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About a decade ago, a group of climate scientists described five scenarios for the future. Called the Shared Socioeconomic Pathways (SSPs), these scenarios suggest how socioeconomic development could evolve in worlds with differing challenges to climate adaptation and mitigation. 

One SSP, “Sustainability,” envisions a collective shift toward green energy, reducing economic inequities and investments in research and development. Another, “Regional Rivalry,” paints a picture of a world riven by nationalism and fighting over resources. In that future, high levels of conflict stifle economic development. Rich countries see slower population growth, while birth rates increase in poorer nations. 

Scientists and policymakers use SSPs to project how today’s choices affect tomorrow’s world. But for complex subjects like public health, these intentionally simple scenarios don’t capture every complexity. Under the SSP “Fossil-Fueled Development,” for example, the world doubles down on fossil fuels, spurring rapid economic growth. That growth, according to the scenario, would spur investments in education and health. But at the same time, increased emissions would degrade the environment, exacerbating health risks.

That description leaves many public health questions unanswered: Would hospital systems be better prepared to handle the increased volume? Could more frequent heat waves lead people to spend more time inside, amplifying mental health burdens? 

Last year, a group of 63 experts in climate change and health met in Vienna to extend the SSPs to better reflect the dynamic nature of public health over the course of the century. Their expanded narratives, published Oct. 5 in The Lancet Planetary Health, provide comprehensive visions of possible population health and health system development and explore how communities might better prepare for shifting future health risks.

Carole Green, a UW doctoral student in environmental and occupational health sciences, attended the workshop and is lead author of the accompanying paper. UW News sat down with Green to talk about where previous climate scenarios fell short, the conference’s work and how we can better prepare to keep each other safe in an uncertain future. 

What are the Shared Socioeconomic Pathways, and how do we use them? 

Carole Green: Shared Socioeconomic Pathways are a narrative framework that can be used in conjunction with pathways of greenhouse gas emissions to project future climate impacts to 2100. The SSPs are basically descriptions of the societal choices that affect the magnitude and pattern of interventions to protect human health and well-being.

The SSPs are essentially five possible alternatives for our future world. These pathways have been expanded to incorporate a wide range of issues of relevance for public health, and have been downscaled to describe what the future might look like in different countries and regions.

SSPs are featured in global processes like United Nations climate conferences, where negotiators come from around the world to debate and agree on approaches to build resilience and sustainability to climate changes. The models help us understand how those choices interact and what the effects might be. 

We also use the SSPs in health research to understand the possible magnitude and geographic pattern of health impacts from climate change over the course of this century. Many projects at UW use future warming levels to analyze things like future wildfire impacts on Washington residents (research done by UW’s Climate Impacts Group). 

What do the SSPs leave out? 

CG: SSPs assume that humans will make socioeconomic changes in the future. The changes described in the pathways originally quantified GDP and population changes. Our work adds complexity, specifically to understand how the future of public health could evolve under these five pathways.

A lot of people are interested in heat waves, for example. Climate modeling alone can capture the planet’s warming, but doesn’t consider issues like how access to hospitals and healthcare could change by 2100. Current heat wave modeling looks at the climate interactions that shape health impacts but don’t explore how concurrent changes in society could interact with climate change to impact people’s well-being. 

Once you added complexity into the SSPs, what changed in your understanding of possible futures? Did you learn anything new or surprising?

CG: We learned that the drivers of health impacts are complex, and many are neither entirely good nor bad. Prioritizing sustainability, mitigation and adaptation will not necessarily lead to the best world for each future health outcome, but it definitely affects the future of health and well-being. Health futures we face globally are not predetermined. Different pathways could lead to vastly different health outcomes, with governance, health-system capacity, resources, equity, and cross-sectoral factors such as water and energy playing critical roles.

For example, under one of the scenarios, people don’t prioritize reducing greenhouse emissions, focusing instead on adapting to the changing climate. Strong investment in technology leads to quite a lot of wealth, which can benefit some health outcomes. But it’s not ideal, because people would also have to spend more time indoors because of the growing heat burden and would have to reduce connection to the outdoors and nature. You really don’t want to live in that scenario.

It’s very much a mix, which is challenging. 

Now that we have these fleshed-out scenarios, what does that allow us to do? 

CG: It allows us to have a more complex understanding of future health risks from climate change. Now we can add a layer of understanding and think about more variables than just warming levels and population numbers. It’s made of a lot of complexities that affect health, and those have their own effects.

In future climate scenarios, what does access to healthcare look like? What is the extent of food insecurity? How are we making sure people have access to clean air and water? When we have some understanding of those interactions, then it can motivate decision-makers to develop appropriate policies. 

What comes next? 

CG: We will apply these narratives to six different countries where there has been limited research using the SSPs. We’re working in Brazil, Senegal, South Africa, India, Vietnam and the Solomon Islands. We’ve started identifying key leads across these countries, where there is quite an appetite for this research. All countries are required to develop national health adaptation plans and to conduct vulnerability and adaptation assessments. They are also interested in modeling future health risks. We want to explore the extent to which the SSP narratives apply in their country’s context. Do they fit? How would they look different? There’s a lot of interest in building on local knowledge and bringing local experts together to talk about possible futures. 

We’re also quantifying specific disease burdens, universal healthcare access, water and sanitation infrastructure and digital health. Some quantifications will look at pairing SSPs with certain warming levels to project impacts. 

Last question: This group — including dozens of the world’s leading experts on climate and health — chose you to write the paper. How did that happen? 

CG: I am definitely not the leading expert in that room, so it was very much an honor to work on this and lead the writing. A lot of it comes from my advisor, Kristie Ebi, who is very supportive of me and my work. That’s been really meaningful. She encouraged me to take this on.

I often tell people that my job is to listen to experts and write down what they say. It was very meaningful to get to make those connections. 

For more information or to reach the researchers, contact Alden Woods at acwoods@uw.edu. Other UW authors include Dr. Jeremy Hess, professor of environmental and occupational health sciences, of global health, and of emergency medicine in the UW School of Medicine; and Helen Pineo, research associate professor of urban design and planning.

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New capybara fossil changes the forecast for the ancient Atacama region

Capybaras like their habitats wet. These large rodents thrive in low-elevation wetlands, migrating along creeks and rivers to nibble on foliage and flowers. That’s why researchers were surprised to find an 8.8 million-year-old fossilized capybara tooth in northern Chile’s Atacama Desert, one of the driest regions on Earth. In a paper published Sept. 5 in Scientific Reports, researchers postulate that the Atacama Desert must have had a wetter climate during the Miocene epoch, based on this discovery. This is the first time a capybara species has ever been seen in the Atacama region of Chile — today these creatures reside in the marshy lowlands across Venezuela, Colombia, Argentina and Uruguay. Researchers had at one time assumed that the Andean mountain chain on the eastern side of Chile would have prevented these short-legged rodents from ever entering the Atacama region. With this discovery, the authors propose that capybaras were able to follow a wetland trail along the northern part of South America, trekking from Bolivia to Peru into northern Chile. In addition to capybaras, the ancient Atacama region also likely had palms and other flowering plants, according to plant fossils analyzed by a UW scientist for the study. These findings challenge the idea that the Atacama was just always a desert, and can help researchers better understand how shifts in climate can drastically affect the environment.

For more information, contact co-author Caroline Strömberg, UW professor of biology, at caestrom@uw.edu.      

A full list of co-authors and funding is included in the paper. Adapted from a release from the University of Arizona.

Multitasking gives marine microbes an edge when nutrients are scarce

The world’s oceans teem with tiny organisms that are difficult to study yet critical to account for. The organisms that make up this microscopic community, many of which are protists, have evolved over time to help keep marine ecosystems balanced. A UW study published Sept. 11 in the ISME Journal, found that organisms that can both photosynthesize and eat to generate energy do better in nutrient-limited environments, which includes warmer water. This flexibility may help them cope with changing conditions and could help researchers gauge how marine ecosystems will respond to future warming. Gathering more data from the bottom of the food web is important for understanding the ecosystem-wide impacts of environmental change. The study also debuted a new genetic method for studying energy production versus consumption that may make it easier to study protists. Samples in this study were collected from the North Pacific, near Hawaii and about 1,000 miles north, but the researchers hope to continue expanding the radius to improve global ocean models.

For more information, contact Sacha Coesel, UW research scientist and engineer of biological oceanography at coesel@uw.edu.

The UW co-authors are Shiri Graff van Creveld, Francois Ribalet and Virginia Armbrust. A full list of co-authors and funding is included in the paper.

