Well, good morning, everyone. I guess we'll go ahead and get started. You know, we may be able to get done early, and we may be out, you know, watching the sailboats go by. So welcome to this session that really is designed to talk a little bit about HRX and, you know, the meeting and what we have planned in 2025. And, you know, I thought what we would do is really just go around the room and get people to introduce themselves. And then I will go through a little bit about the history of the meeting, ask people who have that institutional memory, and then for those who are going to be participating in this year's memory meeting, you know, just talk a little bit about what you feel will be the value proposition of the meeting. So I'm Sunit Mittal. I'm the executive producer of HRX 2025. And I'm going to start with my co-moderator, Sana, and just ask everyone on their way down to just basically introduce themselves. Well, thank you very much, Sunit. Good morning, everyone. I'm Sana Al-Khatib. I'm the program chair for HRS 2025. And, in fact, I was the executive producer for HRX at the very, very beginning. I did that for three years, but the first year we couldn't have the meeting because of the pandemic. Happy to be here. Good morning. My name is Jennifer Silva. I'm a pediatric EP in St. Louis, Missouri at WashU, and I have two startup companies. My relationship with HRX, I've also been involved from the beginning on the production team, is what we call the group of people that furiously work behind the scenes to get things together, and I'm the past executive producer for HRX. So good morning, everyone. Rob Cowell. I run the pacing business at Medtronic, a former or, should I say, recovering EP from practice, and was involved with HRX early on in terms of some of the ideation and the funding support, and was there last year as a shark in the shark tank. I'm John Puccini. Nice to see all of you. I'm an electrophysiologist at Duke and co-producer of HRX this year, and also do clinical trial work and focus on device development. I'm Hamid Gambari. I'm a clinical cardiac electrophysiologist at University of Michigan. I'm also the director of innovation at University of Michigan and the deputy editor of the HRO2. I've been involved with the event, HRX, from the beginning. I've been helping in a variety of ways with production and the relationship with the journals as well. Hello. I'm Giovanni Leo. I'm the European voice coming from Geneva, Switzerland. I've been an entrepreneur in the past in electrophysiology, and I'm now running a fund in Medtech that invests in Medtech and pharma from Geneva, but everywhere in the world. I've participated last year to HRX, and I'm happy if we can contribute more. I'm Diti Virgis. I'm an EP nurse practitioner from Emory University Hospital in Atlanta, Georgia, where HRX 2025 will be. This will be my third year attending. The first year I was just an attendee, and I got to really experience a very unique conference setting, which we'll talk about some more. Last year, I got to be in a couple of panel discussions, and that was very exciting. Looking forward to this year's conference. Steve, we're going to let you introduce yourself. We're basically just introduce yourself and your relationship to the HRX community. I have the hot seat. I'm a clinical assistant professor in emergency medicine at UCSF, and I've been involved for about 11 years now with medical devices, primarily in the cardiovascular biomarker space. I was previously chief medical officer at Echo Digital Stethoscopes and currently a clinical lead at Proton Intelligence. My experience with HRX is we won the HRX Innovation Shark Tank earlier this year, so it's been a great ride with the support of HRS and HRX. I should have prefaced the fact that I was asked to have you download QR codes and things like that, but since we are a small, intimate gathering, if you have any questions at all, just shout them out, and I think the panel will take them. I'm going to start by putting Sana on the spot just for a second because I view Sana as the founding member of HRS and largely responsible. Today we're in San Diego. The first HRX was held in San Diego, so we've come kind of full circle. Sana, I would ask you to just maybe think about when we were conceiving this meeting, a little bit about what went into the thought that there was a need for this meeting, and when you were designing meeting one, because we're going to go through a little bit of the evolution of the meeting in a second, what was the thought process about what we were trying to accomplish? Thank you very much, Sunit. These are excellent questions. Obviously, as we were thinking about innovation and the big emphasis that HRS places on innovation, we felt that it is important for us to think about creating a meeting that would absolutely emphasize innovation in many ways. Of course, we were starting to think about, do we focus innovation just on electrophysiology? Do we go beyond electrophysiology? We weren't sure at the beginning, but our thinking was, well, let's experiment by trying to even go broader than electrophysiology, and so that's what we tried to do in the first couple of years of the meeting. I know you're going to hear about the evolution in terms of where we went, but I felt like we actually did have good representation of different areas with a big focus on digital health, remote monitoring, AI. Those things we absolutely emphasized, and yes, we started off wanting to experiment outside of electrophysiology, but truth is actually about 70 percent of the content at the first meeting was EP-specific. Other areas that were covered were heart failure, because of the significant overlap between us and heart failure, but we really wanted to bring to light a lot of the new technologies, especially in terms of how to deliver care, like talking about virtual hospitals, virtual care, and as I said, AI, remote monitoring. Those were very important for us in the first couple of meetings. Thanks, Sana, and so maybe I'll piggyback on that and now turn it to you, Jen. As executive producer last year, you took the lessons that were taken in years one and two, and we started to evolve the meeting a little bit by year three. You want to talk a little bit about that and what we learned? Yeah, thank you for that question, and one of the things that Sana alluded to was that the first year HRX was supposed to happen, it didn't because of something happened in our world, right? The pandemic happened, and I think that shaped a lot of what we saw content-wise, because very quickly, those of us