ESC Congress 2025: Innovations, AI, and Patient-Centric Care in Cardiology

At this year’s European Society of Cardiology (ESC) Congress in Madrid, one of the world’s largest medical conferences, I was privileged to see how cardiology is evolving and how AI in cardiology and digital health are not just buzzwords but real drivers toward more equitable, effective, and patient-centric care. The sessions offered hope, especially for rare diseases, while also tackling high-prevalence conditions like diabetes. These moments remind you just how impactful our work in medical communications can be.

This article offers a snapshot of our team’s learnings at the Congress, highlighting trends in cardiology and reminding us that the future of cardiology is about innovation, but also about integration, compassion, and collaboration.

Personalized cardiology: Addressing complexity in modern patient care

Sessions at the ESC Congress 2025 emphasized the growing need for personalized cardiology, driven by medical advances like earlier diagnoses and longer lifespans, as well as emerging challenges, such as increasing multimorbidity. Patients today often present with overlapping conditions, such as hypertension, diabetes, and heart failure, requiring tailored therapeutic strategies rather than standardized protocols (ESC 365 – Effects of sacubitril/valsartan in patients with heart failure with reduced ejection fraction and an eGFR below 30 ml/min/1.73 m2). This complexity demands a shift from disease-specific to patient-centric care.

Personalized cardiology is now a necessity for managing increasingly complex patient profiles. ESC experts highlighted that personalized approaches also involve adjusting drug regimens based on tolerability, comorbidities, and genetic markers. For example, a patient with heart failure and chronic kidney disease may benefit from dual mechanism therapy (ESC 365 – Effects of sacubitril/valsartan in patients with heart failure with reduced ejection fraction and an eGFR below 30 ml/min/1.73 m2). Similarly, those with diabetes and cardiovascular risk may be prescribed an SGLT2 inhibitor, which has been shown to reduce heart failure-related hospitalizations (ESC 365 – The effect of malnutrition on the efficacy and safety of empagliflozin: a post hoc analysis of the EMPEROR-Reduced trial).

As cardiology evolves, digital health tools advance, and biomarker-driven insights grow, treatment pathways will be further refined to meet each patient’s unique needs.

Improving adherence in cardiometabolic disease management: A strategic imperative

Improving adherence to therapy and lifestyle guidance is essential in managing hypertension, diabetes, and dyslipidemia. Speakers at ESC 2025 highlighted that poor adherence remains a critical barrier to achieving therapeutic goals, especially in aging populations (ESC 365 – Hypertension management with single pill combinations: the urgent need for control and adherence). Monitoring adherence and simplifying regimens, such as through single-pill combinations (SPCs), can significantly improve compliance. ESC experts stressed that early, intensive treatment using SPCs not only improves control of blood pressure and lipids but also addresses multiple cardiometabolic targets simultaneously (ESC 365 – Hypertension management with single pill combinations: the urgent need for control and adherence).

Moreover, from a health systems perspective, improving adherence through SPCs offers a significant opportunity to optimize costs. Better adherence reduces hospitalizations and long-term complications, thereby improving the cost-effectiveness and sustainability of care delivery (ESC 365 – Quality of care and cost-effectiveness: towards a more affordable healthcare system).

Digital health in cardiology: Real-time monitoring for better outcomes

Digital health is reshaping cardiovascular care, particularly through continuous patient monitoring. Tools such as wearable blood pressure trackers and portable ECG devices now enable 24/7 surveillance of vital parameters, transmitting real-time data to physicians. This proactive approach facilitates early intervention, reduces emergency admissions, and enhances chronic disease management (ESC 365 – The past, present, and future of digital blood pressure-lowering interventions).

ESC experts emphasized that integrating these technologies into virtual clinics and telecardiology platforms is not just a technical upgrade but a paradigm shift in patient-centered care. When the use of AI in cardiology improves these tools (for example, AI algorithms analyzing ECGs, predictive analytics for risk), physicians can focus on actionable data. The convergence of digital health and AI brings scalability and precision, especially for aging populations or settings with resource constraints.

The increasing burden of managing type 2 diabetes

Several sessions at ESC 2025 highlighted the growing burden of type-2 diabetes (T2D), driven by earlier diagnosis and an aging population. Cardiologists are increasingly involved in managing T2D owing to its strong link with cardiovascular risk. The emphasis was on early, intensive treatment strategies to prevent complications (ESC 365 – Treat early, treat intensively, and address multiple goals in type 2 diabetes management).

A major focus was also on the expanding role of GLP-1 receptor agonists and dual agonists, which are instrumental in improving both glycemic control and cardiovascular outcomes. Furthermore, emerging oral therapies in late-stage development show promise in enhancing adherence and accessibility, with a safety profile comparable to injectables (Eli Lilly and Company, 2025). These developments mark a shift toward integrated cardiometabolic care, with novel agents offering dual benefits in diabetes and cardiovascular risk management.