UW engineers capture behavior of ‘edge waves’ on beaches, putting popular wave models to the test

Coastal engineers and oceanographers often think of the motion of water on beaches as “one dimensional”: waves propagating directly onto the beach from offshore. These simplified wave models are used widely from designing shoreline infrastructure to forecasting coastal flooding. However, some waves propagate along the coast rather than crashing into it, and may push an additional meter of water depth onto the beach. For decades, these “edge waves” have not been accounted for in the one-dimensional models commonly used to understand wave behavior. To find out how edge waves might be impacting model accuracy, researchers at the UW and UC San Diego deployed an array of pressure and velocity sensors along a beach in Southern California for 60 days. In a paper published Sept. 4 in JGR Oceans, the researchers describe a model they built to tease out the influence of edge waves in the larger system. While edge waves contributed a significant amount of energy, the team found that ultimately the one-dimensional models that exclude edge waves remain accurate enough for predicting total water levels at the shoreline.

For more information, contact Cassandra Henderson, a postdoctoral scholar of civil and environmental engineering, at cshender@uw.edu.

A full list of co-authors and funding is included with the paper.

How Colombian environmentalists use law and democracy to redefine mountain landscapes

In 2013 and 2017, Colombian voters in two towns backed a legal effort to stop a large-scale gold mining project. In doing so, they are making the mountainous areas where they live more visible and politically relevant. The decision allowed environmental advocates to organize around a larger area defined by elevation, massive volume, and subterranean and arboreal features. Ángela Castillo Ardila, UW assistant professor of anthropology, recently published a research article in the journal Anthropological Forum that examines how the effort used legal tools for citizen participation to not only voice their opinions on extractive projects, but also reconfigure space in unprecedented ways. The case shows that democratic participation can have far-reaching consequences for how landscapes are defined and lived. The article appears in a special issue, called “Ethnographies of Vertical and Volumetric Worlds,” which was co-edited by Ardila and Steven Schwartz of the University of Rochester.

For more information, contact Castillo at acastil@uw.edu.

Funding information is included in the paper.

Researchers develop new way to measure how blood clots form

A wound stops bleeding because tiny blood cell fragments called platelets clump together to form a clot. Researchers know that platelets generate forces that help compact and strengthen clots. However, they’ve struggled to understand how blood clots form in real time. To better understand this system, UW mechanical engineers created a device that measures how platelet forces and stiffness evolve together during the first minutes of clot formation. In a paper published recently in Advanced Healthcare Materials, the research team used the device to apply magnetic forces to clumps of platelets, causing them to strengthen and stiffen through a process called “mechanotransduction” in which cells convert mechanical forces into biological responses. These findings could be used to study how new drugs affect clot formation, how platelets respond to signals when disease is present, and how blood clotting biomechanics contribute to cardiovascular disorders.

For more information, contact Nate Sniadecki, a UW professor of mechanical engineering, at nsniadec@uw.edu.

The UW co-authors are Nikita Taparia, Ava Obenaus, Yoeur-Man Mach and Nakul Sridhar. A full list of co-authors and funding is included with the paper. Adapted from a story by UW mechanical engineering.

UW researchers probe superconducting materials that defy expectations

Most materials resist the flow of electricity to some degree, but unusual materials known as superconductors can carry an electric current with no resistance at all. Superconductors offer a unique window into the physics of materials at tiny scales, and they could one day revolutionize electronics. In recent years, researchers have discovered new forms of superconductivity in stacks of atomically thin materials such as graphene. Resistance typically drops to zero as these materials are cooled, but in some cases it mysteriously levels off at a small finite value, which contradicts expectations of superconductor behavior. In a paper published Sept. 23 in Nature, UW materials scientists tested this behavior with a device consisting of several layers of graphene stacked in a staircase-like pattern. By adjusting voltages applied to the device, the researchers could control whether the graphene exhibited true superconductivity or the more peculiar “failed” form, providing clear evidence that failed superconductivity is real. The team is now working to uncover the origin of this mysterious behavior.

For more information, contact Matthew Yankowitz, a UW associate professor of both physics and materials science and engineering, at myank@uw.edu..

The UW co-authors are Anna Okounkova, Abigail Sohm, Manish Kumar and Derek Waleffe. A full list of co-authors and funding is included with the paper.

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A city’s sewers say a lot about its residents. Sick people often shed pathogens in their waste, adding traceable amounts of bacteria and viruses into wastewater. Testing that wastewater offers a simple, low-cost way to monitor the spread of disease — a practice that began with polio in the 1940s and became more widespread during the COVID-19 pandemic. Today, the CDC’s wastewater monitoring program tests for a variety of common and emerging viruses.

American public health agencies don’t routinely test wastewater for sexually transmitted infections, but new research led by the University of Washington and the Washington State Department of Health found that such methods could be used to effectively identify Chlamydia trachomatis, the bacteria that causes chlamydia.

The study, published Aug, 7 in ACS ES&T Water, could help public health agencies better identify and respond to increased spread of chlamydia and other STIs, which are notoriously underreported in traditional data. The researchers specifically explored wastewater’s potential as a community monitoring tool, and not as a way to identify cases or trace pathogens back to individual people or locations.

“STIs are known for being underreported because of a lot of factors, especially stigma and the prevalence of asymptomatic cases,” said co-lead author Erica Fuhrmeister, assistant professor of environmental and occupational health sciences and of civil and environmental engineering at the UW. “Wastewater is cool because it’s population level. You don’t need people to go to the doctor and seek out treatment to know that there are people in a community shedding specific pathogens.”

Working in collaboration with local health jurisdictions, researchers collected frequent samples from influent wastewater at five wastewater treatment plants across Washington state and six neighborhood-level sewer sites near Seattle. Collection sites ranged from a large, high-population urban area to a rural treatment plant serving fewer than 5,000 people. Researchers masked the specific names and locations of sample locations to protect the privacy of people and communities.

Researchers tested wastewater samples for the pathogens that cause three common STIs: chlamydia, syphilis and gonorrhea. C. trachomatis was the most prevalent pathogen across all test sites. The bacteria that cause gonorrhea and syphilis were found far less frequently, despite data showing confirmed cases of those diseases in the associated areas. 

Further research could reveal why tests captured C. trachomatis more consistently than other STI-causing bacteria and explore the study’s limitations, which included people moving between sewer sites and the influence of demographics.

The researchers are also eager to investigate several trends they observed in the data, such as spikes in pathogen concentration occurring near the winter holidays and after Valentine’s Day.

Among the neighborhood collection sites was a small, densely populated area adjacent to a college campus. More than 87% of residents were young people between 18 and 34 years old, a population considered high-risk for STIs. Clinical health records showed very low case counts of chlamydia, but researchers consistently detected C. trachomatis in wastewater samples. 

That gap could indicate underreporting driven by stigma or asymptomatic cases. It also gives public health officials an opportunity to react to a previously unknown increase in infection activity.

“From a public health perspective, data like this allows us to elevate awareness that this pathogen is here and spreading in the community, even if cases aren’t presenting to clinics or providers are not identifying the infections in their patients,” said co-lead author Breanna McArdle, program manager of the Washington State Department of Health’s wastewater surveillance program. “A small amount of wastewater can tell you so much about the community while simultaneously filling gaps in the traditional methods we monitor disease activity.” 

A full list of co-authors is available with the paper. 

This research was funded in part by the Epidemiology and Laboratory Capacity Infectious Diseases Cooperative Agreement from the U.S. Centers for Disease Control and Prevention. 

For more information, contact Fuhrmeister at efuhrm@uw.edu.

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Nobody is immune from the hazards of summer wildfires, even the experts. At the University of Washington, researchers study both how to mitigate and understand wildfire behavior and how air quality degrades as a result of burning blazes. While UW faculty contribute to a rapidly emerging body of research into the risks of fire and smoke season, they also contend with the decisions that the rest of us face: how to protect themselves and their families, where to find reliable information, and how to manage the anxieties of summer smoke. 

Who better to learn from? As fires rage and smoke smothers the Pacific Northwest — including historic and devastating blazes in Spokane — UW News sat down with five UW experts in fire science, forestry, air pollution and more to ask how they manage wildfire season. 

This summer, the U.S. has been inundated with wildfire smoke, sometimes from fires burning hundreds of miles away. What sources do you use to track wildfires and air quality?

Ernesto Alvarado, research associate professor of environmental and forest sciences: The most reliable source, in my opinion, is the Fire and Smoke Map from AirNow.gov. This map consolidates data from various government sources related to wildfires, prescribed burns, smoke emissions and up-to-date models. It serves as a comprehensive resource for smoke emissions information.

Susan Prichard, research scientist in environmental and forest sciences: For smoke forecasts, I often turn to AirNow, but the Washington Smoke Blog is an excellent friend when we have been inundated with smoke for days and I’m looking for extended forecasts and analyses. Purple Air is also an incredibly helpful site. I’m careful to check if the readings are U.S. EPA PM2.5 with the conversion applied — otherwise the readings generally are higher than reality.

