[Cardiology 2030]

This is a summary of a few of the recent innovations in cardiology that affect our practice. In the area of cardiac intensive care, recent developments included the use of AI algorithms to improve multi-modality monitoring, thus improving patient safety. The use of robots in Coronary Care Units (CCUs) and the extensive use of mechanical support are also some of the major breakthroughs in intensive care cardiology. The area of cardiac interventions is characterized by procedures performed in octogenarians and nonagenarians, including coronary interventions in heavily calcified coronary arteries, and valvular interventions of various kinds. In the field of arrhythmia, there was a recent entrance of new energies for ablation, especially the pulsed field ablation, based on non-thermal electroporation, that is less destructive to the surrounding tissue and is therefore safer to the patient. Another breakthrough is the wide adoption of conduction system pacing which paces the heart in a physiological mode that decreases the long-term damage of pacing to the function of the heart. Another new trend in pacing is the use of small leadless pacemakers that are implanted directly into the heart by an interventional technique via the femoral vein. Innovations in imaging include the increased use of 3-dimensional echocardiography as well as strain echocardiography that increases sensitivity to specific conditions such as drug effects and cardiomyopathy. The new photon counting CT technology improved the quality of CT imaging considerably. Heart failure treatment has improved significantly over recent years, with special emphasis on the use of mechanical support for bridging and destination treatments. This is just a partial list of the great advances that have happened in the field of cardiology.