who were engaging in virtual medicine, telehealth, whereas previously we were sort of on the fringe of our groups, now our groups were turning to us wholesale and saying, okay, how do we take this and implement it broadly? So it was a really interesting time. What we learned and what I learned as we had our first two years of HRX was that we really were electrophysiologists, and I thought we needed to start embracing that a little bit because, I mean, I don't know much about diabetes, and even worse, I'm a pediatric EP, right, so I really don't know a lot about diabetes, but there's something to be learned from those groups, and so we started moving more from the purely digital aspects to really embracing more innovation in EP, and that'll be curious to see what you and John do with it in the coming years. The other thing we did was we realized we had tried different formats for the meeting, and so for those of you who've been to HRX, you know that the format of the meeting is really quite different. This sort of thing does not exist at HRX. We try very hard to make sure it doesn't exist at HRX. It really is meant to be everybody in one room in a really immersive sort of experience. We try different formats and layouts of that. In year one and year two, we had our own personal experiences, and thankfully we had a lot of feedback from people who had been at HRX, and so that informed how we ended up setting up year three, and I think we're starting to sort of hone in on what was working and what's working. Conversations. These roundtable conversations where we don't have people necessarily on a stage talking to people in an audience, but having a group of people that are discussing a topic and really having a conversation about it. Jen, I'm going to push you on one more thing, which is, you know, remarkable that when SANA and creators started this just a few years ago, many of the things that we take for granted today, artificial intelligence, LLM, didn't really even exist, and by the time you were tasked with leading, you know, year three, these had, you know, been introduced into the mainstream, and I know one of the areas you were very passionate about was the issue of implementation of science and how we were going to take concepts that were just hitting, you know, our worlds, you know, both in our real lives, but obviously in our professional medical lives, and, you know, implementing that, and I think that was also a very strong focus last year. It really was, and it came directly out of the experience that I had, and I think so many people on this stage and in this audience had, where we were now being asked to scale something that we were doing as one-offs or things on the side, and this field of implementation science, I am by no means an expert in it. I'm certainly a student of it, and I thought that this was the time, because I think a lot of us know where the innovations are happening in our space, but where, how do you scale that? How do you scale it both from the industry side and from the clinician side, both innovations that are device and drug, but innovations that are process innovations? I know Hamid will talk about that. Yeah. And so that was something that we really focused on in year three. And before I turn it to the others, I'm just going to have John weigh in. I've really been, it's been a delight working with John this year, and you know, John, you know, introduced the concept of pushing this even further by recognizing that our world of innovation, you know, extends beyond what we were looking at initially. And so John, I want to talk a little bit about, you know, the thought process behind that and, you know, how we're evolving this year's meeting to reflect that. Yes. So, you know, if anyone, any of you have been to HRX, we don't, you know, need to explain what it's like because you know how unique and special it is. And I, you know, I think a way to think about it is it's like that backstage pass for a concert, or it's the on the field pass for an NFL game. You really get to mingle and have the conversations and see what's really going on. And HRX has been incredible. And there's been a focus on these truly remarkable innovations like digital health and AI, but we know that in electrophysiology there's innovations all the way from simple things like how we close and how we do transcendental access all the way through new innovative devices and ablation techniques. So we want to focus on that entire pipeline from where the technologies first, you know, exit the stealth mode all the way up to commercialization. And I'll tell you one of the very humbling things is I have, you know, a lot of research collaborations and work with a lot of different companies. And so an exercise, we went and we started writing down all the new technology companies and innovation that are coming down the pipeline. And you think you have an exhaustive list. Then you talk to three more people and you realize that you actually had about 10% of it. So I think the power of HRX is if you want to come to one place where all of that is going to be together, you know, in a highly immersive environment, HRX is the place to be. And I'm going to now turn to Hamid because the other person who's really been involved from day one is Hamid. And, you know, for many of us, we kind of dabble in this space, but this is his, you know, professional, you know, area of expertise. And really he's taught us a lot about this area. And when we started this meeting, Hamid also had a very significant role in a journal that was in existence at that time, the Cardiovascular Digital Health Journal. So, Hamid, can you talk a little bit about, you know, your own, you know, evolution, you know, in terms of thinking and, you know, how this meeting is involved and your thoughts? Well, thank you for that. You know, I think when we started out, there wasn't a clear definition of what innovation means to HRX. And I'm really happy to see that that has really formed and crystallized over time. When I think about innovation, I always think that it means, it doesn't mean that you've invented something new. It's the process of making that something new valuable and extracting some of that value in a form that's meaningful to you. Now, that value could be, you know, an outcome of interest for you, or it could be financial, economic, but you have to not only create value, you have to capture it in some way. So idea without value, it's not really innovation. And I think the evolution of HRX, I've seen that kind of like crystallize. And I think this year, you're kind of like