Brian Harvey, professor of environmental and forest sciences: For personal use and immediate up-to-date information, I really like Watch Duty. As a free app that has lots of options and configurations, it can be really helpful for getting immediate information on any ongoing fire incident and incorporates information from multiple sources. Second, for more detailed maps, photos, and daily incident updates, I frequently check Inciweb, which is the U.S. government interagency website that provides real-time public information and updates on fire incidents. As a forest fire scientist, I also use these sources for archived information about past fires that can better help us in our research.

Let’s say you’re planning a weekend trip, or a hike you’ve been looking forward to. How do you predict and plan around fire and smoke? 

E. Alvarado: I’ll plan my outdoor activities while considering potential smoke impacts. I’ll choose an area that’s unlikely to be affected by smoke for the duration of the activity. During the fire season, I’ll avoid areas with thermal inversions, which can trap smoke at night. For example, canyons or valleys surrounded by mountains are risky.

To predict future smoke concentrations, the National Weather Service is the most reliable source of information. Their weather predictions can indicate fire weather for the duration of the forecast. This is also important for hiking the rest of the year to stay informed about the weather for any outdoor activity.

BH: FireSmoke.ca has nice maps of the U.S. and Canada with high-resolution smoke forecasts over the coming day or two. These maps can be really helpful for planning ahead, though are always subject to change based on changing fire behavior or weather conditions. With our lab group doing field work outdoors all summer long every summer, these are critical tools for us to be able to do our work. 

Do you have an AQI threshold where you’re no longer comfortable being outside? Does that vary depending on what you’re doing outside? If so, how?

Edmund Seto, professor of environmental and occupational health sciences: The AQI is designed for communicating health risk to both general populations as well as populations that may be more susceptible to smoke.  Rather than focusing on the AQI number, I instead focus on the public health messaging (the “Description of Air Quality” column in this figure):

Elena Austin, associate professor of environmental and occupational health sciences: I generally become more concerned when air quality has remained consistently elevated for about 24 hours, because I think about smoke exposure cumulatively over the course of the day.

SP: If it looks like air quality is going to degrade over an AQI of 80, I start thinking about my health and what level of activity I’m going to do. As the science on smoke and human health only becomes more cautionary, I save strenuous exercise like running or climbing mountains for times when the AQI is below 80. 

If you have to be outside during smoky days, how do you protect yourself? 

E. Alvarado: Starting from AQI in the yellow zone, I may wear a N95 mask. However, above the orange zone, an N95 mask is mandatory.

ES: If working outdoors during smoky days, you and your employer should be aware that in Washington State, Labor and Industries has established rules to protect workers from hazardous smoke exposures. Also be aware that oftentimes smoke and heat co-occur, and there are heat exposure rules for working outdoors too.

E. Austin: I always make contingency plans while hiking and camping. In that case, I identify egress routes prior to departing in case a wildfire event limits my ability to return using the route I had planned. I also sign up for emergency text alerts for the county where I am spending time, and check the current fire activity and nearby evacuation status. 

How do you keep your indoor spaces safe during smoke waves?

ES: Thinking ahead and preparing your indoor space for regularly occurring wildfire smoke episodes is just as important as planning for other emergency events.  Can you close doors and windows tightly and have good weather sealing to avoid smoke from infiltrating indoors? Can you set your ventilation system to recirculate air?  Have you replaced your ventilation system (e.g., furnace) filter recently? Have you considered getting a portable HEPA-rated air cleaner that is sized appropriately for your bedroom or living area?  Have you considered building a DIY box-fan filter?

E. Austin: I create a smoke-ready space in my home. This is a separate area, where I set my ventilation system to recirculate indoor air rather than bringing in outdoor air. I also run a HEPA filter, rated to perform well for the square footage of my space, during wildfire events. Lastly, I try to reduce air exchange between the indoor space and outdoors by closing all windows, only opening outdoor doors when necessary, and weatherizing the space around doors and windows prior to the event.

SP: For indoor air, we make sure our HEPA air filters are clean at the end of each fire season so that they are ready to go the following year. When there’s smoke in the air, we make sure windows and doors are closed and use our air filters. We also just got a heat pump so that we can keep windows closed when smoke is a factor at night.

If you find yourself in close proximity to an active wildfire, what steps do you suggest taking?

BH: I suggest being as conservative and cautious as possible. Conditions can change rapidly, and being in the direct line of where a fire is spreading can be extremely dangerous and life-threatening. So first, I would make sure that there is a clear and safe route to safety via a road, trail, path, etc. Second, assessing the situation through any official information or local authorities is critical. If the fire has not been reported, calling 911 immediately is important to alert responders and others. If an evacuation order is issued, leaving immediately is critical to get to safety ASAP.

E. Austin: Many local districts allow you to register your phone and/or email to receive real-time alerts. I also suggest identifying your evacuation route, any obstacles or bottlenecks that would slow down your evacuation and to preplan and even pack critical items that you would need to take with you in an emergency.

SP: I live in the Methow Valley, and we’ve been evacuated around five times in the last 20 years. As a fire ecologist who studies fire behavior and smoke, one of the most upsetting things for me has been to watch neighbors and friends stay to protect their places. We quickly pack a few valuable things — photo albums, laptops, wallets, and passports — and leave. My main message to friends over the years is that it’s not worth the risk — if flames are close that means that smoke and super-heated air may be close, too, and deadly.

How do you manage the stress and anxiety of fire season both here and elsewhere?

E. Austin: I manage that stress by preparing my home before fire season, relying on a small number of curated information sources rather than trying to identify reliable sources in the moment or checking multiple apps, and I try to make flexible backup plans for outdoor activities. I also suggest planning ahead to learn how to obtain and effectively use an N95 respirator to reduce exposures either at work or when outdoors for recreational activities.

SP: Fire and smoke season are stressful. I’ve dealt with some stress and anxiety not only from fast-moving wildfires but also from long-duration smoke events that feel like they will never clear. We have a strong community that is very supportive and understands how fire season can bring up some PTSD-type symptoms. We take care of our place and make sure that we have as low of risk in and around our home as possible. We also remind ourselves how very lucky we are to be able to have flexibility in our work schedules and plenty of friends and family elsewhere to be able to leave when wildfires hit close to home.

BH: Fire is an integral part of life on earth, and in regions like the Pacific Northwest, fire is a key process that will continue to shape this region well into the future. Knowing that it is not if, but when, fire will return to any given area helps me embrace the reality of fire season. Like anything in life, being informed and prepared is a great way to lower stress and anxiety that comes with uncertainty. 

The UW has dozens of experts in wildfires, smoke and related topics. To reach an expert, contact Alden Woods at acwoods@uw.edu.

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Schizophrenia affects approximately 23 million people worldwide, with onset usually occurring during a person’s late adolescence to their 20s. Impairments associated with schizophrenia include hallucinations, delusions and disorganized thinking and behavior.

Now, researchers at the University of Washington are investigating how genetic changes impact the severity of schizophrenia symptoms. A new study, published in the American Journal of Psychiatry, supports the idea that deletions in genes that regulate early brain and neuron development are associated with more severe features of schizophrenia spectrum disorders, particularly lower cognitive abilities.

How schizophrenia manifests — and how severely — differs between patients. Poorer cognitive functioning in schizophrenia is associated with more treatment-resistant forms of the disease. Jennifer Forsyth, co-author and assistant professor of psychology at the UW, said understanding early developmental genetic factors could help identify people who could benefit from earlier, targeted inventions.

“For a subset of individuals, we may need to be thinking about how we can create treatments earlier in brain development that will help compensate for the fact that certain genes are being deleted,” Forsyth said. “Is there some kind of medication that can help with that? Down the road, could there be gene therapies for some of these individuals? I do think this research is going to be important for changing treatment direction.”

The researchers studied the DNA of more than 600 people with schizophrenia spectrum disorders. The team compared these results to data from patients’ relatives, people without schizophrenia and nearly 10,000 children participating in the Adolescent Brain Cognitive Development Study. 

People with schizophrenia who carried the deletions tended to perform worse on cognitive tests — showing poorer memory, thinking and attention skills than people with schizophrenia who didn’t carry the deletions. Similar, weaker associations were also seen in the general population, which suggests these variants may influence brain development more broadly, even in individuals without schizophrenia.

The study also showed these specific genetic deletions were associated with differences in brain structure, including higher gray matter volume and cortical thickness. This is the opposite pattern researchers typically see on average in schizophrenia, Forsyth said, which again suggests variability between patients.

“This study helps us understand the specific way somebody manifests a disorder,” Forsyth said. “It’s sort of a cumulative effect of different risk profiles. We all carry tons of genetic variants, and the specific types of variants we have and how they combine is very complicated. These things aren’t totally deterministic, but I do think understanding which specific aspects of brain development are affected by the genetic variants a person carries, and how this shapes how the disorder manifests, can start to inform how we think about different treatment approaches.”

