Heart Rhythm 2007: Recapitulating

Now that the Heart Rhythm Society meeting in Denver, CO is nearing its' close, it’s time to reflect on this year’s meeting.

As always, it’s nice to see old friends and colleagues, especially other folks I trained with many years ago. Denver, too, seemed to have been placed on its best weather behavior for the meeting – it was beautiful all week. The hotel and city life seemed acceptable to most of the folks I spoke with. There were some great posters and abstract presentations, and overall, I think the meeting was well-received.

Unlike prior years though, there seemed to be little “buzz” about implantable devices like pacemakers and defibrillators (except for perhaps the iPod story) – no doubt the Big Three wanted to keep their noses clean to let the recall dust settle a bit more. And there was little new “buzz” about catheter ablation of atrial fibrillation – it seemed to be more of the same – except for revealing new “guidelines” for a procedure whose method, safety, and efficacy are still a work in progress. If there was any area that generated any new "buzz," at all, most seemed to focus on the mapping systems and robotics. At least until potential customers heard about Hansen Medical’s robotic price tag of about $650,000 or an even heftier price tag for the Sterotaxis robotic system installation for over a million dollars. Enthusiasm waned a bit then.

But there was also something else different about this meeting. It was almost imperceptible. It was insidious. There was a tacit sensation throughout the meeting.

What was it?

People were so polite.

Everyone was on their best behavior throughout the meeting. Pleasantries were shared with polite smiles and handshakes. Invitees to the Afib Summit thanked the co-chairs profusely for allowing them to be invited to the meeting, then went about their way telling their story, their pitch. Some reviewed studies and presented data well, others presented experiences or techniques rather than data, but they all pitched. Whether it was the greatest way to perform ablation, or the next block-buster drug to look for, they told their story.

And no one said a word. They were too busy being polite. Oh sure, there were many, many topics covered, and even a few oral abstract presentations with brief periods of rebuttal in small rooms, but the biggest venues were reserved for platitudes and anecdotes. Only at the end of the Afib Summit, when the invitees were discussion the “state of the art” regarding atrial fibrillation ablation was there a hint of concern that perhaps we were at risk of overstating our success rates with atrial fibrillation ablation as a profession, and risking our credibility with our referring doctors and patients. Just when it started to get juicy, the Summit ended.

Maybe it was the fact that corporate people or analysts outnumbered doctors about three to one (I’m guessing, but that’s how it seemed). Many fewer doctors appeared at this meeting than I remembered in prior years, especially doctors from overseas (could the geography of Denver played a role? I don’t know.) Perhaps that’s why most people were polite – they were on their best corporate behavior.

I remember prior meetings when abstracts would be presented in huge auditoriums and tons of microphones would line the aisles of the large amphitheater and people would get up to rebut a study’s findings or review how they had done the same study 18 years ago, and skewer the poor sole on the podium. Politeness was out. Scientific rigor was in. People were not afraid to make their opinion known. Quality and limitations of studies quickly became apparent to all. Reputations were made by thoughtful intellectual commentary, rather than strictly the number of cases performed.

Instead, attendees this year were greeted to carefully staged sets for the speakers, with plenty of nice lighting and special effects, and no forum for lively discourse, all seemingly to calm the sole and remind folks to be polite.

After all, we wouldn’t want the corporate sponsors to get upset.

-Wes