As digital health moves from promise to practice, several studies presented during a Hot Line Session at ESC Congress 2026 demonstrate how technology can accelerate the implementation of guideline-directed cardiovascular care. From digital strategies that support uptake of SGLT2 inhibitors in patients with heart failure (HF) to remotely delivered exercise programs, targeted outreach to improve statin adherence, and virtual e-health systems for ICD management, these investigations highlight the growing role of technology in optimizing patient care and outcomes.

In the randomized ADHERE-ASCVD study, simultaneously published in JAMA, Ankeet Bhatt, MD, MBA, ScM, FACC, et al., found that adaptive digital outreach improved short-term statin refills in patients with documented low statin adherence vs. usual communication. Additionally, a second outreach produced additional gains among initial nonresponders, although switching communication modalities provided no additional benefit, researchers said.

They highlight that the trial findings support adaptive, sequential health system outreach strategies to improve cardiovascular prevention when integrated into population health programs. In a related editorial comment, Luke J. Laffin, MD, FACC, notes that, “the principal contribution of ADHERE-ASCVD may not be the modest improvement in statin adherence, but the demonstration that important clinical questions can be tested rapidly and rigorously within existing health system infrastructure.” He writes that the study’s “most durable legacy may be the model it provides for iterative experimentation at scale, even as the search for more effective solutions to statin nonadherence continues.”

In the EMAIL-HF trial, a registry-based digital strategy that identified untreated patients and proactively invited them for specialist evaluation more than doubled initiation of guideline-recommended SGLT2 inhibitor therapy.

“The findings show that digital systems can be developed that proactively identify and contact patients who are missing out, helping more patients to receive guideline-recommended treatment in a timely manner, without relying on their next hospital visit or hospitalization,” said Mariam Elmegaard, MD, of Herlev and Gentofte Hospital in Copenhagen. “If adopted more widely, this type of digital strategy could help narrow the gap between medical evidence and the care patients actually receive.”

Findings from the Remote Exercise SWEDEHEART study demonstrate that remotely delivered cardiac rehabilitation, when added to center-based programs, resulted in a similar number of completed sessions as center-based programs only. Researchers noted that exercise capacity improved similarly in both groups and serious exercise-related adverse events were uncommon.

“Our findings suggest that remotely delivered exercise-based cardiac rehabilitation should be viewed as an additional patient-centered option, rather than a replacement for center-based rehabilitation or a stand-alone solution for poor uptake,” said Maria Bäck, MD, from Sahlgrenska University Hospital and University of Gothenburg in Sweden. “It appears that there are other participation barriers that are not related to travelling, which may include other co-existing diseases, language barriers, socioeconomic factors and varying levels of digital health literacy.”

In the VIRTUES ICD study, a virtual e-health system designed to check the functional status of ICDs remotely was found to be as safe and effective as regular clinic visits, with the added benefits of cost savings and good patient satisfaction.

“In addition to similar safety and efficacy and the cost savings, patients were strongly supportive of this digital approach,” said Ratika Parkash, MD, MS, the trial’s principal investigator. “The VIRTUES system could be scalable for use globally although it has only been tested in Canada so far and further studies would be needed in other regions.”

Visit ACC’s ESC Congress 2026 coverage page to explore the latest science and key takeaways shaping cardiovascular care.

Clinical Topics: Arrhythmias and Clinical EP, Cardiovascular Care Team, Heart Failure and Cardiomyopathies, Implantable Devices, SCD/Ventricular Arrhythmias, Acute Heart Failure

Keywords: ESC Congress, ESC26, Heart Failure, Telerehabilitation, Cardiac Rehabilitation, Atherosclerosis, Defibrillators, Implantable, Pacemaker, Artificial, Telemedicine