Attending the American College of Cardiology 75th Annual Scientific Session in New Orleans reaffirmed what I have come to cherish over more than 20 years at this meeting: the collegiality, the exchange of ideas, and the privilege of learning alongside colleagues from across the U.S. and around the world is priceless.
This year's scientific program was record-setting, with more than 10,000 abstract and case submissions. Over 60 clinical trial presentations spanned seven Late-Breaking Clinical Trial sessions, five Featured Clinical Research sessions, and three Investigative Horizons sessions. Results from HI-PEITHO, CHAMPION-AF, VESALIUS-CV, and others are poised to shape guideline updates and clinical practice for years to come. Our team was also privileged to present our own institution's research findings on cardiology's international stage, a highlight for all of us.
Yet what made ACC.26 feel genuinely different from prior meetings was not the record volume of submissions. It was the unmistakable signal that cardiology has reached a turning point in its embrace of artificial intelligence. AI has moved from buzzword to bedside. Outside of radiology, cardiology now holds the second-highest number of FDA clearances (more than 200) for AI algorithms used in direct patient care. The meeting's opening showcase set the tone with a live demonstration of "Ask Artie," an AI assistant integrated directly into the ACC.26 conference app.
The most defining theme of the meeting was a decisive shift: the field is no longer asking whether artificial intelligence belongs in cardiology, but how to implement it responsibly. The AI Intensive sessions, the Louis F. Bishop keynote, and the Douglas P. Zipes, MD, MACC, Distinguished Young Scientist Award Keynote were not forecasts of what AI might one day do. They were practical, immersive sessions offering actionable strategies for integrating AI into clinical workflows, scaling solutions within health systems, and most importantly, building clinician trust.
Sessions like "From Code to Clinic: AI Transforming Cardiac Imaging" reflected a welcome maturity. We are past the honeymoon phase. The field is now wrestling seriously with algorithmic bias, data governance, reimbursement, and the preservation of the physician-patient relationship in an era of automated decision support. AI-driven ECG interpretation and echocardiographic analysis are already changing how we screen, diagnose, and risk-stratify patients. The central question is no longer if we use these tools, but how we ensure that clinical judgment remains the final arbiter, while leveraging AI's ability to extract deeper patterns from physiologic and imaging data that even experienced clinicians might otherwise miss.
One of the most important takeaways, in my view, was the emphasis on oversight. Technology will always outpace regulation. It falls to us as clinicians to insist on transparency, validation, and equity in every AI tool that touches patient care. ACC.26 provided the vocabulary and evidence base to have those conversations with hospital administrators, IT departments, and patients alike.
I leave New Orleans energized. The city's unparalleled culinary heritage and cultural richness made for an ideal backdrop to reconnect with colleagues, mentors, and friends over beignets and gumbo between sessions. More importantly, ACC.26 reinforced my belief that cardiology is entering its most dynamic era. The integration of AI, the explosion of clinical trial data, and the growing emphasis on multidisciplinary care are reshaping our landscape in real time.
Our responsibility as clinicians is to remain engaged, critical, and patient-centered as we navigate these changes. I am more convinced than ever that the future of cardiovascular medicine is extraordinarily bright so long as we remember that the most powerful algorithm in the room is still the one between a physician and their patient.
Dr. Makaryus has no conflicts of interest to report.
Animation by Diana Connolly