Other UW co-authors from the Department of Psychology were graduate students Jinhan Zhu, Zachary Trevorrow and Mahnoor Hyat, undergraduate research assistant Ariana Chavannes, research coordinator Sam Sievertsen and research technologist Sophie Ferreira-Ianone. Matthew Conomos, a UW senior research scientist in biostatistics, was also a co-author.

A full list of co-authors is included with the study.

This study was funded by the National Institute of Mental Health, the Brain and Behavior Research Foundation, the National Center for Advancing Translational Sciences UCLA Clinical and Translational Science Institute, the UCLA Brain Research Institute and the Shear Family Foundation.

For more information, contact Forsyth at jenforsy@uw.edu.

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• In a study to test an artificial intelligence (AI) model for evaluating heart ultrasound exams (echocardiograms), the AI-assisted interpretations were comparable in accuracy to preliminary interpretations prepared by sonographers and cardiologists.
• Having AI-generated preliminary interpretations reduced the time cardiologists spent interpreting each scan by nearly half, from 8.5 to 4.6 minutes, and the AI-generated reports were more consistent with historical clinical reports.
• Researchers say these results demonstrate the potential for AI to be a useful tool that can assist cardiologists and improve the efficiency of cardiology practice.
• Note: The study featured in this news release is a research abstract. Abstracts presented at the American Heart Association’s scientific meetings are not peer-reviewed, and the findings are considered preliminary until published as a full manuscript in a peer-reviewed scientific journal.

Embargoed until 10:22 a.m. CT/11:22 a.m. ET, Monday, Nov. 9, 2026

CHICAGO, Nov. 9, 2026 — AI-generated (artificial intelligence created) interpretations of echocardiograms were comparable in accuracy to preliminary interpretations prepared by ultrasound technicians (sonographers) and cardiologists. The assistance of AI preliminary interpretations also reduced the time cardiologists spent interpreting each scan almost by half. All of this is according to new, independent, preliminary late-breaking science presented today at the American Heart Association’s Scientific Sessions 2026. The meeting on Nov. 6-9 in Chicago is a premier global exchange of the latest scientific advancements, research and evidence-based clinical practice updates in cardiovascular science.

An echocardiogram or heart ultrasound is the most widely used type of heart imaging, giving healthcare professionals key information to diagnose heart conditions and select treatment options. The current process is for a sonographer to acquire the images, and a cardiologist to review the images and write a report assessing various heart structures and function. In this study, researchers tested the use of an AI tool to analyze ultrasound images and draft preliminary reports to assist cardiologists.

Researchers say this is the first randomized trial testing an AI tool to craft a full echocardiogram report including interpretations and measurements. In the research study, an AI tool, a sonographer and a cardiologist each prepared preliminary reports for the same 1,200 echocardiograms previously acquired during routine clinical care. The preliminary interpretations were then randomly assigned to cardiologists for review and finalization without knowing whether the first draft was made by a sonographer, a cardiologist or the AI tool. Researchers assessed accuracy by looking at how often cardiologists made substantial changes to the preliminary interpretations before finalizing them. Additionally, the time spent completing each interpretation and consistency with historical interpretations in the medical record were evaluated.  

What are the study’s key findings?

• Cardiologists made substantial changes to 50.6% of the AI-generated preliminary interpretations, compared with 49.7% of the preliminary interpretations prepared by sonographers and cardiologists. The results showed that the AI-assisted approach was comparable in accuracy to the human-assisted approaches. The results met the study’s criteria for the AI-assisted approach to be considered non-inferior, or comparable in accuracy, to the human-assisted approaches.
• Cardiologists spent an average of 4.6 minutes per echocardiogram reviewing and finalizing AI-generated preliminary interpretations, compared with 8.5 minutes to generate interpretation reports without AI assistance, a time savings of about 46%. These results demonstrate the potential for AI to improve the efficiency of everyday cardiology practice.
• The AI-assisted reports were more consistent with historical reports in the medical record than reports in the comparison group.
• The reviewing cardiologists could not identify whether the preliminary interpretation was prepared by the AI tool, a sonographer or another cardiologist.

“We designed this study to capture even small differences between the preliminary reports and the cardiologists’ final interpretations, allowing us to take a careful look at how well AI performed in a rigorous scientific manner,” said co-senior author Keane K. Lee, M.D., M.S., a cardiologist at Kaiser Permanente Santa Clara Homestead Medical Center in Santa Clara, California. “Based on our prior work, we expected AI to demonstrate excellent accuracy, which was confirmed in this randomized trial. However, what surprised us was the extent to which using AI-generated reports reduced the time cardiologists needed to interpret echocardiograms.”

“Because of the large number of echocardiograms cardiologists read, even a few minutes saved per interpretation can add up to a significant amount of time over the course of a day,” Lee said. “For patients, this could potentially mean faster turnaround of results and more access to care, and for cardiologists, more time to spend with patients.”

“AI cannot, however, replace the human team,” Lee added. “The cardiologist remains ultimately responsible for interpreting the echocardiogram and certifying the accuracy of the final report, even when AI assists with the process. Moreover, the physician applies clinical judgment and knowledge of the patient to the final interpretation to develop a personalized care plan for each individual.”

According to a July 2026 study published in the Journal of the American Heart Association, experts anticipate a shortage of cardiologists in the U.S. over the next two decades, with research projections from the U.S. Department of Health and Human Services’ Health Resources and Services Administration estimating a national shortfall of about 7,000cardiologists by 2036. That study notes the need to implement strategies to strengthen the cardiology workforce.

What are the study’s details, background, design and limitations?

• The study included 1,200 echocardiogram exams performed over two weeks in March 2025 in hospital and outpatient clinic settings within 21 medical centers across Kaiser Permanente Northern California.
• The patients’ average age at the time of the echocardiograms was 69 years old, and 47% of participants were women and 53% were men. About 54% of participants self-identified as white adults; 16% were Hispanic adults; about 16% were Asian adults; 8.8% were Black adults; and 5.8% self-identified as other.
• Nine sonographers (average of 7.2 years of experience) and 20 cardiologists (average of 11.7 years of experience) participated in the study.
• The AI tool, sonographers and cardiologists each prepared a preliminary report for every echocardiogram. The reports were randomly assigned to cardiologists, who finalized them without knowing who prepared them.
•  The study measured how often cardiologists made substantial changes to preliminary interpretations, how long they spent completing interpretations, consistency with historical reports in the medical record and whether they could tell if the preliminary interpretation was AI- or human-generated.
• Limitations of the study include that it did not test whether using AI to help interpret echocardiograms improves patients' long-term health. In addition, cardiologists knew they were part of this study, so they may have adjusted their usual work patterns.
• More research is needed to assess how AI-assisted interpretation may perform in real-world clinical settings with larger scale and volume of exams.

Co-authors, disclosures and funding sources are listed in the abstract.

Statements and conclusions of studies that are presented at the American Heart Association’s scientific meetings are solely those of the study authors and do not necessarily reflect the Association’s policy or position. The Association makes no representation or guarantee as to their accuracy or reliability. Abstracts presented at the Association’s scientific meetings are not peer-reviewed, rather, they are curated by independent review panels and are considered based on the potential to add to the diversity of scientific issues and views discussed at the meeting. The findings are considered preliminary until published as a full manuscript in a peer-reviewed scientific journal.

The Association receives more than 85% of its revenue from sources other than corporations. These sources include contributions from individuals, foundations and estates, as well as investment earnings and revenue from the sale of our educational materials. Corporations (including pharmaceutical, device manufacturers and other companies) also make donations to the Association. The Association has strict policies to prevent any donations from influencing its science content and policy positions. Overall financial information is available here.

Additional Resources:

• Multimedia is available on the right column of the release link.
• View the abstract in the American Heart Association Scientific Sessions 2026 Online Program Planner
• American Heart Association news release: An AI tool detected structural heart disease in adults using a smartwatch (Nov. 2025)
• American Heart Association news release: AI image-recognition program could read heart images faster, speed care (Nov. 2024)
• American Heart Association health information: Use of Artificial Intelligence in Improving Outcomes in Heart Disease A Scientific Statement From the American Heart Association
• About Scientific Sessions 2026
• For more news at the American Heart Association’s Scientific Sessions 2026, follow us on X @HeartNews, #ScientificSessions26

###

About the American Heart Association

The American Heart Association is a relentless force for a world of longer, healthier lives. Dedicated to ensuring equitable health in all communities, the organization has been a leading source of health information for more than one hundred years. Supported by more than 35 million volunteers globally, we fund groundbreaking research, advocate for the public’s health, and provide critical resources to save and improve lives affected by cardiovascular disease and stroke. By driving breakthroughs and implementing proven solutions in science, policy, and care, we work tirelessly to advance health and transform lives every day. Connect with us on heart.org, Facebook, X or by calling 1-800-AHA-USA1.