really hitting it very well. And I think we've been trying to understand like what part of that process is conducive to, you know, the scientific publication and how, you know, how we can marry the, like the vigor and the science to the process of innovation. And I think that not all the steps involved in the innovation process lend themselves to the publication and the rigor of manuscript writing, like the marketing, for example, or like the reimbursement problems that everybody has. So I think journal fills a very important role in parts of the innovation process, and HRX is very nicely addresses the other ones, which I think the conference is much better vehicle for addressing all the other things. And the other part of, I think, HRX does very well is that it brings the key players together. I think that's like so important for, you know, the innovation process, because you have to bring the innovators together with the people that are actually going to be using it. And they need to talk, they need to understand what is value mean for the institutions, and what are the mechanisms of capturing of that value over time. And I think we've evolved to understand that it's innovation, it's just not new products. It's process innovation is very important. It's probably very meaningful for us as well in EP. And you oftentimes can, you know, get way more value from the process innovations than new gadgets. So I'm really happy to see that as well. And I think it's just scratching the surface. I think now that we're understanding what that means, bringing the payers, bringing insurers, bringing the innovators together. And finally, I would say, like, I, over time, I've really seen it kind of becoming something on its own to now serving the overall mission of HRX, which was really important. Now I can see it like the whole the puzzle is fitting, putting together a lot better than before. Sandra, did you have a comment? Yeah. Yes, I completely agree with everything you said, Hamid. The only thing I want to add is like, if you think of the innovation cycle, because we got this question quite a bit, and even our thinking actually evolved when we were working on like the program in year one, year two, and onward. So like, if you think of the innovation cycle, HRX, our annual meeting, our most important meeting, I would argue, it really mostly focuses on post market, like talking about things that have made it to the market. And what we were hoping to target with HRX is what happens before those products actually come to the market and are available for use. So pre market translation, those different steps. So that made it easier also for us to kind of envision what innovation means for HRX. Rob, I'm going to turn to you. I mean, by nature, you're an electrophysiologist, but even in the course of these few years, we've had this meeting, your own professional role has morphed from chief medical officer to someone now running a pacing business where there's a lot of innovation, certainly, share some insights about how you would think about it as an EP, as well as someone who's on the other side of things. No, it's been a lot of fun to watch and kind of help not being in the center of it, but see how it evolves. And I think one of the things that we forget, which is the X, the X stands for explore. And that was how it was originally pitched to me. And I think what's been fun now is the evolution over three years is doubling back down on the explore. And it started, I think, as this idea to go to digital, and then it kind of got locked in there. And now we've reinvigorated this explore idea to a broader space. And I want to capture a couple of the ideas that a few of you have talked about. One is the implementation piece. The other is kind of value comes from a lot of different places. And I think one of the things that I like the direction where it's going is it seemed with the digital side, it kind of started with the, wow, this is so interesting. These are really kind of neat new things. But what was hard, and this is no fault of anyone, was are those things actually scalable? And can they eventually move the needle? And I like this idea of how do you take some early ideas, but also think about them, not just from, oh, that's a great idea. How do we get them going? But how do we think to the next step of can these be scaled? Can they actually move the needle in healthcare? And that's where getting all these different players involved is important. And what's fun is, for example, I was on the shark. I was a shark on the shark tank. Wait, I voted for you. But that led to a phone call. And we've traded, we spent an hour on the phone together. That's traded interactions. That leads to more interactions. And then, for example, on the implementation side, we're about to launch a new trial in the HFPEP arena that we talked about last year. And what did we do? One of our co-PIs is an implementation scientist. So I think whether it is this early phase or later in the process, adding that component is so critical to this ability of taking innovation from an idea to something of value. And I think that that transitions nicely, I think, Giovanni, to you. I mean, as you're a venture capitalist, so you're obviously thinking about it from the perspective of how this creates value, economic value, to the people you're working with. And so I'd like to hear a little bit about how does a VC think about this meeting and the value that this may bring to you as well as our members in having these opportunities to interact with people in your ecosystem? Thank you for the question. The value of a meeting or like HRX, to me, is fundamentally in the fact that it is focused on a subject. And nowadays, all these areas that we study are very specialized. And we really need to understand the details, the dailies and the details. And having the opportunity to meet people that are highly specialized in one sector allow us really to understand what are the needs, the user needs, on the one hand. And on the other hand, we see what are all the opportunities that are being developed that are offered. And having these two aspects makes, for me as a VC, the meeting very, very interesting. And it's also, one thing is that what kind of VC might be interested because, of course, if you look at late-stage VCs, groups of VCs, they will see less interest into this activity. But there are many early-stage VCs around, and I think that they would take, really make the most of the interest from them. Steve, you chose to present your work at this meeting. Talk a little bit about why you chose the