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You won’t believe how quickly the field of cardiology evolved over the past year. From physiology-guided PCI and next-generation stent platforms to pulsed-field ablation, subcutaneous ICDs, remote heart failure monitoring, and a new era of lipid and lipoprotein therapy — 2025 delivered some of the most practice-changing evidence we’ve seen in decades. In this annual clinical update, Dr. Anuj Shah breaks down what clinicians need to know heading into 2026, including: • Why physiology-guided complete revascularization is now the default strategy in multivessel disease • How radial access, lithotripsy, IVUS/OCT, and thin-strut DES are reshaping modern PCI • The durability of TAVR and the rapid rise of transcatheter mitral valve therapy • Why pulsed-field ablation and conduction-system pacing are redefining electrophysiology • How subcutaneous ICDs are reducing long-term device complications • The growing impact of remote pulmonary artery pressure monitoring in heart failure • And why PCSK9 inhibitors, oral PCSK9 therapy, RNA-silencing drugs, and gene editing may permanently change lipid and Lp(a) management Last year’s innovations weren’t trends — they were the foundation. This year’s trials show how powerful those tools become when fully integrated into modern cardiovascular care. At Apex Heart & Vascular, the mission is simple: Turn this evidence into immediate, real-world benefit for patients. Welcome to cardiology heading into 2026. 🫀📊⚡