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ACC 2026 Late-Breaking Trials
Live trial results, expert commentary, and discussion with 10+ trial authors
Research Feed
Pulsed Field Ablation Versus Sham to Treat Atrial Fibrillation: The PFA-SHAM Randomized Clinical Trial
PFA markedly outperforms sham for AF recurrence and QoL; confirms ablation benefit beyond placebo in symptomatic patients.

Pulsed Field Ablation as Initial Therapy for Persistent Atrial Fibrillation
Supports first-line PFA over AADs in persistent AF; challenges guidelines mandating drug trial first and extends paroxysmal AF evidence.
“These findings have implications for clinical practice, for guidelines, and for insurance coverage because “there’s a lot of people that are dissuading us from doing persistents because it’s lower yield,” Tung said.”

Prescribe physical activity for cardiometabolic gains irrespective of weight loss; extends evidence for multimodal obesity management.

Supports women's heart centre implementation to reduce sex-based care gaps; extends consensus on specialized pathways and training.

Angiotensin Receptor Neprilysin Inhibitor in Heart Failure with Preserved Ejection Fraction and Secondary Mitral Regurgitation: the PRAISE-MR Randomized Trial
Supports sacubitril/valsartan over SOC in HF with adverse exercise hemodynamics; extends prior ARNI trials to this invasive endpoint.
“The PRAISE-MR trial is the first prospectively randomized trial to demonstrate that sacubitril/valsartan significantly improves exercise hemodynamics, functional capacity, and quality of life in patients with HFpEF and AFMR. These findings underscore that the phenotypic heterogeneity of HFpEF nec...”

Adverse Effects and Treatment Discontinuation of Blood Pressure–Lowering Drugs and Combinations
CCBs raise and ARBs lower adverse-event discontinuations versus placebo; extends class-specific tolerability data to inform initial antihypertensive selection.
“Results from the study by Wang, et al., can help inform clinicians' selection of antihypertensive therapies for patients initiating medications for hypertension, particularly when comorbidities, such as the presence of diabetes with microvascular disease, do not warrant a specific therapy.”

Finerenone Across Cardiovascular-Kidney-Metabolic Syndrome Stages
Supports finerenone across CKM stages in T2D-CKD; extends prior RCTs to include syndrome regression.
“Importantly, participants who experience new-onset AFib/AFL were at a substantially higher subsequent risk of adverse cardiovascular and kidney outcomes than were those who remained free of AFib/AFL during follow-up. These findings highlight the role of finerenone in reducing the risk of new-onset AFib/AFL, mitigating downstream complications, and ultimately improving outcomes in patients across the CKM spectrum.”

Precardioversion Heart Rhythm Monitoring Using Smartphone Photoplethysmography
Reduces same-day cancellations and resource waste in AF cardioversion; extends smartphone photoplethysmography evidence to preprocedural monitoring.

Subcutaneous Defibrillator Implantation With or Without Defibrillation Test: The Primary Results of the Randomized PRAETORIAN-DFT Trial
Supports PRAETORIAN-guided omission of routine DFT in S-ICD patients; confirms non-inferior efficacy and reduced procedural risk.
“The risk-benefit ratio of routinely performing DT seems to favor not doing routine testing.”

Predictors of Long-Term Outcomes in Hypertrophic Cardiomyopathy
LV scar burden by LGE may refine HCM risk stratification; this observational link extends prior markers but leaves open prospective validation before guiding therapy.
“This is an important next step to do a better job of identifying HCM patients at high risk," he said. "This adds to presently used risk markers derived from the patient's and their family's prior history.”