meeting, what you got out of it, what were the positives, what advice you would give us as somebody. And then also tell us a little bit about what's transpired in the past year since you won this competition. Yeah, so I think the first thing I would think about with HRX, the reason why we focused on it was a word of mouth, quite frankly, actually. One of our advisors, Dr. Murat Fudim, had mentioned this conference to us. It had been on my radar before, several years ago when I was at ECHO. But at Proton Intelligence, it wasn't even on our radar. This is outside of what we did, which is essentially a continuous potassium monitoring patch, similar to a CGM, but the analyte that we detect is potassium. But we saw, as soon as he mentioned it, sort of these connections with electrophysiology, especially because what we're trying to prevent is sudden cardiac death. And so that sort of light bulb came, and when I arrived, I was actually shocked to see eValue almost immediately because I've never seen a conference where FDA had its own corner inside of a conference. And so that was immediate value to any, when we talk about sort of early stage, pre-market, you gotta have regulatory on the table. So that was shocking to me. I also think I faced the stiffest but most constructive commentary from the audience during and after that pitch there of all the conferences that we had been to in the past year. So I think the academic nature and sort of meets the regulatory meets sort of pre-market, real stakeholders that you have to confront all in one room was actually unique to all the conferences. Since the winning of the HRX, we've actually accelerated dramatically. We went first in human to Uzbekistan, actually, through clinical accelerator, and had an N of 20 study completed with very strong data. And we are moving to our next phase of clinical. And we're also currently fundraising. We'll always be fundraising, but we're on to another round. So things were quite positive in the past six months, nine months, I think, since HRX, and it's been a remarkable ride since then. Fabulous. This actually gives me goosebumps, honestly, just hearing your story. So congratulations. Dee, I haven't forgotten about you. And I wanna now turn to you because we have had tremendous support of this meeting from our APP community. And each year, we've really just been impressed by more and more turnout. And this year, we are even expanding things further by having a shark tank, for example, dedicated to APPs for all the great ideas. Can I ask you to just weigh in as an APP for yourself and the greater APP community? Like, what are we doing right? And what are the things that are driving value to your colleagues? Thank you for that question. I felt that innovation, as several of the panelists mentioned, was very personal. The conversations that we specifically had at the roundtables, they weren't just abstract. They were actionable strategies that you could take back to work on Monday. One example was patient education, like videos. There was a center from, it was a children's center from California that actually created a whole patient experience video from when they check in to all the way back to the lab and what the patient can experience. We're actually taking that now to Upbeat TV. Which should hopefully come out sometime this year. But it seems like most of us have very similar issues, maybe slightly unique, and it was a good platform to collaborate on ideas to improve our workflow. Fabulous. Hamid, I'm gonna turn back to you, because you were involved in many sessions last year, but of the two that I found really remarkable were really, what I thought were really a desire by people to learn new languages. And one new language is the language of PPG, which is basically everywhere. And the other is LLM, which is obviously everywhere, and we're all trying to struggle with it. So one of the things I'm gonna ask you is that to learn these new languages, is HRX really the best forum we have currently for people to learn it? Because you come to a meeting like this and you're thinking more about how you're gonna do your next AF ablation, but if you're really trying to understand what patients are coming to us with, all these wearables and people trying to understand where to do it, is that's what's resonated with a whole number of people? Because your sessions have always been overflowing at these meetings. That's very nice of you to say. I don't think it's because of me, but the people that were on the panel, I was just trying to get the most out of them. It's hard to learn these complicated topics in such a short amount of time, and I think what happens is that you maybe hope to pique the interest of people in something like PPG and kind of let them know that there's a world that they're not thinking about, and hope that they can pursue it in some way. Also, you're putting the experts on display there, so people, I think, know who to look for and who to ask questions from if they have questions that they want to have. What I think is really interesting is get people that are actually doing this stuff, as opposed to, it's one thing to do the science, but one thing to try to put it in practice and try to make it, try to create a model that's sustainable long-term. That's just the hardest part. I can't, I mean, you probably know, and Yudhoyobani probably knows, it's the graveyard of great ideas that couldn't capture value is deep and wide. I think that the LLM part is also, was really, we had Karen Deep, I mean, I didn't have to do much with Karen Deep, but just, he's such an amazing speaker and a wealth of information, but also, he's a practitioner. I think that's really important, somebody who's just not doing the science, but actually putting it into practice. And I think that piqued the interest of people, but I think just to try to get a deep understanding of something like that, you just have to be knee-deep in it. I do PPG research on my research side, and I do LLM research on my research side, so it's, I think the best hope we could have is to kind of pique the interest of people and let them know that there's a world out there and there's actual practical applications, and then hope that they would pursue it further. So the co-chair for this session, I'd like to ask if anyone in this audience has any questions. Please feel free to walk up to the microphone and ask your questions. We'd love to get some questions from the floor. Let me actually ask a couple of questions, if I may. Not to put John on the spot, but John, you're gonna be the executive producer for