolio.
• Moreover, VitalConnect’s biosensor platform can track up to 11 physiological parameters, pushing iRhythm into inpatient and hospital-to-home segments.

iRhythm is framing this acquisition as complementary, not redundant. Rather than replacing its flagship Zio, the company positions VitalConnect as filling gaps Zio doesn’t.

• Since ambulatory monitoring isn’t one-size-fits-all, clinical needs, workflows, and patient preferences vary, and different use cases call for different monitoring models.
• The combination is meant to give clinicians more choice across settings through iRhythm’s commercial scale, while accelerating VitalConnect’s growth.

The move comes at a time when education is key. Though MCT and the broader RPM category have shown immense potential for arrhythmia detection and post-stroke or post-ablation monitoring, the cardiology community has been slow to adopt it.

• Hurdles like clinical workloads, EHR integrations, and overall process complexity act as an adoption barrier for iRhythm and VitalConnect’s technologies.
• So while this expansion is a big move for iRhythm, it will still have to work to convince cardiologists that the juice is worth the squeeze.

The Takeaway

Acquisitions can be a sign of a maturing market, and in the case of iRhythm’s RPM model, bringing VitalConnect into the fold makes perfect sense. Whether or not the expansion into MCT will pay off is a matter of physician perception.

AHA Scientific Sessions Discussion: Heart Failure Treatment Developments and Impact on Women

Women with heart failure with preserved and mildly reduced ejection fraction (HFpEF and HFmrEF, respectively) often present with different symptoms than men, leading to underrecognition. Moreover, the incidence of HFpEF in women is increasing more than in men. Watch Dr. Martha Gulati discuss prevalence and changing treatment options.

Staying ALERT with Tempus

Undertreatment and time to treatment of valvular heart disease are among the biggest challenges health systems face today, but Tempus’ AI-driven EHR notifications can change that. Read the results of Medtronic and Tempus’ ALERT trial which found that delivering data directly to providers resulted in a 40% relative increase in life-saving valve procedures.

From Fetal to Adult Cardiovascular Ultrasound

Continuity of care is critical when it comes to a patient’s cardiovascular health. That’s why cardiologists across America are picking Fujifilm’s Lisendo 880 cardiovascular ultrasound for its versatility and precise imaging starting at a patient’s fetal development to adulthood.

The Wire

• Closing a Gap in Coronary Imaging: New research in JSCAI found that quality-improvement initiatives dramatically increase the use of intracoronary imaging during PCI, while potentially narrowing one of the procedure’s long-standing sex-based gaps. As part of a BCBS of Michigan initiative, ICI-guided PCI in women jumped from 7.0% in 2019 to 54.2% in 2024, mirroring the rise in men (7.3% to 56.0%). While the improvement in care equality is commendable, it’s still uncertain how much of a benefit ICI provides following recent trials like OPTIMAL and IVUS-CHIP.

• ACOs Boost Preventive Heart Care in Medicaid: A JACC report suggests that Medicaid accountable care organizations (ACOs) can strengthen preventive cardiovascular care for low-income adults. Comparing data from Massachusetts and Rhode Island, which launched broad Medicaid ACOs, against New York as a control, researchers found that ACOs led to larger gains in statin use across every high-risk condition, ranging from +8.8 percentage points for stroke/TIA to +12.2 for hyperlipidemia. They also posted greater increases in antihypertensive use (+10.1 points) and in lipid testing for diabetes and CAD.

• IQVIA Backs Medera’s Gene Therapy: Clinical research giant IQVIA and clinical-stage biopharma Medera announced a collaboration to accelerate cardiac gene therapy development. The deal pairs IQVIA’s clinical trial and commercialization infrastructure with Medera’s two platforms: (1) Sardocor, which focuses on gene therapies for cardiovascular diseases, and (2) Novoheart, which uses engineered cardiac tissue for disease modeling and drug screening. Sardocor will tap IQVIA’s regulatory expertise to advance its AAV-based gene therapy programs while Novoheart will work to expand into other organ systems under the FDA Modernization Act 2.0.

• Buying a Fast Pass for Plozasiran: Arrowhead Pharmaceuticals acquired an FDA Rare Pediatric Disease Priority Review Voucher (PRV) from an undisclosed third party. The PRV will be used to support its upcoming supplemental new drug application for plozasiran, as the company aims to expand the drug’s approved indication to include patients with severe hypertriglyceridemia. The voucher secures a Priority Review, which accelerates the FDA’s action timeline to roughly six months versus 10 under standard review.