For Media Inquiries and American Heart Association Expert Perspective:

American Heart Association Communications & Media Relations in Dallas: 214-706-1173; ahacommunications@heart.org

Michelle Kirkwood: michelle.kirkwood@heart.org

For Public Inquiries: 1-800-AHA-USA1 (242-8721)

heart.org and stroke.org

• An artificial intelligence (AI) model analyzed ECG recordings from two different brands of smartwatches for more than 2,200 adults in South Korea. The study found that the AI model was able to identify people with and without reduced heart pumping function, or left ventricular systolic dysfunction (LVSD). However, for 9% of participants, the results differed between the two smartwatch brands: positive (suggesting possible reduced heart pumping function) on one and negative on the other.
• Among another set of 146 adults who recorded ECGs at home on their own smartwatches, requiring positive results on at least 2 of 3 consecutive days, compared to acting on results on a single positive day, halved false-positive results (from 18 to 9 among 70 people without LVSD) in the 108 who recorded for at least 5 days, but missed two more people with LVSD.
• The findings suggest that smartwatch ECGs analyzed with AI may help identify people who need additional heart screening such as an echocardiogram. More research is needed before smartwatch ECG readings can replace traditional screening exams.
• Note: The study featured in this news release is a research abstract. Abstracts presented at the American Heart Association’s scientific meetings are not peer-reviewed, and the findings are considered preliminary until published as a full manuscript in a peer-reviewed scientific journal.

Embargoed until 9:55 a.m. CT/10:55 a.m. ET, Monday, Nov. 9, 2026

CHICAGO, Nov. 9, 2026 — An artificial intelligence (AI) software tasked with evaluating heart signals (ECG data) measured by smartwatches may help identify a hidden and dangerous heart condition known as left ventricular systolic dysfunction (LVSD), although results varied between smartwatch brands and across ECG recordings, according to new, preliminary, independent late-breaking science presented today at the American Heart Association’s Scientific Sessions 2026. The meeting on Nov. 6-9 in Chicago is a premier global exchange of the latest scientific advancements, research, and evidence-based clinical practice updates in cardiovascular science.

LVSD occurs when the heart’s main pumping chamber, the left ventricle, does not contract effectively. In this study, LVSD was defined as a left ventricular ejection fraction of 40% or less, meaning that the chamber pumps out no more than 40% of the blood it contains with each heartbeat. LVSD can be present without symptoms, and without treatment it can lead to symptomatic heart failure. The researchers examined whether AI analysis of ECG signals measured by smartwatches could help identify people who may need traditional screening exams such as an echocardiogram, or ultrasound scan of the heart. This study evaluated a novel AI model that analyzed smartwatch ECG recordings for signs of reduced heart pumping function.

“Some people have reduced heart pumping function without noticeable symptoms,” said study author Hak Seung Lee, M.D., FAHA, chief medical officer of Medical AI Co., Ltd., which developed the AI model, and a cardiologist at the Digital Healthcare Institute, Sejong Medical Research Institute in Incheon, South Korea. “Our study explored whether AI analysis of smartwatch ECGs could help identify people who may benefit from additional screening for LVSD or other heart conditions.”

What are the study’s key findings?

• Among 2,211 adults scheduled for an echocardiogram at an outpatient cardiology clinic, ECGs were recorded on both an Apple Watch and a Samsung Galaxy Watch during the same visit. The AI model distinguished people with and without LVSD about equally well on both watches. However, when the same AI-score cutoff (set in advance using separate Galaxy Watch data) was applied to both groups, 200 participants (9%) were classified as positive on one watch and negative on the other.
• A second group of study participants included 146 adults who recorded ECGs at home via smartwatches. Among 108 of the 146 participants who recorded ECGs on at least five days in the first week, when positive results in the AI analysis were required for at least 2 of 3 consecutive recording days, false-positive LVSD classifications were reduced from 18 to 9 participants among the 70 participants who did not have LVSD. This method of requiring at least 2 of 3 consecutive recording days of positive data allowed the AI model to identify 31 of 38 participants with LVSD, compared with 33 participants when ECG data from single-positive days were analyzed. Thus, false positives were reduced by 50%; however, two additional cases of LVSD were missed compared with the single-positive-day rule. This was one of several repeat-testing rules examined.
• Among all 146 home-recording participants, 81% of those with consistently positive results had LVSD confirmed by echocardiography, versus about 6% of those with consistently negative results. Nearly half (49%) had a mix of positive and negative results, and 40% of this group had confirmed LVSD.
• Because LVSD was more common in this study population than in the general population — participants were patients referred for an echocardiogram, many of whom already had known heart failure — the researchers adjusted the analysis to account for this difference and estimated results at lower prevalence.

“A single smartwatch ECG is a snapshot, and repeated recordings can give different results,” Lee said. “Requiring repeated positive results reduced false positives in our study, yet it also missed some additional cases that should have been positive. Larger studies are needed to determine how best to use these results to guide further evaluation.”

What are the study’s details, background, design and limitations?

• Two groups of adults were enrolled in the study at Incheon Sejong Hospital in South Korea. The first group was enrolled between July 2023 and May 2024, and the second group was enrolled between July 2024 and December 2025.
• Group 1 included 2,211 adults who were scheduled for an echocardiogram at an outpatient cardiology clinic. Each participant had ECGs recorded using both an Apple Watch and a Samsung Galaxy Watch, back-to-back during the same clinic visit, under staff supervision.
• Group 2 included 146 outpatients, enrolled separately, who recorded ECGs at home on their own smartwatches with staff reminders to keep recording (94% of participants in this group used a Galaxy Watch). Each participant in group 2 recorded a median of 2.4 ECGs per day, and recordings from the first week were analyzed.
• In both groups, ECGs were recorded on the smartwatch as a 30-second, single-lead recording of the heart’s electrical signals. Group 1 participants were recorded on both an Apple Watch and a Samsung Galaxy Watch; Group 2 participants used their own smartwatch at home (94% Galaxy Watch). The AI model analyzed these recordings for signs of weakened heart function.
• A clinical diagnosis of LVSD was then confirmed by transthoracic echocardiography (TTE), an ultrasound of the heart to show how blood is flowing through the heart and heart valves. In both groups, ECGs were recorded within 14 days before or after the echocardiogram.
• The study has several limitations. It was conducted at one hospital in South Korea and included patients referred for echocardiography, so the results may not apply to the general population. The comparison of repeat-testing rules in Group 2 included only 108 participants, and these findings are exploratory. Poor-quality ECG recordings (less than 3%) were excluded from the analysis, and Group 2 participants received reminders to keep recording at home.
• The study did not determine whether using these AI results leads to earlier treatment, fewer hospitalizations or improved survival. In addition, 12-lead ECGs were not available for comparison in the group that had smartwatch ECG measures taken in the clinic.

Co-authors, disclosures and funding sources are listed in the abstract.

Statements and conclusions of studies that are presented at the American Heart Association’s scientific meetings are solely those of the study authors and do not necessarily reflect the Association’s policy or position. The Association makes no representation or guarantee as to their accuracy or reliability. Abstracts presented at the Association’s scientific meetings are not peer-reviewed, rather, they are curated by independent review panels and are considered based on the potential to add to the diversity of scientific issues and views discussed at the meeting. The findings are considered preliminary until published as a full manuscript in a peer-reviewed scientific journal.

The Association receives more than 85% of its revenue from sources other than corporations. These sources include contributions from individuals, foundations and estates, as well as investment earnings and revenue from the sale of our educational materials. Corporations (including pharmaceutical, device manufacturers and other companies) also make donations to the Association. The Association has strict policies to prevent any donations from influencing its science content and policy positions. Overall financial information is available here.

Additional Resources:

• Multimedia is available on the right column of the release link.
• View the abstract in the American Heart Association Scientific Sessions 2026 Online Program Planner
• American Heart Association news release: Artificial intelligence-enhanced ECGs may speed heart failure diagnosis and treatment (Aug. 2020)
• American Heart Association health information: Ejection Fraction Heart Failure Measurement
• American Heart Association health initiative: Get With The Guidelines® - Heart Failure
• About Scientific Sessions 2026
• For more news at the American Heart Association’s Scientific Sessions 2026, follow us on X @HeartNews, #ScientificSessions26

###

About the American Heart Association

The American Heart Association is a relentless force for a world of longer, healthier lives. Dedicated to ensuring equitable health in all communities, the organization has been a leading source of health information for more than one hundred years. Supported by more than 35 million volunteers globally, we fund groundbreaking research, advocate for the public’s health, and provide critical resources to save and improve lives affected by cardiovascular disease and stroke. By driving breakthroughs and implementing proven solutions in science, policy, and care, we work tirelessly to advance health and transform lives every day. Connect with us on heart.org, Facebook, X or by calling 1-800-AHA-USA1.