the meeting. But we will. This coming year, what's your vision for the future of HRX? How do you see this continuing to evolve? Yeah, does anyone have a problem with there not being enough meetings out there in the audience? Right, I think in our field, if you wanted to, you could go to a meeting every single weekend. And I don't think any of those experiences are bad, but the concept that the world's leading collaborative organization for heart rhythm health, that we just have one big meeting in April or May, and then we disperse, I think there's a real need for a second major meeting for our community. And I think at HRX, we really focus on what we're doing now. And most of what we learn here, we can immediately implement in the clinic when we go home. And not to say that we don't focus on implementation, because implementation, I agree, is a totally critical piece of innovation. But I really see HRX as a home where we can explore together what heart rhythm care looks like two, three, five, 10 years down the road. And you know, it's like Sonoma, we're home at Duke, right? If we see a problem on the horizon, and we don't deal with it right away, we're fighting off our back foot. But if we are really intentional and proactive about the changes that are coming, we're much better prepared. And so that's what I think collectively, we're all visualizing together as HRX, is it's a meeting where we bring a very wide array of people to think about how we're gonna change the future in five to 10 years. And part of that is marshaling investors and financial resources. Part of that is understanding the regulatory environment. If I think to my experience last year, I remember I was sitting in the audience watching the Shark Tank, and I was like, wow, I have a lot to learn about device development. And I, you know, do it quite a lot. So I think that ecosystem of helping all of us think about tomorrow and what we need to do today to prepare for that and to lead in that environment is really, and I suspect it's gonna continue to evolve more, you know, as our different technologies change. But I don't think the people will ever change. We all know who the important people in this ecosystem are. That's great, sounds great. Thank you so much. I was just gonna add to that, because I think one of the other aspects of the evolution of this was, you know, when you come to someone at Medtronic, Abbott, or Boston, we wanna go into a pre-market meeting, and the immediate thing is, okay, no. One, like no one wants to talk about it. Two, you can't, right? So when FTA's at the table, there's a lot more leeway for a startup than one of us suddenly talking about all the pre-market stuff. So there was this immediate sense of, I don't even know how you begin to do this. So then it's like, okay, well, support, but this isn't a meeting for us. And then I can tell you, as we've started talking more, and you and I talked, Cindy, last year, the conversation moved to specific of technology to ideas. And we had a conversation about, how do you change the paradigm and thinking of pacing, for example? And there are other areas as well. And so that's a really attractive part of this, is we've been doing a lot of thoughts on how do you rethink early feasibility work? So you're not putting people at risk. And those are great topics. Whether you're a startup or a strategic, how we think about that and socialize it is really important in having all the people at the table. So that evolution's been fantastic, I think. That's great to hear that perspective. Let me just give him a chance to ask his question, and then we'll get back to you, Jen. Sure, thanks. I don't know anything on what Jonathan was talking about. We don't need more meetings, et cetera. But innovation is just moving so quickly and so fast. It doesn't only happen in early September. I guess I would ask the panel, what are the plans to keep the community together, to have ongoing conversations in our innovation community outside of our meetings? Jen, you wanna talk about Innovation Hub? Yeah, I mean, so HRX is the main event for the HRX panel. But there are tons of resources that the whole HRX team and community have put together. And the Innovation Hub is a really important part of that. Like, just this morning, we had a producer's meeting, and someone said, before someone comes to HRX, it might be nice for them to be able to go someplace and get a didactic on, I have an idea. When I pitch it to an investor, what do I need to say? And what should I certainly not say? And what background do I need? We hope to have videos in the Innovation Hub where people can come and get a tutorial on what that process is like. So it's a critically important point. I think you're gonna see more of HRX spread across the calendar year, in addition to the in-person meeting in September. I'm not sure if anyone else wants to say anything about the Innovation Hub. I'm sure that would say remarkably. You know, I would also say that, Steve, you are obviously thinking about this now at a health system level. Sana interviewed Dr. Califf yesterday. I was really struck by his concept about the cockpit. So we're all seeing that, right? Like, people come to our offices at an individual practitioner level, I have an app for this, right? This will solve this problem, right? And then, like, all of a sudden, you're inundated. Like he said, there's a dial here and a dial there, and you can't fly the ship, right? Now you're thinking about this, maybe at a service line level or an institution level, and then when Hamid interviewed Dr. Singh last year, he's thinking about it, even a larger healthcare system level. So all of this is, like, challenging us at a level that we're just not used to dealing with, and I'm hoping that meetings like this will provide us not only the problems, but finally have the discourse that leads to effective solutions that makes our lives a little bit easier. But if you have any suggestions, by the way, especially after you check out the Innovation Hub, and there's a ton of information on that on the website. If you have any thoughts, please send them our way. We'd love feedback from you and others. Jen, go ahead. Yeah, I actually wanted to follow up on that as well. One of the things, this was actually from HRX year two. We had a session on putting clinicians and engineers in the same space and how do we get them to talk the same language. It was however the format was, but what came out of that was somebody came up to me afterwards and he said, I need to solve this problem locally. I'm going to, and of course it was a