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Cardiac Rehab, LAAC Data, and More Diagnostic AI
By Viktor Zarev, Virginia Hunt
October 8, 2026
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Together with
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“I predict that AVR with TAVR removal will become the new CABG on previously stented patients and the number of surgical AVR will re-surge in the years to come. However, the outcomes will worsen because of technical challenges and surgeons’ lack of open training.”
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George Tolis, MD
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Well folks, it’s about that time of year where I run away into the woods for a bit. Don’t worry though, Monday’s issue of Cardiac Wire is a special one — 0ur very own Writer and Editor, Virginia Hunt taking the reins.
She’s as brilliant of a scientific analyst as she is a writer, so I imagine y’all won’t miss Vik too much.
Thank you for reading, and I’ll catch y’all next Thursday.
– Viktor (Vik) Zarev, Senior Editor
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Cardiac rehabilitation is already proven to help patients who survive a myocardial infarction, but a new JACC study suggests that type 2 MI patients are referred for rehab far less often than type 1 MI patients, even if the patients themselves would gladly go.
- Type 1 MIs are far more common (75-85% of MIs) and happen when a blood clot forms in the coronary artery.
- However, type 2 MI (supply-demand mismatch) carries higher all-cause mortality than type 1, largely due to comorbidities like CKD, COPD, and cancer.
- Thus, type 2 MI patients typically receive less overall cardiac care, since they’re usually someone else’s patient before a cardiologist sees them.
But a heart attack is a heart attack, and proper rehab after both type 1 and 2 is critical for recovery. To determine the rehab referral rate for type 2 patients compared to type 1, MGB researchers paired a survey of 118 clinicians with one of 50 inpatients who had a type 2 MI and found…
- Only 30% of clinicians said they “always” or “often” refer patients to rehab after type 2 MI.
- Meanwhile, 80% said they refer to rehab after type 1 MI (a substantial 50-point gap).
- Fewer clinicians perceived cardiac rehab as beneficial for type 2 MI (69% vs. 98%).
- Curiously, most clinicians still rated cardiac rehab safe for both MI types (93% vs. 99%).
That means the rehab referral gap is both significant and clinician-driven. The good news is that the study also looked at what causes these referral barriers, and it’s more about knowledge gaps than safety.
- The top reason clinicians listed for not referring type 2 MI patients was lack of awareness of their rehab eligibility (35%), followed by patient preference and comorbidities.
- Moreover, roughly 1 in 5 clinicians said they were unfamiliar with the referral process for type 2 MI, while nearly a quarter wanted more evidence that rehab helps these patients.
Speaking of patients, researchers surveyed type 2 MI patients as well, finding that perspectives on undergoing cardiac rehab are overwhelmingly willing.
- 90% believed rehab would benefit their health.
- 80% felt it would make returning to activity safer
- 82% said they’d likely attend if referred.
- Notably, home-based (54%) and hybrid (50%) rehab formats were preferred over in-person.
The Takeaway
With both evidence and guidelines backing cardiac rehab for the two types of MI, this study clarifies that it’s more of an educational barrier than a safety one that decreases type 2 MI patient referrals. With more data and better messaging, this trend could change.
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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.
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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%.
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- Caring for Clinicians: Patients and visitors are common sources of mistreatment for physicians, with a disproportionate burden of harassment falling on women or racial and ethnic minorities. The ACC is trying to give cardiologists, nurses, and clinicians resources to diffuse these situations through its new Cardio Safe online-learning program. Supported by funding from The Physicians Foundation, the five-module course includes deescalation tactics and bystander intervention strategies to handle aggressive or disrespectful encounters. The ACC’s website will also feature a resource hub and other opportunities.
- HeartBeam Named Breakthrough: HeartBeam’s at-home heart attack detection device has been given breakthrough status by the FDA. This nod comes months after the company published data showing that the 12-lead ECG system halved physicians’ false-positive rates while maintaining strong sensitivity, potentially preventing unnecessary ER trips. As HeartBeam is moving towards a crucial study for the device, the Breakthrough Device Designation allows prioritized review of those results and a streamlined pathway to Medicare coverage.