For Media Inquiries and American Heart Association Expert Perspective:

American Heart Association Communications & Media Relations in Dallas: 214-706-1173; ahacommunications@heart.org

Michelle Kirkwood: michelle.kirkwood@heart.org

For Public Inquiries: 1-800-AHA-USA1 (242-8721)

heart.org and stroke.org

Research Highlights:

• In a randomized clinical trial of more than 300 adults, ages 55 years and older in China with high blood pressure who had an ablation procedure for atrial fibrillation, treatment with a combination of sacubitril and valsartan was associated with fewer recurring irregular heart rhythms than treatment with valsartan alone, after a 12-month follow-up period.
• Blood pressure decreased by similar amounts in both groups, suggesting the difference in recurring abnormal heart rhythms may not be explained by blood pressure reduction alone.
• Note: The study featured in this news release is a research abstract. Abstracts presented at the American Heart Association’s scientific meetings are not peer-reviewed, and the findings are considered preliminary until published as a full manuscript in a peer-reviewed scientific journal.

Embargoed until 4:00 p.m. CT/5:00 p.m. ET, Sunday, November 8, 2026

This news release contains updated information provided by the researchers and not listed in the abstract.

CHICAGO, Nov. 8, 2026 — Among older adults with high blood pressure and atrial fibrillation, treatment with a combination of two blood pressure medications was associated with fewer recurring irregular heart rhythms after an ablation procedure compared with only one of the medications alone, according to new, independent, preliminary, late-breaking science presented today at the American Heart Association’s Scientific Sessions 2026. The meeting on Nov. 6-9 in Chicago is a premier global exchange of the latest scientific advancements, research and evidence-based clinical practice updates in cardiovascular science.

According to the American Heart Association atrial fibrillation, also called AFib, is an irregular heart rhythm that can cause symptoms such as a fast, fluttering or pounding heartbeat, shortness of breath, tiredness or weakness, and/or chest pain or difficulty exercising. AFib ablation is a procedure that uses heat or cold to treat small areas of heart tissue that are causing the abnormal electrical signals, helping the heart maintain a more normal rhythm. Although ablation treats the abnormal electrical activity responsible for AFib, it may not reverse underlying structural changes in the heart that may contribute to AFib. Over time, high blood pressure can place additional stress on the heart and contribute to enlargement, increased pressure and scarring of the heart muscle, and also narrowing of the arteries. These physical changes to the heart create an environment in which AFib can develop again even after an initially successful ablation.

“For many patients, AFib recurrence after an ablation can mean the return of symptoms, additional monitoring, medications or treatments to help restore a normal heart rhythm, and sometimes another ablation procedure,” said the study’s lead author Wei Zhang, M.D., Ph.D., a cardiologist in the department of cardiovascular medicine at the Shanghai Institute of Hypertension at Ruijin Hospital, Shanghai Jiao Tong University School of Medicine in Shanghai, China. “Our goal was to find out whether treatment with a single or combination of blood pressure medications after ablation could affect the chance of AFib returning.”

What are the study’s key findings?

• At 12 months after an AFib ablation procedure, the sacubitril/valsartan combination was associated with a lower rate of documented recurrence of AFib or related atrial arrhythmias compared with patients in the valsartan-alone group.
• Documented atrial tachyarrhythmias (abnormally fast heart rhythms that begin in the heart’s upper chambers) recurrence occurred in 18% of participants in the sacubitril/valsartan group compared to 28.3% in the valsartan group.
• Systolic blood pressure measured at clinic visits fell by about 10 mm Hg in both groups, and there was no significant difference in the reduction in 24-hour ambulatory blood pressure between the two treatment groups.

“Our findings reinforce the idea that treating AFib does not end with the ablation procedure, and managing hypertension remains an important part of comprehensive AFib care. What was particularly interesting to us was that the difference in AFib recurrence was observed even though blood pressure reductions were similar between the two groups. This raises the possibility that after AFib ablation, the type of treatment used to lower blood pressure may be as important as how much blood pressure is lowered,” said Zhang.

He added that the study findings should not be interpreted as suggesting that ablation alone or medication alone is sufficient to prevent AFib from recurring. “AFib is a complex condition, and successful long-term management requires both effective rhythm treatment and careful management of underlying cardiovascular risk factors, particularly hypertension,” Zhang said.

What are the study’s details, background, design and limitations?

• The randomized, controlled trial included 320 patients with both AFib and hypertension (clinic blood pressure >130/80 mm Hg) who received catheter ablation at three hospitals in China between February 2023 and January 2025.
• Participants were an average age of 68 years old; 41.2% were women; and 66.6% had paroxysmal AFib (irregular heart rhythm that occurs in episodes and returns to a normal rhythm).
• After the ablation procedure, 161 patients were randomly assigned to start sacubitril/valsartan (100 mg once daily), and 159 patients were randomly assigned to start valsartan (80 mg once daily). Since all the participants had high blood pressure and required treatment, researchers used valsartan, an active blood pressure medication, as the comparison instead of a placebo. Valsartan blocks the angiotensin II type 1 receptor, while sacubitril is converted to an active metabolite that inhibits neprilysin, an enzyme that breaks down natriuretic peptides.
• Researchers monitored the participants for 12 months after their ablation procedure, with scheduled visits at 1, 3, 6 and 12 months, to determine whether they had a documented recurrence of AFib or related abnormal heart rhythms. During follow-up, heart rhythm was assessed using handheld single-lead ECG devices for home monitoring, as well as standard 12-lead ECG and 24-hour Holter monitoring at scheduled visits.
• The study had several limitations. It was an open-label trial, meaning that patients and treating physicians knew which medication group they had been assigned to; however, ECG-documented recurrence events were centrally adjudicated by an independent team blinded to information about which patients received which treatment. Heart rhythm monitoring was intermittent rather than continuous, so some brief or symptom-free AFib episodes may have been missed. In addition, the study focused on older adults with hypertension undergoing AFib ablation in China, so the findings may not necessarily apply to younger adults, people without hypertension or people living in other countries.

Co-authors and disclosures are listed in the abstract. The study was supported by research grants from the National Natural Science Foundation of China, the Ministry of Science and Technology of China, Shanghai municipal research programs and the Clinical Research Program of Ruijin Hospital, Shanghai Jiao Tong University School of Medicine. The funders had no role in the study design; collection, analysis or interpretation of the data; preparation or review of the manuscript; or the decision to submit the results for publication.

Statements and conclusions of studies that are presented at the American Heart Association’s scientific meetings are solely those of the study authors and do not necessarily reflect the Association’s policy or position. The Association makes no representation or guarantee as to their accuracy or reliability. Abstracts presented at the Association’s scientific meetings are not peer-reviewed, rather, they are curated by independent review panels and are considered based on the potential to add to the diversity of scientific issues and views discussed at the meeting. The findings are considered preliminary until published as a full manuscript in a peer-reviewed scientific journal.

The Association receives more than 85% of its revenue from sources other than corporations. These sources include contributions from individuals, foundations and estates, as well as investment earnings and revenue from the sale of our educational materials. Corporations (including pharmaceutical, device manufacturers and other companies) also make donations to the Association. The Association has strict policies to prevent any donations from influencing its science content and policy positions. Overall financial information is available here.

Additional Resources:

• Multimedia is available on the right column of the release link
• View the abstract in the American Heart Association Scientific Sessions 2026 Online Program Planner
• American Heart Association news release: Ablation reduces stroke risk for AFib and may remove need for some types of blood thinners (Nov. 2025)
• American Heart Association/American College of Cardiology Guideline news release:  Early Rhythm Control, Lifestyle Modification and More Tailored Stroke Risk Assessment Are Top Goals in Managing Atrial Fibrillation (Nov. 2023)
• American Heart Association health information: Diagnosis and Treatment of Atrial Fibrillation
• About Scientific Sessions 2026
• For more news at the American Heart Association’s Scientific Sessions 2026, follow us on X @HeartNews, #ScientificSessions26

###

About the American Heart Association

The American Heart Association is a relentless force for a world of longer, healthier lives. Dedicated to ensuring equitable health in all communities, the organization has been a leading source of health information for more than one hundred years. Supported by more than 35 million volunteers globally, we fund groundbreaking research, advocate for the public’s health, and provide critical resources to save and improve lives affected by cardiovascular disease and stroke. By driving breakthroughs and implementing proven solutions in science, policy, and care, we work tirelessly to advance health and transform lives every day. Connect with us on heart.org, Facebook, X or by calling 1-800-AHA-USA1.

