Conference Reports in 2014
Dr Junaid A B Zaman
Cardiology Registrar & Clinical Research Fellow
National Heart & Lung Institute, Imperial College London.
1) European Cardiac Arrhythmia Society, Munich, 23rd-25th March
The 10th meeting of ECAS featured as usual a very strong UK EP presence, with the second highest submitted abstracts after Germany. The program was diverse yet compact and featured the following highlights:
• A large population study on additional genetic susceptibility loci for AF in Europeans and Japanese by Dr Moritz Sinner (Munich University). This was complemented by an excellent overview lecture of the nine currently identified areas of interest (of which PitX2 is the most significant) by Dr Patrick Ellinor (Harvard University). Mechanisms for the effect of these loci are now being sought, but recent data implicate a calcium activated potassium channel (chromosome 1q21 locus, encoding for KCNN3), which when over-expressed in mice led to a sudden death syndrome
• The highest scoring abstract was awarded to Dr Fu Siong Ng (Imperial College London & Washington University, St Louis, USA) for his work on the functional role of ‘M-cells’ in human ventricular wedges from explanted hearts. This work showed that in well coupled healthy tissue these cells, whose existence has long been debated, play little role whereas when carbenoxolone, a gap junction uncoupler was used, the discrepancies in action potential and repolarization gradients became more evident. This has important implications for understanding the specific conditions required to generate ventricular arrhythmias in ischaemia and heart failure
• An excellent commemorative lecture ‘A brief history of the AV junction’ detailing the contribution that Dr Philip Coumel made to electrophysiology, given by Dr Jeronimo Farre.
The next meeting will be held in Paris on 19-21 April 2015.
2) Heart Rhythm Society Scientific Sessions, San Francisco, 6th-9th May
The largest annual meeting in electrophysiology was the stage for many research and clinical updates, and always featured a very high yield program. A few selected highlights were (more device focused ones to follow soon):
• The AF summit started with a superb Founders lecture by Dr Jose Jalife ‘Basic science insights on atrial remodeling and fibrosis’ and was followed by a vigorous panel discussion of whether AF was just a manifestation of a global atrial fibrotic cardiomyopathy. The afternoon session was dominated by discussion of rotors in persistent AF and why the different global mapping approaches showed differing rotor stability with an update on the role of CFAEs as targets. The highest scoring abstract by a fellow (Dr Rajeev Pathak, Adelaide, Australia) was also presented in the summit and showed how aggressive CV risk factor reduction alone reduces post ablation AF recurrence (ARREST-AF)
• The opening plenary was a different format to previous years, with 4 speakers given short talks and then a panel discussion on emerging technologies in EP and the future directions for the field. The highlight was the technology editor of Yahoo outlining the ways in which people’s ability to ‘quantify’ themselves using smartphones, fitness monitors, smartwatches etc. would revolutionize how we practice medicine and especially how we will reach and interact with EP patients in the not so distant future
• A comprehensive and enjoyable history of EP session led by Professor Igor Efimov focusing on ‘Dr George Mines: A Century of ideas on fundamental mechanisms of arrhythmias’ showing how the current debate over rotors in AF stretches back over a century
The next meeting will be held in Boston on 13-16 May 2015.
3) British Cardiac Society, Manchester 2nd-4th June
The annual general cardiology meeting was well attended and had a strong electrophysiology track:
• An excellent ‘Tomorrow’s world – in cardiac rhythm management’ session detailed the role of rotors in human AF, leadless pacing and subcutaneous ICDs
• The Thomas Lewis Lecture was given by Professor Barbara Casadei ‘ A radical view of atrial fibrillation’ focussing on the role of nitric oxide in the remodelled AF substrate
• The BHRS had a special session on ‘non-drug options for AF’ which presented an overview of AF ablation, cardioversion, ‘ablate and pace’ and AF surgery.
The next meeting will be held in Manchester on 8-10 June 2015.
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