meeting, right? He's like, I'm gonna put a meeting around this. I was like, oh, another meeting. But he did put a meeting around it. He tweaked it, though. He put clinicians, engineers, and CMIOs, and instead of it being a meeting, it was more like a think tank, and it just happened a couple of weeks ago. It was directly a result from this, but he identified a problem, went back to his local institution, healthcare system, really, gathered the relevant people, threw them in a room together, and shut the door, brought in a couple of us from outside, and said, we have to learn from what other people are doing. We have to know what we have, what you guys are willing to do, what we're willing to do, what the engineers are willing to do, and put it all in a room together. And I think that's another way that HRX is gonna perpetuate throughout the year. The Innovation Hub, I agree. That is something that's gonna be broad, content-driven, a really important resource. But what I thought was really interesting from what Javier did, was he said, I need to take this home, how do I do that? And he was trying to solve that problem in the Austin area, and I thought that was really interesting. I have a question. I'm gonna argue with you a little bit. Okay. So, it's a yes, Anne. I have a mantra where I tell our engineers, don't talk. Don't talk to people and ask them what they want, go watch them. Because it's only when you go to the lab and watch people, or go to the clinic and watch people, do you realize that most people don't even know what they do, because their hands and their brains are in automatic mode. And so, it's just an extension. And being a bit facetious isn't extending, but I think some of this is, it, hopefully the innovation hub can be a visitation hub. I just, I had a conversation with an engineer, second year, in Medtronic, and I said, don't, go to the lab, he asked how. I said, go introduce yourself to an EP and say, I don't know anything, I don't wanna watch. And I promise you, they will invite you. And that happened. And the experience of actually not talking, but watching, was eye-opening. This person came back, so full of energy, had 35 ideas, too many by the way. But that, we have to move this into that deeper space beyond just kind of talking over a table. I agree. I think what I thought was interesting about that, and I totally agree with you, particularly in device development, right? What I have learned is that I don't necessarily know the boundaries and I certainly don't understand their timelines, right? So when I'm constantly pushing on my engineering team, I need this, Giovanni's laughing because he knows I do this. I want this, I want this, I want it in two weeks and they're just like, that's cute. Like that's nice that you want that. I do, I do know they're doing that. I've learned that actually, it's taken me years. But I think it's just, it's understanding how to also do that kind of communication. But I think your point is really important. For those of you who haven't been to HREX, there's these roundtable meetings which are like little mini think tanks that incorporate not only the innovation but the implementation. So I had not participated in one until last year and so I got this invitation to be on a cryptogenic stroke roundtable and I was like, this is odd. Like we're going to sit at a table and talk and people will find that interesting and we had an incredible conversation. I think one of the great things about HREX is there was an EPP that led a cryptogenic stroke protocol at one institution and there was a neurologist and there was someone with expertise in AI and ILR analysis and we had an incredible conversation about how we do it now, how we probably should be doing it, what the differences at our institutions were and what new technologies can help us with the problem. So these like mini think tanks are a super incredibly valuable part of HREX. Blairon, maybe I can put you on the spot, I see you sitting here. You have been a very strong supporter of HREX, including abstracts and seeing value in that. Could I ask you to go to the mic and just maybe give your perspectives of how a meeting like HREX brings value to your company and maybe just for those who don't know exactly what your company is? Yeah, so, sorry about my voice crack today, so I'm a founder at 91 Life and we started the company on the conviction that math is going to change every facet of human activity but in particular medicine as we move into this new technology of applied data science which unfortunately the world chooses to call AI today, maybe too often. So we started participating in HRS right off the get-go because we realized this is the meeting where you start to learn what's going on. You can imagine, even though my wife's a cardiologist, I came into this world very naively from Wall Street where data is integrated and we've been doing data science, well I started doing in 2001 but Jim Simon started in 1984 with a lot of success. So HRS was a great place to learn and I've been extremely fortunate to meet the leading minds in one place, it's an amazing concentration of talent and pioneers that have created electrophysiology but we get lost in the shuffle, it's way too much and it's very hard to even, let's say Hamid, I've met him once in the last two days but I met him at HRX, I don't know, 15 times, we have a joke going, every time we meet each other we say, nice to meet you again. So HRX is a forum where you really meet like-minded people that care a lot more about what the future's going to look like, how we can change it rather than what's the status quo, how do we deal with current problems with adding more physicians or more APPs or more RVUs, we don't talk a lot about money so I think everyone there is, it's a mission driven, HRS is to a good degree a mission driven meeting as well but it's a mission driven meeting with a purpose of defying the boundaries and pushing further so it's a bit challenging from a commercial perspective because you don't really expect, you don't really go there, for example we also run a remote monitoring platform as the basis of having started this company to start to get data and solve a problem that's tangible rather than just raise a pile of money and work on an idea that's not applicable so we don't go to HRX to really find clients, we go to HRX to find people that challenge our ideas and work with us to move that forward so I think it's a different meeting, it's the kind of meeting that I would have set up, maybe slightly different because it's set up from HRS as opposed to the industry