Integrated Interventional Cardiology: a joint strategy of the ESC and EAPCI

Initially, cardiology was a specialty mainly based on clinical observation and examination, later using ECG, chest X-ray, and echocardiography. Over the years, effective drugs became available, but interventions were exclusively in the hands of surgeons until on 16 September 1977, when Andreas R. Grüntzig performed his seminal percutaneous coronary balloon angioplasty (PTCA) on a stenosis of the left anterior descending coronary artery in a 38-year-old insurance trader at the University Hospital Zurich.1 This revolutionized cardiology and transformed it into an interventional specialty. However, restenosis rates were high, and dissections were an unwanted and dangerous complication of PTCA. Angioplasty became much safer with the introduction of intracoronary stents by Ulrich Sigwart in Lausanne in 19862: as a consequence, it was renamed as percutaneous coronary intervention (PCI). The interventional therapeutic options were further expanded by catheter-based electrophysiology and ablation of atrial fibrillation by Michel Haïssaguerre,3 then by the first transfemoral pulmonary valve implantation by Philipp Bonhoeffer,4 and eventually transcatheter aortic valve implantation (TAVI) by Alain Cribier.5 The stitch of the surgeon Ottavio Alfieri finally paved the way to mitral transcatheter edge-to-edge repair of mitral regurgitation6 and eventually to tricuspid transcatheter edge-to-edge repair.7 Simultaneously, cardiologists specializing in congenital heart disease used the new approach for structural interventions such as closing of atrial septal defects,8 of a patent foramen ovale,9 or an open Botalli duct. The last step is now catheter-based implantation of mitral and tricuspid valves.10 Thus, during a quarter of a century, the contribution of members of the European Society of Cardiology (ESC) and beyond to percutaneous cardiovascular interventions is impressive and forms a strong tradition that shapes the future. Early on, the ESC founded the ESC Working Group (WG) on Coronary Circulation, led in the 1990s by Bernhard Meier, a trainee of Grüntzig and a pioneer himself, and later many others. The legacy of the late Grüntzig is also honoured with an annual lecture carrying his name. The ESC further awarded Gold Medals to Michel Haïssaguerre, Ulrich Sigwart, Alain Cribier, and Marie-Claude Morice, among other prominent interventional cardiologists. Besides the pioneers, several ESC Presidents such as Hans-Peter Krayenbuehl, Michel Bertrand, Günther Breithardt, Jean-Pierre Bassand, Stephan Achenbach, and Franz Weidinger were, and are active, interventional cardiologists. The European Heart Journal, the flagship journal of the ESC, has published numerous papers on interventional cardiology. Since 1994, the ESC Clinical Practice Guidelines Committee, with involvement from ESC associations, published several editions of recommendations for the management of angina, acute and chronic coronary syndromes, and revascularization, as well as valvular heart disease guiding clinical practice in interventional cardiology worldwide (Figure 1). Of note, ESC Clinical Practice Guidelines are downloaded over 8 million times per year and are highly cited, reflecting their global impact. The embodiment of EAPCI within other ESC associations as a basis of integrated interventional cardiology On 31 August 2004, when Jean-Pierre Bassand was ESC President, the current ESC President, at that time as vice-president of the ESC WGs, announced the formation of ESC associations to address the growth of cardiology. At first, the European Heart Rhythm Association (EHRA) and the European Association of Echocardiography (EAE; now European Association of Cardiovascular Imaging; EACVI) was founded, followed in 2006 by the European Association of Percutaneous Cardiovascular Interventions (EAPCI) and up to now five others. Several other constituent bodies complement the activities of the ESC in interventional cardiology: WG on Adult Congenital Heart Disease; WG on Aorta and Peripheral Vascular Diseases, WG on Cardiovascular Surgery; WG on Coronary Pathophysiology and Microcirculation; WG on Thrombosis; and last, but not least, the ESC Council on Valvular Heart Disease. Despite this, the ESC leadership decided in 2006 to outsource its educational offer in interventional cardiology to EuroPCR (course in interventional cardiovascular medicine), a highly successful interventional course in Paris and later London, run by EUROPA. Accordingly, a contract was signed by which EuroPCR runs congresses and EAPCI gives courses and webinars. Furthermore, EuroIntervention, published by EUROPA, was made the official journal of EAPCI. In return, members of EAPCI were involved in PCR educational offers in Paris and London. After years of partnership, the ESC leadership feels that now is the right moment to revisit and re-establish the ESC–EAPCI strategy, with the intention of growing and supporting the community. However, there was no dedicated EAPCI congress or journal dealing with interventional cardiology despite the fact that the ESC Clinical Practice Guidelines on interventional cardiology and beyond have made the biggest impact around the world, putting the ESC and EAPCI centre stage. Therefore, in July 2025, the ESC leadership decided to reconsider the collaboration with EuroPCR and to find new project-oriented ways of collaborating with its partners and all other players in interventional cardiology and cardiovascular surgery. The interventional community is large, and hence, there is room for several educational