EP Lab Digest - October 2007 - (Page 23)

OCTOBER EP MEETING when some of the most serious complications, such as an atrial - esophageal fistula, should be screened for. The Consensus Statement on Catheter and Surgical Ablation of Atrial Fibrillation has also had a positive impact on the community of academic electrophysiologists who are involved in reporting the outcomes of clinical trials of AF ablation. Soon after the consensus document was published, reviewers for many of the major medical journals have insisted that the consensus statement’s recommendations for reporting outcomes be adhered to. This includes using a standardized definition of success: "Freedom from symptomatic or asymptomatic atrial fibrillation/flutter/ tachycardia or more than 10 minutes duration off antiarrhythmic drug therapy"; as well as insisting that clinical trials report single procedure outcomes. Another important recommendation of the consensus document was that compliance with monitoring protocols for asymptomatic atrial fibrillation be provided and the results of this monitoring reported. It is reassuring to see that reviewers of articles for medical journals are voluntarily acting as "policemen" to raise the standards for reporting the outcomes of clinical trials of AF ablation to those recommended by the Consensus Document. It is clear that this consensus statement has had a significant impact in the EP medical commuity. Patient care is improving and the quality of clinical research in this field is also witnessing improvement in its standards and guidelines. time to provide highly accurate data. Still, he believes a consensus agreement based on the input of experienced physicians is important, as it shows the status of what physicians performing AF ablation know and summarizes the latest expert opinions with regard to this technique. Kenneth Ellenbogen, MD, explained that the clinical trials section of the document is important, as it has established a framework to guide investigators so trials will be reported in a uniform way. In addition, he said the statement is valuable to physicians because it outlines what information to tell patients. For example, the vocabulary section provides definitions on the various types of AF, complications, appropriate follow-up, and success and failure. David J. Callans, MD, stated that the document provides a framework on the minimal standards for how efficacy and safety results should be reported. He urged EPs to maintain these minimal standards so credibility is not lost. Paul A. Friedman, MD, said the document highlights the importance of educating both patients and referring physicians, and believes the consensus will have a true impact on patient outcomes.The document will set expectations, for instance, by letting patients know potential complications and how they are presented. “The document’s strength is providing a dialog for future research and a state-of-the art summary that will hopefully improve patient care,” stated Dr. Friedman. Electrophysiology in the West Summit Paul J.Wang, MD Professor of Medicine and Director, Cardiac Arrhythmia Service, Stanford University School of Medicine Stanford, California I n this feature, the author provides an in-depth look into one of the upcoming events for EP professionals. Tracks There are 3 tracks designed to provide in-depth workshop sessions, enhancing the educational value of the programs.Track 1 will focus on Cardiac Electrophysiologists and Fellows; Track 2 will be for Cardiologists and Internists; and Track 3 is for Associated Professionals. References Summary of Expert Panel Discussion: Adopting and Implementing the AF Ablation Consensus Statement Doug L. Packer, MD, co-chair of the AFib Summit, convened members of the expert panel discussion, stating to the audience that panelists would provide their opinion on the document: where it fits in the treatment of AF and guidelines in general, where it fits overall in the management of AF, and what impact it may have on the practice of medicine. Peter R. Kowey, MD, session chair, argued that the consensus statement should not be used as a guideline, as it merely summarizes opinions and does not include solid data to support any of the approaches. Albert L. Waldo, MD, echoed that sentiment, insisting the document is state-of-the-art and should not be considered a guideline; despite the opinion of these two experts, the statement does outline the need for more clinical trials in order to obtain data that is lacking. Josep Brugada, MD, PhD, elaborated that the growing technique for AF ablation has been expanding so fast there has been no 1. Calkins H, Brugada J, Packer DL, et al. HRS/EHRA/ECAS Expert Consensus Statement on Catheter and Surgical Ablation of Atrial Fibrillation: Recommendations for Personnel, Policy, Procedures and Follow-Up: A report of the Heart Rhythm Society (HRS) Task Force on Catheter and Surgical Ablation of Atrial Fibrillation. Developed in partnership with the European Heart Rhythm Association (EHRA) and the European Cardiac Arrhythmia Society (ECAS); in collaboration with the American College of Cardiology (ACC), American Heart Association (AHA), and the Society of Thoracic Surgeons (STS). Endorsed and Approved by the governing bodies of the American College of Cardiology, the American Heart Association, the European Cardiac Arrhythmia Society, the European Heart Rhythm Association, the Society of Thoracic Surgeons, and the Heart Rhythm Society. Heart Rhythm 2007;4:816-861. 