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Article History

Received: 11 March 2026

Accepted: 14 April 2026

First Online: 10 May 2026

Competing interests

: D.J.v.V. is an established investigator of the Netherlands Heart Foundation, but has no conflicts of interest to report (and has received no personal payments in relation to the DECISION Trial). M.R. has received an unrestricted research grant from the Netherlands Heart Foundation, which is conducted in collaboration with and supported by the Dutch CardioVascular Alliance, 01-002-2022-0118 EmbRACE. He has also received unrestricted research grants from the Netherlands Cardiovascular Research Initiative: an initiative with support of the Netherlands Heart Foundation; RACE V (CVON 2014–9) and RED-CVD (CVON2017-11). He has also received an unrestricted research grant from the European Union’s Horizon 2020 research and innovation program under grant agreement EHRA-PATHS (945260). In addition, he has received consultancy fees from Bayer, InCarda Therapeutics and Novartis to the institution and speaker fees from Daiichi Sankyo and Pfizer, which all have been paid to his employer UMC Groningen. A.M. is the Chair of the Scientific Advisory Board and Chair of the Clinical Trial Committee of the Netherlands Heart Foundation, for which he receives no payments. He has no other conflicts of interest. M.A. reports no conflicts of interest. A.A.V. has received consultancy fees and/or research support from Anacardio, Astra Zeneca, Bayer AG, Boehringer Ingelheim, Cardurion, Corteria, EliLilly, Merck, Novartis, Novo Nordisk, QTsense, Rycarma and SalubrisBio, which all have been paid to his employer, UMC Groningen. K.D. reports speaker/consultancy fees from Abbott, Astra zeneca, Boehringer Ingelheim, Novartis, FIRE1 and Echosense, which all have been paid to his employer UMC Groningen. A.D.I.v.A. reports no conflict of interest. M.L.B. reports no conflicts of interest. J.S. has received payments for lectures and advisory boards from General Electric, Boehringer, Novo Nordisk, Novartis, Lilly, Astra Zeneca and Pharma Nord, not related to the submitted work. E.E.v.d.W. reports no conflicts of interest. H.J.G.M.C. has received fees and honoraria for lectures, education and scientific advice activities from Atricure, Medtronic and Armgo. D.J.T. reports no conflicts of interest. P.A.M.H. reports no conflicts of interest. J.E.C.V.d.S. has held paid lectures for Abbott; there are no other conflicts of interest. R.J.S. reports no conflicts of interest. A.v.d.S. reports no conflicts of interest. O.B. reports no conflicts of interest. T.J.R. reports no conflicts of interest. T.O. reports no conflicts of interest. G.L.B. reports no conflicts of interest. S.K. has received consultancy fees or educational grants from Astra Zeneca, Novo Nordisk, Boehringer Ingelheim, Novartis, CSL, Amarin, Bayer and Amgen. P.A.D. reports no conflicts of interest. G.C.M.L. reports no conflicts of interest. I.A. reports no conflicts of interest. H.G.R.D. reports no conflicts of interest. A.S. reports no conflicts of interest. M.E.W.H. reports no conflicts of interest. R.G.T. reports grants from Medtronic and Abbott, and personal fees from Boehringer Ingelheim, Daiichi Sankyo, Bayer and Pfizer/Bristol Meyer Squibb all outside the submitted work. D.J.A.L. reports no conflicts of interest. I.C.D.W. reports no conflicts of interest. M.A.T.V. reports no conflicts of interest. G.H.D.V. reports no conflicts of interest. A.H.d.V. has no conflicts of interest. E.L.M.-S. reports no conflicts of interest. D.P. reports no conflicts of interest. G.L. reports no conflicts of interest. J.G.P.T. reports no conflicts of interest. P.v.d.M. is supported by a grant from the European Research Council (ERC CoG 101045236, DISSECT-HF). He has received consultancy fees and/or grants from Novartis, Pharmacosmos, Vifor Pharma, Astra Zeneca, Pfizer, Pharma Nord, BridgeBio, Novo Nordisk, Bayer, Boehringer Ingelheim and Ionis, which all have been paid to his employer, UMC Groningen.