- Isometric Work Improves BP: Holding a plank or a wall sit a few times a week could be enough to lower blood pressure. Among 100 participants with normal to high blood-pressure who underwent isometric training 3x/week for a month and then 0x, 1x, 2x, or 3x weekly afterward, all groups had significant reductions in systolic and diastolic blood pressure. These results held through the maintenance phase, especially for those keeping up the 3x/week pace, whereas the benefits reversed in the group which paused the exercises completely.
- AI-ECG & Tricky Heart Attacks: A new post-hoc analysis of the ROMIAE study suggests that an AI-ECG developed by South Korea’s Medical AI Co. is capable of detecting NSTEMI despite the condition’s lack of obvious ECG changes. Across the study’s 944 NSTEMI and 6,907 non-AMI patients, the AI-ECG tool maintained sensitivity (99.4%) across the diagnostically challenging MI subgroups. However, its ability to rule-out MI diminished when patients presented with prior MI, AFib, or left bundle branch block.
- Plaque Composition and Preventive PCI: Which matters more – plaque morphology or composition? A deeper look at the PREVENT trial suggests it’s the former. Researchers analyzed 598 patients whose scans showed non-flow-limiting lesions, finding that those with lipid-rich plaque lesions faced higher event rates (12.5% vs. 4.7%). Within that group, preventive PCI significantly reduced the composite rate of cardiac death, MI, revascularization or hospitalization compared to medical therapy alone (7.3% vs. 17.6%). Meanwhile, researchers found no benefit to using PCI when patients had non-lipid-rich plaques.
- CardioMEMS Shows Patients Their Data: Abbott received FDA approval for updates to its CardioMEMS HF System that, for the first time, let U.S. patients view their pulmonary artery pressure readings on their smartphones. The readings are now delivered through the CardioGuide HF App and the newly approved update includes the Dynamic Treatment Plan feature which lets clinicians send personalized medication adjustment instructions directly to patients based on pressure changes. Mounting evidence suggests showing patients their data can have a powerful impact on treatment adherence.
- A Watchman Study Under Scrutiny: The publisher of EP Europace is currently investigating a paper from May of 2026 about Boston Scientific’s Watchman FLX device due to some fishy registration details. Apparently, someone uncovered that the study’s listed clinical trial registration number corresponds to an unrelated ablation study, not the device trial described. The cited registration also labels the study retrospective, while the paper claims it was prospective. Critics, including electrophysiologist John Mandrola, MD, fault the authors and reviewers for poor attention to detail while questioning the study’s rigor.
- Reframing LAAC’s Role: Speaking of the WATCHMAN device and LAAC, a new Stroke meta-analysis argues that the procedure is better for stroke prevention than oral anticoagulation. Researchers pooled data from six randomized trials (7,028 patients), including the two major 2026 trials and found that overall stroke rates were similar between arms, but ischemic stroke was more frequent with LAAC (OR: 1.41), while nonprocedural bleeding was lower (OR: 0.58). However, LAAC’s bleeding benefit held steady in standard-risk and postablation patients but not high-bleeding-risk ones.
- Bunkerhill’s AVC Validation: Adding to CT’s utility in valve interventions, new research validated Bunkerhill’s AVC deep learning algorithm, proving it can quantify aortic valve calcification from nongated, noncontrast CT. Tested on 239 patients, the algorithm correlated nearly perfectly with radiologist reference standards (r = 0.99) and detected high calcium burden tied to moderate-to-severe AS with 92% sensitivity and 98% specificity. With nearly 20M chest CTs done annually in the U.S. an algorithm like this could enable opportunistic aortic stenosis screening on scans.
- Semaglutide’s HF Impact: Adding to the evidence behind semaglutide’s non-weight loss related CV benefits, a recent rat study suggests the drug improves cardiac function in HFpEF. By giving rats and other animals with HF GLP-1 doses that didn’t induce weight loss, researchers found that the drug improved diastolic function (cutting LVEDP ~60% in rats), reduced hypertrophy and fibrosis, and shrank ectopic fat depots. Protein and genome analysis traced the benefits to suppressed pro-fibrotic signaling and boosted fatty acid oxidation in cardiomyocytes, suggesting GLP-1s may help HFpEF through cellular mechanisms.
