What is the one pharmaceutical, device or other technology in the pipeline today that you are most eager for, and why?

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The recently reported CANTOS trial represents an enormously important development in cardiovascular medicine. For the first time, an anti-inflammatory drug (canakinumab) given by injection every three months has been shown to reduce morbidity and mortality. Trial entry criteria required a hsCRP level >2 mg/L and stable coronary heart disease. The 150-mg dose reduced the risk of nonfatal myocardial infarction, stroke and cardiovascular death by 15 percent with no effect on lipids. These benefits were observed in patients already treated with the best available therapies, including high-dose statins and antiplatelet drugs. The importance of these findings extends far beyond the CANTOS trial. Now that we know that treating inflammation can reduce cardiovascular morbidity and mortality, the search for other anti-inflammatory regimens can proceed with the high likelihood of successful clinical trials.

Steven E. Nissen, MD

Chairman, Department of Cardiovascular Medicine, Cleveland Clinic Foundation; Professor of Medicine, Cleveland Clinic Lerner School of Medicine at Case Western Reserve University

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The device currently in development that I am most eagerly anticipating is the Heart Light (Cardiofocus). This technology is potentially disruptive to the field of ablation as we know it, in that it could potentially provide several advantages over existing tools in the current marketplace. This new tool could reduce the procedure time as compared to conventional radiofrequency ablation and possibly even cryoballoon technology as well. More important, the operator could directly visualize the pulmonary veins and titrate the strength of the laser to achieve a thorough, uniform lesion around the pulmonary veins. Given that atrial fibrillation affects millions of Americans, and currently has about a 70 percent success rate at two years, it will be interesting to see how this new tool will affect things.

Yasser Rodriguez, MD, MBA

Clinical Fellow in Cardiac Electrophysiology, Brigham and Women’s Hospital, Harvard Medical School, Boston

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I am most interested in the application of artificial intelligence (AI) to cardiology. Although most efforts have thus far focused on disease or event prediction, where AI may be most useful is in assisting clinicians to do things that can be laborious, cumbersome or prone to error. Examples include assisting with interpretation of ECG and holter, intracardiac tracings in the electrophysiology lab (PVC, VT localization, mechanism) such as device tracings and semiautomated interpretation of cardiovascular imaging (echocardiography, angiography, nuclear scintigraphy).

Mintu Turakhia, MD, MAS

Associate Professor of Medicine, Stanford University; Executive Director, Stanford Center for Digital Health; Director of Cardiac Electrophysiology, VA Palo Alto Healthcare System