New frontiers: Advances in ATTR-CM therapy

Transthyretin Amyloid Cardiomyopathy (ATTR-CM) is a progressive and potentially fatal heart condition caused by the misfolding of a protein that leads to amyloid deposits in the heart, impairing its ability to pump effectively (American Heart Association, 2025). Once considered a rare and fatal condition, with treatment limited to symptomatic care or, in some hereditary cases, liver transplant, recent years have seen a major therapeutic transformation (American College of Cardiology, 2018).

Recent innovations include next-generation stabilizers and RNA-based treatments that target the underlying pathology more precisely. Clinical trials have shown promising outcomes in reducing cardiovascular events and improving quality of life. Looking ahead, the pipeline includes further RNA silencer therapies, gene-editing strategies, and monoclonal antibodies targeting amyloid clearance, signaling a shift toward precision medicine (Kittleson et al., 2020; Patel et al., 2024). From a once untreatable disease to one with multiple targeted therapies, ATTR-CM exemplifies how translational research and clinical innovation are transforming cardiology. These innovations illustrate how cardiology is embracing precision medicine.

Artificial intelligence (AI) in cardiology: Progress, challenges, and future directions

Artificial intelligence (AI) is rapidly transforming cardiovascular medicine. Experts at ESC 2025 agreed that AI will not replace cardiologists but will fundamentally reshape their roles, creating a future where human expertise and AI work hand in hand.

The growing complexity of cardiovascular care, combined with an aging population and earlier, more precise diagnoses, is driving demand for innovative solutions. Estimates suggest that 10 million additional cardiovascular specialists may be needed by 2030, particularly in low-resource settings (ESC 2025 session: Great Debate: human vs. machine – cardiac imaging in 2030 – who wins the heart?). AI offers potential solutions by:

• Enhancing prediction, diagnosis, and disease classification
• Reducing healthcare disparities in underserved regions
• Supporting robotic interventions and novel diagnostic tools

AI is already demonstrating strong performance in controlled environments, achieving diagnostic accuracy comparable to human experts in areas such as ECG interpretation and cardiac imaging (Goto et al., 2021). AI’s strengths include speed, accuracy, and scalability. However, significant challenges remain:

• Generalizability: AI models trained on controlled datasets often underperform in real-world scenarios with incomplete or inconsistent data (ESC 2025 session: Artificial intelligence in heart failure: help or hype?).
• Adaptability: Unlike humans, AI cannot interpret what it has never seen and requires retraining as medical knowledge evolves.
• Ethical and equity concerns: The use of suboptimally trained AI systems by less experienced clinicians risks creating healthcare disparities, where some patients benefit from expert clinical oversight while others rely predominantly on AI-driven decision-making with limited human expertise. 
• Data security and regulatory compliance: Ensuring patient privacy under evolving data regulations remains a critical issue.

Experts envision a shift from reactive to predictive cardiology, where AI anticipates events such as cardiogenic shock and recommends timely interventions (ESC 2025 session: Artificial intelligence in acute cardiac care: challenges and opportunities). The goal is actionable AI systems that predict but also guide clinical decisions. However, these innovations will require robust clinical validation before widespread adoption.

Additionally, a key question at the Congress was: Who holds accountability when AI makes clinical decisions? Current thinking suggests that liability may rest with clinicians, as it does when prescribing drugs, but this remains an area for legal and regulatory development. Another provocative point that emerged was whether physicians could one day be held liable for not using AI, particularly if it is shown to benefit patient outcomes (ESC 2025 session: Great Debate: human vs. machine – cardiac imaging in 2030 – who wins the heart?).

ESC 2025 highlighted how AI is reshaping cardiovascular medicine, enhancing the cardiologist’s role through predictive diagnostics, improved disease classification, and support for clinical decision-making. However, challenges around generalizability, ethics, and accountability remain. The future lies in integrating AI into proactive, patient-centered care, with clinicians guiding its use responsibly.

Be part of the cardiovascular revolution

Transformation of cardiology requires champions at every level. Whether you’re a clinician, researcher, healthcare administrator, or industry professional, there are concrete steps you can take to advance the necessary innovations:

• Advocate for patient-centric care in your practice: prioritize what matters to patients.
• Use medical communications to explain complex concepts in accessible ways (e.g., AI, genomics, digital tools).
• Push for ethical deployment of AI in cardiology, ensuring transparency, validation, and patient safety.
• Embrace digital health solutions, such as wearables, remote monitoring, and telehealth, that support continuous care.

The innovations showcased at ESC 2025 represent more than scientific achievement; they represent hope for millions of patients worldwide. By working together to implement these advances thoughtfully and equitably, we can create a future where cardiovascular disease is not just treated, but truly conquered.

Ready to join the conversation? Share your thoughts on how these innovations shared at ESC 2025 could impact your practice or organization. Connect with our medical communications team to explore how we can help translate these breakthroughs into real-world solutions that improve patient outcomes.

Note: The abstracts of most of the ESC 2025 references cited in this article can be found here: https://esc365.escardio.org/esc-congress/abstract.

Disclaimer: This article was written by the author with assistance from Microsoft Copilot for language check and style improvements. The author curated, edited, reviewed, and verified the final output.