offers. Of note, the ESC database alone contains more than 70 000 colleagues and an estimated 150 000 PCI operators worldwide whose main interest is interventional cardiology. What will the new EAPCI–ESC strategy look like? First and foremost, EAPCI must grow as an Association, supporting its community and developing its profile. To this end, the ESC and EAPCI leadership will organize the first EAPCI Summit in Munich on 19-20 February 2026 (Figure 2). The first EAPCI Summit in Munich, 19 and 20 February 2026 It goes without saying that this new educational offer will focus on an integrated approach to interventional cardiology with the aim of implementing ESC Guideline recommendations and scientific documents with a Heart Team approach into everyday practice (Figure 3). The strength of the ESC is that it offers research, data, knowledge, and recommendations in all aspects of cardiovascular medicine: we will take advantage of that fact. Hence, the first EAPCI Summit (Figure 2) will be run in close collaboration with other associations—e.g. EAPC to assure optimal secondary prevention after PCI; HFA to educate interventionalists on heart failure medication after valvular interventions; EHRA to assure that pacemakers and cardiac resynchronization therapy are properly used in these patients; and ACVC to discuss the most recent evidence and management in cardiogenic shock—the last frontier in acute cardiac care. We will also involve ACNAP because without their help in the catheterization laboratory the success of interventions would not be assured. From periprocedural to lifetime management: integrated interventional cardiology with transarterial valve implantation, transcatheter edge-to-edge repair, and percutaneous coronary intervention in the centre, embedded in competence on imaging and medication before, during, and after the intervention But networking will go beyond the ESC itself and will involve important partner societies and bodies such as the European Association for Cardio-Thoracic Surgery (EACTS) to assure that the Heart Team is onsite, as well as the ESC National Cardiac Societies and ESC Affiliated Cardiac Societies that are the basis of the ESC, as well as many other scientific societies and partners in Europe and around the world. One particular strength of the ESC are its Clinical Practice Guidelines, and its most recent ESC Chat, an interactive AI model that provides all valid documents in a nutshell for a very user-friendly access.11 The most recent ESC Guideline on valvular heart disease12 will be centre stage in the programme, as will be the ones on acute13 and chronic coronary syndromes.14 According to the new ESC Bylaws, the leadership of all constituent bodies is elected by its members; and we will do so for EAPCI with its 1500 odd members. In order to align the start and end of the mandate of each elected board with the timelines of other associations and the ESC at large, the mandate of the current 2024–26 board will be prolonged for 4 months until the 2026 ESC Annual Congress with the next mandate starting on 1 September 2026. The elections for the next EAPCI Board will, therefore, take place in early June 2026 and will be announced in Q3 2026. As two senior EAPCI Officers were conflicted due to the senior positions they have accepted on the PCR Board, the ESC President—in line with the ESC Statutes and Bylaws—has been mandated by the Management Group to appoint an ad interim EAPCI Past President and Chair of the Nominating Committee of EAPCI, as well as an ad interim Chairperson of the ESC Council on Valvular Heart Disease. The EAPCI will continue to offer its new Educational Pathway on topics of interventional cardiology such as the recent EAPCI Coronary Course held on 9–10 October in Hamburg, Germany; the upcoming 2026 EAPCI Structural Course in Milan, Italy; the recent first level collaborative EAPCI ACVC School of Cardiogenic Shock in Paris in early September; and the upcoming second level on January 2026 in Barcelona, Spain. As well, there will be webinars and journal clubs. There are ongoing discussions in the ESC about how to best serve the EAPCI community through the Journal family. Of course, the European Heart Journal will continue to publish interventional cardiology papers. Around 150 manuscripts from this area of expertise are submitted to the European Heart Journal every year, and several hundred more reach the European Heart Journal–Acute Cardiovascular Care, as well as other specialty journals of the ESC Journal Family. The EAPCI will also fully support the growth of the newest journal in the ESC Journal Family, the European Heart Journal–Valvular and Structural Heart Disease launched earlier this year under the Editorship of Professor Marco Metra. The EAPCI is on the move to become an important player within the interventional community by providing a novel, integrated, and more academic educational offer aligned with the vision and strategy of the ESC and its associations, while remaining open for collaboration with all sister associations, interventional societies, and events around the world. T.F.L. reports outside this work that he has received research and educational grants to the institution from Abbott, Amgen, AstraZeneca, Alnylam, Bayer Healthcare, Boehringer Ingelheim, Cytokinetics, Daiichi Sankyo, Eli Lilly, Novartis, Novo Nordisk, Pfizer, Sanofi, and Vifor. He does not accept honoraria from industry. A.C. reports that she has accepted honoraria from industry partners outside this work, including consultant and speaker fees from Abiomed, Abbott Vascular, Boehringer, Cordis, Menarini, and Penumbra.