• A $180M Gift for a Texas Heart Institute: The Sealy & Smith Foundation committed more than $180M to advance cardiovascular care at the University of Texas Medical Branch (UTMB). The donation marks UTMB’s largest philanthropic investment in its history and is among the largest ever to a cardiovascular institute at a U.S. academic medical center. The funds will help expand UTMB’s Sealy Heart & Vascular Institute while backing a major buildout on the Galveston campus, including an inpatient cardiovascular hub, an outpatient cardiovascular medicine center, and new research and educational spaces.

• A Dual-Energy Catheter Reaches the Ventricle: Expanding its competitiveness in the ablation market, Medtronic received an expanded CE Mark for its Affera Mapping and Ablation System with the Sphere-9 Catheter for treating ventricular arrhythmias. The new coverage includes ventricular tachycardia (VT) and premature ventricular complexes (PVCs), making the Sphere-9 the first all-in-one mapping and ablation, dual-energy catheter CE marked for ventricular ablation. In parallel to the CE mark, the FDA granted the catheter Breakthrough Device Designation for ventricular arrhythmias.

• A Minimally-Invasive Choice for CABG: Cutting between the ribs instead of along the sternum may make recovery from coronary artery bypass grafting easier, per a new The Lancet study. Data from 170 patients showed physical component scores were nearly three points higher for patients who underwent small thoracotomy compared to sternotomy after one month. Another plus: Safety results were equal for both groups after a year. The authors recommend clinicians consider this less invasive option for improved patient comfort and recovery. 

• Slower Inflation = Better Outcomes: For patients undergoing coronary intervention with drug-coated balloons, a new JAHA article shows it may be better for the procedure to take longer. Among 1.2k Swedish patients who underwent balloon inflation either <30 or ≥30 seconds, those who had longer inflation times were half as likely to have revascularization after a year. Prolonged inflation was also associated with a 68% reduction in risk of heart attack stemming from the coronary artery of interest.

• Cognitive Benefits of AFib Ablation: Taking a closer look at patients who underwent catheter ablation for AFib revealed that the procedure isn’t just cognitively safe, it might even slightly boost brain health. A JAMA study among 75 patients found those who underwent ablation had a 2.81 point improvement in the 202-point R4Alz neurological assessment. Short-term memory and perceptual inhibition were especially enhanced after six months compared to the control group, as were scores on the Montreal Cognitive Assessment.

• Who’s Keeping Sonographers Safe? The American Society of Echocardiography is trying to protect sonographers with the release of a new guideline. Up to 90% of cardiac sonographers experience musculoskeletal disorders related to their work, which often requires long hours in awkward positions. Recommendations include leveraging AI to automate some tasks, as well as policies like “buddy scanning,” which split a scan’s physical load. The authors emphasize that fixing the problem requires a multi-pronged effort with help from health systems and tech manufacturers.

• A Long-Term Look at TAVR Versus SAVR: A JACC study reveals the TAVR-SAVR battle is looking like a tie when it comes to endurance. Among 943 patients, those who underwent TAVR had better health status after a month (+16.7 points), but that gap dwindled by two years (+1.9 points). Then, SAVR caught up. Results were even from years three to seven, with 60% of patients in both groups showing excellent results. This builds upon recently published 10-year data that showed variability in how valves age.

How to Streamline Your Reporting Process

Like many medical centers, Baystate lacked a single cardiovascular database to streamline the documentation process and ensure accuracy. Read this Optum case report to learn how Baystate improved its percentage of unsigned charges within a 5-day window from a high of 89% to under 10%.

The Benefits of Outsourced Post-Processing

Using an outsourced cardiac image post-processing solution doesn’t have to mean sacrificing control of the results. Discover how PIA’s customizable post-processing workflow can help you get the most out of your images.

Telemedicine Isn’t About Technology. It’s About People.

With temporary telehealth rules expiring, millions of Medicare patients may lose their ability to see their doctors remotely. Read why Monebo and the Alliance for Connected Care are urging Congress to make telemedicine a permanent part of the healthcare system.

The Resource Wire

• How Automated MRI Software Transformed Radiology Regional: Radiology Regional recently integrated automated MRI scanning software into their imaging practice imaging. Hear from their team how automating CMR scans transformed their practice and enhanced patient care.

• 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. 

• 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.

• 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. 

• 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%.

The Industry Wire

1. FDA approves first mRNA flu vaccine.
2. Senate committee votes to hold Fauci in contempt.
3. Lab-leak proponent in line to take Fauci’s previous job.
4. What China knows about COVID-19’s origins.
5. Michigan nurses track down origins of cyclosporiasis cases.
6. FDA approves twice-rejected melanoma drug. 
7. Merger of pharma giants seen as “unlikely.” 
8. Philips forms partnerships around wearable devices.
9. Fight erupts in Washington, DC, over opioid settlement money. 
10. GLP-1 users are spending less on groceries.