but we are participants, we're stakeholders in that meeting rather than just supporters of that meeting first and foremost from let's say the startup community and maybe to some degree industry overall and then the conversations and discussions that are facilitated definitely engender ideas but also gave us a great forum to challenge our own thoughts and our ideas of what innovation would look like and what's applicable versus theoretical so this year I think we've expanded, we're supporting the abstract pavilion from one days to two days and we had like a different format, it was really good, we knew I was at HRX from day one here in San Diego and then we kept increasing our sponsorship on meeting two and three and this year even more so our expectations are that this meeting as it grows it will attract some pretty significant innovators that are really looking at this from the perspective of how the world is changing very fast and I think what I see at HRX is yeah we're talking a lot about AI, we're talking a lot about innovation but the status quo still is let's say two standard deviations of the game, I think the people that are thinking about how this is going to massively change are outside the two standard deviations and those are the people that are at HRX, I think those are the people that will be the stakeholders of this revolution and I think it is going to be a revolution like it or not, I think ablating the entire atrium is going to be too barbaric if it's not already and I think remote monitoring is going to be very different and I think electrophysiology is going to change, it's going to lead, it's going to be the beachhead for where cardiology is going with AI and those that come to HRX at minimum will have a chance to see what participation looks like, they'll be stakeholders and we cannot miss it, I think there's a terrible sort of wasted opportunity for those that do not attend and I think it's a great opportunity for those that fear sort of math and AI, what it looks like because it's a great opportunity to learn, people are humble and willing to really work with you because I think it's a place of a lot of talent and the smarter people are the more confident and comfortable they are to know that they don't know everything and likewise they share those ideas with others. Thank you Blair, I appreciate that. So thank you for sharing that perspective, I just wanted to share with the group here that when we first, in the very early days of the meeting, thinking about what the meeting is going to be about and we had some ideas and everything, we got to a point where we asked ourselves the question, what are we going to call the meeting? So HRX, this came about like okay, we're going to call it HRX, HRX, what's the X for? So you mentioned, I love that you mentioned explore because really the initial answer was like it could be anything depending on what the year is, what the focus is, what someone wants it to be, so we were very flexible with that but really for me, especially in the early days, X stood for the experience and that was a big thing for us as we were envisioning HRX, that we wanted it not just to be different in terms of focus, in terms of potential attendees and what have you, but also the experience that people have at the meeting. We wanted it to be very different from our annual meeting and so those of you who have come to HRX know that it is indeed very different, we're all in one room but there's so much happening in that same room. You have like one stage, you have with different sessions occurring simultaneously and we have the headsets where you can actually tune into one conversation and then change it to another discussion and that's like the lively thing and as you're walking, you meet a friend, you stop, you talk to them and then you go back and listen. It's that like organic flow of things and being able to talk with different people that makes it so unique in my view. Very unique experience. And no 6.30 a.m. meetings. So Giovanni, I have a question, you know, obviously at a meeting like this, you're coming to CISA but there are many people, you know, who are coming to try to connect with someone with your level of expertise, you know, can you talk a little bit about, you know, who would be the kind of person where you would provide the most value and how would they be able to connect with you at a meeting like this? Yeah. Yeah, it's a very good question because we come to this meeting, I come to this meeting with the idea that I might find good opportunities. So this is really what motivates me and of course if I can contribute and help some people or companies improving the way they present or these kind of things, I do this with pleasure but the main motivation is to find the opportunities. And my main, so of course I can be contacted, my main feedback to the companies that opportunities that they contact us is that they should design the company not to be acquired but rather design the company so that it's a company that can evolve, grow and live. Because if you design a company to be acquired, you arrive at the moment where there might be a delay, you may not be acquired and then you are in deep problems. And acquisition may happen, it should be considered as an accident. I mean, we develop the company and if more companies are developed this way, I'm not saying that it's easy, it's very difficult, especially in the current environment, but this is the way they should really design the company for and that their mindset should be this one. So this would be my main advice. Rob, you are pitchfork. Wait, you just said that's really hard. It's monstrously hard. It's monstrously hard. It's exactly spot on but like when you look at, I mean, look at the behemoths that are here and the barriers to entry, it's so hard to do. I did three companies, so I know. But I think that's the point, right? I think that's why meetings like this exist because that's the first thing they teach you. When you're thinking about starting a company, the first thing you will learn if you talk to any person is an acquisition is not a strategy. It's not a strategy. But talking to people and understanding, that's critical to informing what the strategy is. And I think that those relevant stakeholders are in the room at HRX and I think that's something that's been very carefully cultivated over time and I'm really excited to see how it grows. Okay, sorry. No, I was going to say, Rob, you are pitch companies. I mean, left and right, all stages, big, small. You mentioned that you voted for Steve's project. What advice