2. European Heart Rhythm Association; Heart Rhythm Society, Fuster V, Rydén LE, Cannom DS, et al.ACC/AHA/ESC 2006 guidelines for the management of patients with atrial fibrillation — executive summary: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines and the European Society of Cardiology Committee for Practice Guidelines (Writing Committee to Revise the 2001 Guidelines for the Management of Patients With Atrial Fibrillation). J Am Coll Cardiol 2006;48:854-906. 3. Tracy CM,Akhtar M, DiMarco JP, et al.American College of Cardiology/American Heart Association 2006 update of the clinical competence statement on invasive electrophysiology studies, catheter ablation, and cardioversion: a report of the American College of Cardiology/American Heart Association/American College of Physicians Task Force on Clinical Competence and Training developed in collaboration with the Heart Rhythm Society. J Am Coll Cardiol 2006;48:1503-1517. The Electrophysiology in the West Summit (or “EP in the West Summit”) brings together a nationally-known group of experts in electrophysiology in a retreat-like, historic setting on the Northern California coast. The Summit will be held from November 30 to December 2, 2007, and will present the latest advances in state-of-the-art cardiac electrophysiology in a setting that provides an opportunity for extensive discussion and interaction with the faculty and others interested in the field. The target audience includes cardiac electrophysiologists, arrhythmia nurses and technicians, and cardiologists and internists with special interest in arrhythmias. Special tracks are designed to meet the needs of each group of attendees. During the course of the two and a half day program, attendees will gain a better understanding of the advances in the field of arrhythmias, and be able to apply this information to their practices. The program will also serve as way for practitioners who are located west of the Rockies and throughout the rest of the country to network. Venue The venue for the Summit is the historic La Playa Hotel in Carmel-by-the-Sea, California. The La Playa Hotel was originally designed as a Mediterranean villa in 1905, and is now one of the prestigious Historic Hotels of America. The 80-room hotel is located two blocks from the Carmel beach, and offers a wonderful retreat for the Summit. Course Directors and Faculty The Program Chair is Paul J.Wang, MD, Director of the Cardiac Arrhythmia Service at Stanford University School of Medicine. The honorary Co-Chairs are Jeffrey E. Olgin, MD and Melvin Scheinman, MD of the University of California San Francisco. The faculty are drawn from these two institutions. Guest faculty include Dr. David J. Callans, Professor of Medicine at the University of Pennsylvania, Dr. Fred Morady, McKay Professor of Cardiovascular Disease at the University of Michigan, Dr. Douglas L. Packer, Professor of Medicine at the Mayo Clinic College of Medicine, and Dr. William G. Stevenson, Professor of Medicine at Harvard Medical School. Educational Objectives • The participants should be able to: Outline and explain the ways that clinical cardiac electrophysiology continues to evolve, and investigate how the future appears to be one of continued evolution of techniques, refinement of indications, and continued clinical applications; Summarize the challenges faced in the electrophysiology community in developing new techniques and establishing uniformity of methods; Apply new data regarding techniques and indications for the ablation of ventricular tachycardias and atrial fibrillation; Detect and describe cardiomyopathies, genetically-based arrhythmias, and arrhythmias in athletes, and analyze the various treatments recommended by the AHA; and Define and compare HRS-approved resynchronization and ICD therapies and investigate new therapies. • Sponsor and Accreditation The Continuing Medical Education of the Stanford Hospital & Clinics is the sponsoring entity for this program.The educational activity is designated for a maximum of 16 AMA PRA category 1 credits and up to a maximum of 19.4 contact hours as a category 1 nursing course. • • Registration Information about registration may be obtained online at www.cme.stanford hospital.com. Hotel reservations may be made at (800) 592-8900. See SUMMIT page 24 • http://www.cme.stanfordhospital.com http://www.cme.stanfordhospital.com

Table of Contents Feed for the Digital Edition of EP Lab Digest - October 2007

Finally! The New Registered Cardiac Electrophysiology Specialist (RCES) Credential: Interview with Christopher M. Nelson, RN, RCIS, FSICP ECG 101: Closing the Gap Phenomenon Contents Letter from the Editor ICD Patient Support Group: St. Peter’s Hospital Spotlight Interview: Community Healthcare System Use of Magnetic Catheter Navigation for Ablation of Focal Tachycardias Echocardiography: The Preeminent Front Line Screening and Diagnostic Tool for Cardiovascular Imaging and Physiological Assessment First Annual EP Lab Digest Salary Survey: Last Chance! Clinical Trial Update: 2007 Email Discussion Group Adopting and Implementing the AF Ablation Consensus Statement Electrophysiology in the West Summit Events Calendar The Sustained Treatment of Paroxysmal Atrial Fibrillation (STOP AF) Clinical Trial: Interview with Kevin Wheelan, MD Industry News and Products

EP Lab Digest - October 2007

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