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Cardiovascular diseases are the leading cause of death globally and contribute significantly to the cost of healthcare. Artificial intelligence (AI) is poised to reshape cardiology. Using supervised and unsupervised learning, the two main branches of AI, several applications have been developed in recent years to improve risk prediction, allow large-scale analysis of medical data, and phenotype patients for personalized medicine. In this review, we examine the key advances in AI in cardiology and its limitations regarding bias in the data, standardization in reporting, data access, and model trust and accountability in cases of error. Finally, we discuss implementation methods to unleash AI's potential in making healthcare more accurate and efficient. Several steps need to be followed and challenges overcome in order to successfully integrate AI in clinical practice and ensure its longevity., (© 2022. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.)

Objective: Evaluate the impact of 82-Rubidium positron emission tomography (PET) myocardial perfusion imaging (MPI) availability on patient management presenting at the emergency department (ED) with chest pain (CP)., Methods: This is a single-center retrospective study of clinical databases. Patients presenting with CP with a non-definitive suspicion of acute coronary syndrome (ACS) at the ED between April 2016 and February 2020 were divided into 2 groups based on PET availability. The proportion of invasive coronary angiography (ICA) without significant coronary artery disease (CAD), length of stay (LoS), and additional downstream testing were evaluated., Results: There were 21,242 ED visits for CP without definitive ACS: 5,492 when PET is not available and 15,750 when PET is available. When PET is available, proportion of patients undergoing a MPI study was greater (20.7% vs 17.6%, P<0.0001), proportion of ICA without significant CAD was similar (18.5% vs 21.4%, P=0.24), and median ED LoS was shorter (16.6 vs 18.1 hours, P=0.03). Patients undergoing SPECT MPI had significantly more downstream testing (8.9% vs 6.4%, P=0.003) and a higher rate of coronary angiogram without significant CAD (21.2% vs 14.2%, P=0.09) compared to those who underwent PET MPI., Conclusion: Availability of PET MPI was associated with an increased number of MPI referral from the ED, similar rates of ICA without significant CAD, decreased LoS, and fewer downstream testing., (© 2022. The Author(s).)

Purpose: Spine cryoablation (SC) of posterior vertebral lesions exposes to neuronal damages and incomplete treatment due to the proximity of the spinal canal. Carbon dioxide (CO 2 ) dissection is a nerve protective method that can be used during spine cryoablation that tends to distribute in non-dependent areas. The purpose of this technical note was to expose the feasibility of anterior epidural CO 2 dissection during SC in prone decubitus., Materials and Methods: Three consecutives patients underwent SC of metastases abutting the posterior wall of the vertebra with anterior epidural CO 2 dissection. A post-ablation MRI was performed after each cryoablation to state if the treatment was complete or incomplete. Complications were reported using the Common Terminology Criteria for Adverse Events v5.0 (CTCAE)., Results: Peri-procedural anterior epidural injection of CO 2 was successful in all 3 procedures. Treatment was considered complete on all post-ablation MRI with ablation margins encompassing the targeted metastasis. No complication according to the CTCAE was reported., Conclusion: CO 2 dissection of the anterior epidural space was successful in all 3 procedures allowing complete treatment on all post-ablation MRI., (© 2021. Japan Radiological Society.)

Purpose of Review: With the rising cost of cardiovascular clinical trials, there is interest in determining whether new technologies can increase cost effectiveness. This review focuses on current and potential uses of voice-based technologies, including virtual assistants, in cardiovascular clinical trials., Recent Findings: Numerous potential uses for voice-based technologies have begun to emerge within cardiovascular medicine. Voice biomarkers, subtle changes in speech parameters, have emerged as a potential tool to diagnose and monitor many cardiovascular conditions, including heart failure, coronary artery disease, and pulmonary hypertension. With the increasing use of virtual assistants, numerous pilot studies have examined whether these devices can supplement initiatives to promote transitional care, physical activity, smoking cessation, and medication adherence with promising initial results. Additionally, these devices have demonstrated the ability to streamline data collection by administering questionnaires accurately and reliably. With the use of these technologies, there are several challenges that must be addressed before wider implementation including respecting patient privacy, maintaining regulatory standards, acceptance by patients and healthcare providers, determining the validity of voice-based biomarkers and endpoints, and increased accessibility., Summary: Voice technology represents a novel and promising tool for cardiovascular clinical trials; however, research is still required to understand how it can be best harnessed., Competing Interests: Conflict of InterestA.S. reports receiving support from the Fonds de Recherche Santé Quebec (FRSQ) Junior 1 clinician scholars program, Alberta Innovates Health Solution, European Society of Cardiology young investigator grant, Roche Diagnostics, Boeringer-Ingelheim, Novartis, and Takeda. All authors declare no conflicts of interest., (© The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature 2021.)