would you have to people as they think about their own pitch competitions, engaging in the short tanks? Just what are the things to do and what are the things you're like, man, don't do that because the minute you do that, I'm basically out. I think the easy one on what's out is if you can't build it. If it is a tangible object, it has to be scalable and it's very interesting. I mean, a lot of what we're talking about is on more of the digital side, but when you look at objects like catheters, sheets, whatever, it's one thing to be able to make 300 for a trial. It's another thing to be able to make 300,000 to actually take care of people and actually have a dent for patient care. So that's one thing. The other thing is I don't need to hear about the scourge of hypertension. We know it. So it really is like, what are you doing, what's the thinking, and how do you actually get to changing things, right? And we joke, we talk about like, the exit for us doesn't matter. The exit can be huge, but if it doesn't help a single patient, then who cares? So it really is about, do you have a vision towards what you're talking about, actually taking this into the marketplace and how it gets implemented? Because ideas are a dime a dozen. There are a lot of people, there's a lot of them. It's what is the thing that's going to translate that idea to moving the needle? Personally, I'm just partial to ideas that push back on the status quo and just are, think outside the box a bit. So at Stanford Biodesign, I joke, great meeting, 75 talks, there were two things that caught my eye, and that was it, because of all those factors. It's hard. It's really hard. I sit on the easier end of it, actually. We have a question. Go ahead, please. Thank you. As you were saying a while ago, do you have any type of resources for someone who is not just an innovator, but an inventor? If you have an invention, do you have resources to help that person beyond just the invention portion? He does. Where to go from there? I don't know where to go from there. By resource, you mean help in the setting, in making the proposal more attractive and more sound for an investor? I wouldn't even know where to start to look for... I have an invention that I just patented, but I don't know where to go from here. So I don't know who to approach or where to... I don't know where to go from there, I guess. Do you have resources? We can certainly speak after the meeting, but HRX would be a great place, for example, to explore these kind of things. I'm going to pitch right now the innovation hub. Like John spoke to earlier, there are resources in the innovation hub that help you understand what are the things you can do once you've sort of gotten through the invention process, which is in and of itself a whole field, right? And some of them just stay at invention. But if you really want to move it along, you're going to find a lot of resources in the innovation hub that will prepare some of your thoughts, so that if you were to attend HRX, that you would go with a little bit more than simply, I have an idea. You have to start with that, right? But moving it along, I think, is what you're asking about. But having a patent. Yes, don't talk to anybody without that. I have a patent and I have a prototype of my invention, but I don't really know where to go from here. It's really my issue, so I didn't know. That's why I was thinking about attending HRX this coming year, is just to help me find where to go from there. Yeah, there was a great session this last year that was step-by-step how you take an idea and get it all the way to a commercialized product. And there'll be more content like that this year. Okay, thank you. Steve, you were, of course, the winner. But often, prior to actually winning, there may have been other things where you pitched at other meetings you didn't win. Tell a little bit about the advice, the constructive feedback you received in other settings, and how that informed you to the point where you were able to win this competition, and why that may be important to someone who's thinking about entering the pitch competition with us this year. Yeah, I mean, I think for any venture at the beginning, you have to be ready to go out there to pressure test your idea, your prototype, etc. At the very beginning of Proton Intelligence, we went to where we thought the most innovative folks would be. It turns out, not quite, but it was nephrology-focused. So we probably pitched maybe 500 nephrologists, something like that, over this sprint of a few months, and got incredibly impactful feedback. But I don't think that it really took us to the next level until we started talking to folks who were more on the med-device-oriented tracks. I think part of the problem is when you have a prototype, the first thing you're going to do is go straight to the med-device people. The problem with that is that you may not actually understand the workflow, or the unit economics of deploying these kinds of technologies. And so I think we did it the right way, although we didn't actually get to meaningful acceleration until we started talking to the med-device people. And that was actually what I was going to say, is that there are a lot of other conferences like MedTech Innovators, where you are confronted with the only med-device investors, only med-device folks, developers, the big medical device manufacturers. But I think one thing that maybe the HUG could focus on, as well as HRX, is access to a real understanding as a way to pressure test. Kind of like a speed dating, or like a mini shark tank. I would suggest some mechanism to do that. And the other thing is sort of access also goes past that into after you've got the idea, you need to keep coming back. And you need to keep pressure testing the ideas after you've built your prototype. So kind of like being part of the continuous life cycle, I can envision something like HRX, HUG, being this touch point to go back to to keep pressure testing. Sana, do you want to close? Yeah, no, absolutely. I just want to thank everyone here for your insightful comments. You shared great information, hopefully with the audience. I learned as well. We do want to thank you so much for being here and for your questions as well. If you have any follow-up questions, please feel free to connect with any of us. We'd love to continue the conversation. And with this, I want to thank my co-chair, Dr. Mittal, who's a pro. And wish you the best for the rest of the day. And register for HRX. Definitely register for HRX.

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