For Media Inquiries and American Heart Association Expert Perspective:

American Heart Association Communications & Media Relations in Dallas: 214-706-1173; ahacommunications@heart.org

Amanda Ebert: Amanda.Ebert@heart.org

For Public Inquiries: 1-800-AHA-USA1 (242-8721)

heart.org and stroke.org

• Left bundle branch pacing, a pacemaker technique that follows the heart’s natural electrical pathway, led to better outcomes for people with an implanted pacemaker compared to those with pacemakers with right ventricular pacing, the standard treatment for people with atrioventricular block, a condition also known as heart block, which is a type of heart rhythm disorder.
• The international, multicenter, clinical OptimPacing trial with nearly 700 adults found that people with pacemakers using left bundle branch pacing had fewer deaths, hospitalizations for heart failure and incidences of pacing-induced cardiomyopathy (weakened heart muscle) compared to people with pacemakers using right ventricular pacing.
• During a planned interim analysis, left bundle branch pacing met the study’s pre-established criteria for superiority over right ventricular pacing, leading an independent monitoring committee and the study’s steering committee to recommend ending the trial early.
• Note: This trial is simultaneously published today as a full manuscript in the peer-reviewed scientific journal NEJM.

Embargoed until 3:30 p.m. CT/4:30 p.m. ET, Sunday, November 8, 2026

This news release contains updated information provided by the researchers and not listed in the abstract.

CHICAGO, Nov. 8, 2026 — People with heart block, a type of heart rhythm disorder, had lower incidences of death, hospitalization for heart failure and pacing-induced cardiomyopathy when the pacemaker technique implemented was left bundle branch pacing rather than right ventricular pacing, according to independent, preliminary, late-breaking science presented today at the American Heart Association’s Scientific Sessions 2026. The meeting on Nov. 6-9 in Chicago is a premier global exchange of the latest scientific advancements, research and evidence-based clinical practice updates in cardiovascular science.

Atrioventricular block, also known as heart block, is a condition in which electrical signals between the heart’s upper chambers (atria) and lower chambers (ventricles) are delayed or interrupted. This can cause symptoms including a very slow heart rate (known as bradycardia), fatigue, dizziness, fainting, chest pain and, in severe cases, cardiac arrest.

The standard treatment for heart block is a pacemaker that sends electrical signals to the heart’s right ventricle. The pacemaker technique that is the current standard of care for heart block is called right ventricular pacing, and it has been routinely used for decades to prevent bradycardia and cardiac arrest in people with atrioventricular block. Although it can keep the heart from beating too slowly, pacing only the right side can make the heart’s lower chambers beat out of sync. Over time, this imbalance may enlarge or weaken the heart muscle (pacing-induced cardiomyopathy) and contribute to heart failure in some people.

A newer pacing technique called left bundle branch pacing sends the pacemaker signal into part of the heart’s own electrical pathway. It mimics the heart’s natural electrical activation sequence, which helps the lower chambers squeeze in a more coordinated pattern.

“Not all pacing options are the same, and people who need a pacemaker to keep their heart beating properly should talk with their healthcare team about which pacing approach is appropriate for their condition,” said study author Jiangang Zou, M.D., Ph.D., a professor of cardiology at First Affiliated Hospital, Nanjing Medical University in Nanjing, China. “Our findings show that left bundle branch pacing helped the heart beat in a more natural way and was linked to fewer serious heart-related events than the standard pacing approach of right ventricular pacing.”

The international, multicenter OptimPacing trial tracked nearly 700 men and women with atrioventricular block being treated with a pacemaker over a five-year period.

What are the study’s key findings?

• Left bundle branch pacing was associated with a 59% lower risk of death, heart failure hospitalization or cardiomyopathy compared with outcomes in the right ventricular pacing group.
• At four years, an estimated 8.5% of participants in the left bundle branch pacing group had died, were hospitalized for heart failure or developed pacing-induced cardiomyopathy, compared with 19.2% in the right ventricular pacing group.
• No participants in the left bundle branch pacing group developed pacing-induced cardiomyopathy, compared with 11.7% in the right ventricular pacing group.
• Heart failure hospitalization occurred in 1.5% of the left bundle branch pacing group vs. 2.9% of the right ventricular pacing group.
• An independent data monitoring committee reviewed the results of the planned interim analysis after a median 3-year follow up, which found that the primary outcome of mortality, heart failure hospitalization and pacing-induced cardiomyopathy occurred in 8.5% of patients receiving left bundle branch pacing compared with 19.2% receiving right ventricular pacing. The committee recommended ending the trial early because left bundle branch pacing met the study’s pre-established threshold for superiority.

“We expected that the group with left bundle branch pacing would do better than the group with right ventricular pacing. However, the difference between the two groups was greater than we expected. This study shows that left bundle branch pacing should be the first choice for patients with heart block who need a pacemaker,” Zou said.

What are the study’s details, background, design and limitations?

• The trial was conducted at 17 centers in mainland China, Hong Kong, the United Kingdom, Poland and the United States from June 2021 to January 2025.
• The trial included 685 adults with an average age of 68.4 years, and 57.5% were men. Participants had second-degree or complete atrioventricular block, or ongoing atrial fibrillation with an average heart rate below 50 beats per minute and related symptoms. Most of the participants had normal left ventricular ejection fraction (LVEF), a measure of the heart’s pumping strength, at the start of the study.
• Half of the participants were randomly assigned to get pacemakers with left bundle branch pacing, and the other half received pacemakers with right ventricular pacing.
• Information was collected before the participants were assigned to left bundle branch pacing or right ventricular pacing, immediately after pacemaker implantation, at 6 and 12 months post-implantation, and then annually thereafter.
• Researchers tracked participants’ deaths, heart failure hospitalizations, pacing-induced cardiomyopathy, other safety events, heart ultrasound results and pacemaker data.
• All major health events were independently reviewed and confirmed by a committee that did not know which treatment the patients received.
• The study had several limitations. The trial’s early termination could potentially lead to an overestimation of the benefits of left bundle branch pacing and reduce the precision of estimates. Most participants started with normal heart pumping strength (normal ejection fraction), so the findings may not apply to people with already reduced heart function. All left bundle branch pacing procedures used the same type of lead, so it is not known whether the results apply to other pacing tools.

“Future research is needed to refine which pacing technique is most appropriate for which patients, compare different pacing approaches that follow the heart’s natural electrical system, and examine long‑term safety and cost‑effectiveness to help inform updates to clinical guidelines,” Zou said.

Co-authors and disclosures are listed in the abstract. The Project on New Technology of Jiangsu Province, Clinical Competence Improvement Project of Jiangsu Province Hospital, National Natural Science Foundation of China and 135 Project for Disciplines of Excellence–Clinical Research Incubation Project of West China Hospital funded the study.

Statements and conclusions of studies that are presented at the American Heart Association’s scientific meetings are solely those of the study authors and do not necessarily reflect the Association’s policy or position. The Association makes no representation or guarantee as to their accuracy or reliability. Abstracts presented at the Association’s scientific meetings are not peer-reviewed, rather, they are curated by independent review panels and are considered based on the potential to add to the diversity of scientific issues and views discussed at the meeting. The findings are considered preliminary until published as a full manuscript in a peer-reviewed scientific journal.

The Association receives more than 85% of its revenue from sources other than corporations. These sources include contributions from individuals, foundations and estates, as well as investment earnings and revenue from the sale of our educational materials. Corporations (including pharmaceutical, device manufacturers and other companies) also make donations to the Association. The Association has strict policies to prevent any donations from influencing its science content and policy positions. Overall financial information is available here.

Additional Resources:

• Multimedia is available on the right column of the release link
• View the abstract in the American Heart Association Scientific Sessions 2026 Online Program Planner
• American Heart Association news release: Reconditioned pacemakers worked as well as new ones (Nov. 2024)
• American Heart Association news release: Lifestyle & risk factor changes improved AFib symptoms, not burden, over standard care (Nov. 2024)
• American Heart Association Scientific Statement: Periprocedural Management and Multidisciplinary Care Pathways for Patients With Cardiac Implantable Electronic Devices (July 2024)
• American Heart Association/American College of Cardiology Guideline news release: Early Rhythm Control, Lifestyle Modification and More Tailored Stroke Risk Assessment Are Top Goals in Managing Atrial Fibrillation (Nov. 2023)
• About Scientific Sessions 2026
• For more news at the American Heart Association’s Scientific Sessions 2026, follow us on X @HeartNews, #ScientificSessions26

###

About the American Heart Association

The American Heart Association is a relentless force for a world of longer, healthier lives. Dedicated to ensuring equitable health in all communities, the organization has been a leading source of health information for more than one hundred years. Supported by more than 35 million volunteers globally, we fund groundbreaking research, advocate for the public’s health, and provide critical resources to save and improve lives affected by cardiovascular disease and stroke. By driving breakthroughs and implementing proven solutions in science, policy, and care, we work tirelessly to advance health and transform lives every day. Connect with us on heart.org, Facebook, X or by calling 1-800-AHA-USA1.