- Cognition and Stroke: We’ve heard a lot recently about frailty and cardiovascular outcomes, and new data suggests there’s also a link between cognitive decline and stroke risk. A Swedish longitudinal study of 4.9k older adults found that those in the lowest perceptual speed category faced higher stroke risk (HR: 1.40). This risk was most pronounced in people aged 60-69, where low global cognition (HR: 1.86), episodic memory (1.68), and perceptual speed (1.66) all predicted stroke.
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Most Health Systems Have Deployed AI. Few Have Scaled It.
75% of health systems have deployed GenAI, yet only 4% report scaled implementation with measurable outcomes (Becker’s 2026). Cardiology shows the difference: HCM diagnosis in about three months versus 2 to 5 years, and pre discharge ILR placements up from 3 to 51. Join Viz.ai CMO Tim Showalter, MD on October 22 to hear what it takes. Register now.
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How to Operationalize and Scale a New CV Service Line
Advances in AI, imaging, and coronary CT are creating new opportunities for cardiovascular care. Explore this Frost & Sullivan Executive Brief for the key things to consider when establishing a coronary plaque service line—from choosing your delivery model to integrating AI cardiovascular imaging workflows and capturing reimbursement value.
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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.
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- 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.
- VASCADE MVP® XL Vascular Closure System: Sometimes EP procedures call for a venous vascular closure system that is simply bigger. Haemonetics’ VASCADE MVP XL closure system comes with 58% more collagen and a 9% larger disc compared to the VASCADE MVP system as well as an expanded indication for utilizing 10-14F inner diameter sheaths.
- Pulmonary Hypertension Detection With a Single Echo Clip: Pulmonary hypertension is often diagnosed late, when irreversible vascular remodelling has already occurred. That’s changing, however, with Us2.ai’s spatiotemporal transformer technology that can process apical four-chamber echo and accurately detects pulmonary hypertension far beyond the single-view echocardiographic benchmark.
- The EP-Heart Failure Collaborative Model: Cardiac contractility modulation therapy can significantly benefit heart failure patients who don’t receive CRT, with no extra training needed for EPs. Hear how Daniel A. Steinhaus, MD and Timothy J. Fendler, MD combined their HF and EP programs to better identify and serve the patients who need CCM.
- Integrating AI for Enhanced Echo: Sometimes it pays dividends to be an early adopter. Find out how the Christ Hospital’s early evaluation of Merge Cardio 12.5 allowed for remote echocardiography measurements, enhanced reporting accuracy, and a seamless user experience, bringing even greater efficiencies and clinical confidence.
- Circadian Rhythms Revolutionize Cardiac Monitoring: Understanding a patient’s natural circadian rhythms can reveal deeper insights during cardiac monitoring. Find out how Monebo’s monitoring approach provides a visual representation of heart rate, cardiac muscle relaxation, and QT-RR throughout the circadian cycle.
- 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.
- Canon’s 30 Years of Caring: For over 30 years, Canon has helped advance pediatric interventional cardiology through innovation and a commitment to better care. Learn more about how and why modern pediatric cardiac angiography came to be from one of its founding members, Dr. John P. Cheatham.
- ALL‑RISE Trial Results Are In: The CathWorks FFRangio™ system met noninferiority to wire-based physiology for MACE at one year with statistically significant improvement in resource utilization and reduced procedure time. CathWorks FFRangio™ system is the new standard in coronary physiology. See the ALL-RISE data. The information provided by the CathWorks FFRangio™ system is intended to be used by a qualified clinician in conjunction with the patient’s clinical history, symptoms, and other diagnostic tests, as well as the clinician’s professional evaluation. Source: Fearon et al. NEJM 2026. doi: 10.1056/NEJMoa2600949
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