For Media Inquiries and American Heart Association Expert Perspective:

American Heart Association Communications & Media Relations in Dallas: 214-706-1173; ahacommunications@heart.org

Amanda Ebert: Amanda.Ebert@heart.org

For Public Inquiries: 1-800-AHA-USA1 (242-8721)

heart.org and stroke.org

• A study including nearly 3,500 adults in India with heart failure found that participants in a yoga-based cardiac rehabilitation program reported improved quality of life and walking distance compared to the group that received enhanced standard care.
• However, there was no statistically significant difference in the combined rate of death, hospitalization or stroke between the yoga-based cardiac rehab group and the enhanced standard care group.
• The study investigated whether people with heart failure may benefit from participating in yoga-based cardiac rehabilitation alongside usual heart failure treatment. The yoga-based cardiac rehab program was developed to provide an affordable and accessible alternative to a traditional cardiac rehab program in communities with limited resources and for patients who may prefer a low-impact physical activity option.
• Note: The study featured in this news release is a research abstract. Abstracts presented at the American Heart Association’s scientific meetings are not peer-reviewed, and the findings are considered preliminary until published as a full manuscript in a peer-reviewed scientific journal.

Embargoed until 4:00 p.m. CT/5:00 p.m., ET, Saturday, Nov. 7, 2026

This news release contains updated information provided by the researchers and not listed in the abstract.

CHICAGO, Nov. 7, 2026 —A yoga-based cardiac rehabilitation program improved the quality of life for people with heart failure with reduced ejection fraction, compared to patients who received enhanced standard cardiac rehab. The yoga-based cardiac rehab program did not, however, significantly reduce the combined rate of death, hospitalization or stroke. All this according to late-breaking science presented today at the American Heart Association’s Scientific Sessions 2026. The meeting on Nov. 6-9 in Chicago is a premier global exchange of the latest scientific advancements, research and evidence-based clinical practice updates in cardiovascular science.

“Between 8 and 10 million people in India are living with heart failure, many of whom are typically 10 years younger, on average (most younger than age 65) compared to adults with heart failure living in high-income countries,” said lead study author Dorairaj Prabhakaran, M.B.B.S., M.D., D.M., executive director of the Centre for Chronic Disease Control in India, President-Elect, World Heart Federation, Geneva and adjunct professor at Rollins School of Public Health at Emory University in Atlanta. “Reducing hospitalizations and improving quality of life and physical function for heart failure patients, these are valuable shifts that are much needed in countries like India.”

Cardiac rehabilitation programs are medically guided and designed for people who have experienced a heart attack, heart failure, or heart surgery. Cardiac rehab programs can lower the risk of another cardiac event and improve a person's ability to engage in daily living and activities through exercise guidance, education on healthy living, and counselling for stress relief. However, cardiac rehabilitation can be costly, and participation rates are low, particularly among women, older adults and people from some racial and ethnic groups, according to the 2025 American Heart Association Scientific Statement: Cardiac Rehabilitation in Women.

“Cardiac rehab programs are inaccessible to many, and their uptake is poor in many countries,” said Prabhakaran. “Innovations are needed to reduce costs, scale up cardiac rehab and make it sustainable. Yoga is culturally acceptable in countries like India, and it can provide many of the benefits of cardiac rehab at a lower cost. A yoga-based cardiac rehabilitation delivered by a single healthcare professional may be effective, scalable and sustainable. However, the evidence for such an approach is sparse.”

What are the study’s key findings?

• At three months, participants in the yoga-based cardiac rehab group had significantly greater improvement in quality of life than the enhanced standard care group: their Minnesota Living with Heart Failure Questionnaire scores improved by about 8 points (lower scores indicate better quality of life).
•  There was no statistically significant difference between groups in the combined rate of death, hospitalization or stroke: 364 participants (21.0%) in the yoga-based rehab group died, were hospitalized or had a stroke during a median follow-up of 15 months, compared to 401 (22.8%) in the enhanced standard care group.
• Greater improvements were also observed in the yoga cardiac rehabilitation group patients’ physical functioning abilities compared to the enhanced standard care group when based on the distance participants could walk in six minutes and the between-group difference in change from baseline. Participants in the yoga group walked, on average, 25.5 meters farther than the participants in the enhanced standard care group.
• The health status based on EQ-5D-5L questionnaire (Quality-adjusted utility-values with Indian dataset) was better among the people who underwent the yoga-based cardiac rehabilitation than the comparison group.

“This study tested a yoga-based cardiac rehabilitation program incorporating health education and tailored behavior change with individual participant goals and a standardized set of physical practices of yoga,” said Prabhakaran. “We found the Yoga-CaRe program helped improve quality of life and physical function in people living with heart failure. In our trial, a board-certified yoga & naturopathy practitioner delivered this structured, yoga-based cardiac rehabilitation package for adults with heart failure. These results are potentially scalable and sustainable in settings where cardiac rehab is not easily available and resources are limited. The cultural acceptability of the yoga-based rehab was also high, as shown by strong participation in the supervised sessions and in home practice. Though a formal cost-effectiveness analysis is yet to be conducted, we expect it to be affordable and accessible for patients with heart failure.”

What are the study’s details, background, design and limitations?

• Between April 2023 and December 2025, the trial recruited almost 3,500 adults with heart failure across 16 medical centers in India; 27% were women; and the median age was 57 years. Nearly 40% of participants were recruited from inpatient/hospital settings.
• Study participants had heart failure with reduced ejection fraction, or HFrEF, which means the heart’s main pumping chamber pushes out 40% or less of the blood it contains with each heartbeat. The study also included patients hospitalized for acute decompensated heart failure and those with chronic heart failure.
• About half of the study participants had New York Heart Association (NYHA) Class III heart failure, which means they had marked limitation of physical activity: they were comfortable at rest, but less-than-ordinary activity caused fatigue, heart palpitations or shortness of breath.
• Of the 3,492 heart failure patients with reduced ejection fraction, half were randomly assigned to participate in the yoga-based cardiac rehabilitation program (n=1,737 in the intervention group), and the other half received enhanced standard care (n=1,755 in the control group).
• The intervention group received Yoga CaRe – a standardized and structured yoga program – and health education using “Healthy Living with Heart Failure” booklet with tailored advice using a goals-based approach. The program was delivered in 20 supervised sessions over three months, and then one session every three months until the end of follow-up.
• The second group received enhanced standard care that included three health education/information sessions over three months, and the same health information booklet used by the patients in the intervention group.
• The researchers measured the time to the first medical event, which was a composite of death by any cause, hospitalization for any reason or a stroke occurrence during the study follow-up period.
• The study also measured the participants’ quality of life after three months using the Minnesota Living with Heart Failure Questionnaire. The self-reported questionnaire includes 21 questions pertaining to the physical, emotional and socioeconomic ways heart failure can adversely affect a person’s life.
• Researchers also assessed the participants’ 6-minute walk distance.
• The EuroQol 5D-5L (EQ-5D-5L), a standardized, self-reported survey to measure a person’s health-related quality of life, including mobility, self-care, usual activities, pain/discomfort and anxiety/depression, was conducted at three months.
• The quality of life, 6-minute walk distance and quality-adjusted utility value (a score that describes how good or difficult a person's health condition feels in everyday life that is often used to compare the benefit of different treatments) were assessed at 6, 12 and 24 months.
• The study has some limitations. As is the case with all cardiac rehabilitation trials or behavioral interventional trials, the study intervention cannot be blinded because participants knew which cardiac rehab they were participating in. Secondly, the number of interactions between the patients and yoga instructors in the intervention sessions was higher than the enhanced standard care (20 sessions versus 3 sessions), which could have impacted the results.

The authors note that future research should be centered around implementing yoga-based cardiac rehab at-scale and also evaluating this approach in other healthcare settings and countries.

“This trial is one of the largest studies of cardiac rehabilitation in people with heart failure that evaluated an alternative cardiac rehab program that may be easier and more cost-effective to deliver in limited-resource settings,” said Prabhakaran.

Co-authors, disclosures and funding sources are listed in the abstract.

Statements and conclusions of studies that are presented at the American Heart Association’s scientific meetings are solely those of the study authors and do not necessarily reflect the Association’s policy or position. The Association makes no representation or guarantee as to their accuracy or reliability. Abstracts presented at the Association’s scientific meetings are not peer-reviewed, rather, they are curated by independent review panels and are considered based on the potential to add to the diversity of scientific issues and views discussed at the meeting. The findings are considered preliminary until published as a full manuscript in a peer-reviewed scientific journal.

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Additional Resources:

• Multimedia is available on the right column of the release link.
• View the abstract in the American Heart Association Scientific Sessions 2026 Online Program Planner
• American Heart Association news release: Women face barriers in accessing, participating in cardiac rehab despite proven benefits (October 2025)
• American Heart Association health information: How Will I Benefit from Cardiac Rehab?
• American Heart Association health initiative: Core Components of Cardiac Rehabilitation Programs: 2024 Update: A Scientific Statement From the American Heart Association and the American Association of Cardiovascular and Pulmonary Rehabilitation
• About Scientific Sessions 2026
• For more news at the American Heart Association’s Scientific Sessions 2026, follow us on X @HeartNews, #ScientificSessions26

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