|Opening Day HRS2013|
First, we should acknowledge the efforts by the Heart Rhythm Society to limit the bling at the meeting. There were fewer large advertising displays, trucks driving through the streets with ads on top of them, and late-night rendezvous. Heart Rhythm Society handbags were like paper-thin grocery bags or recycled from prior years. Technology was used to a much greater extent, especially for smart phones, with an iPhone app meeting organizer that showed promise, but still needs some fine-tuning, especially in its scheduling functionality. As a result, aside from the Bill-Fest, the meeting felt more like a scientific session rather than a trade show.
Next we saw the evolution of thinking about the most common arrhythmia that electrophysologists treat: atrial fibrillation. Work on our understanding of atrial fibrosis via MRI assessment as it might pertain to long-term success of ablation was intriguing. Even more, since the introduction of the mystical focal impulse and rotor modulation (FIRM) mapping several years ago, attention is clearly returning back to understanding of the electrophysiology of atrial fibrillation from one of just approaching the disease anatomically. Many of the abstracts and studies presented revolved round (pun intended) an understanding of rotors or point sources (or both) for the genesis of atrial fibrillation. With this comes an entirely new vocabulary of cardiac electrophysiology with terms like "clockwise or counterclockwise rotor," "phase mapping," "frequency gradients," and "singularities." The black box nature of Topera Medical's FIRM mapping technique with it's 1960's music box-like maps (video) (that are difficult to interpret) adds to the mysticism of the moment, but it was clear that there was an appreciation that they are on to something.
|Medtronic's version of the leadless pacemaker|
|Boston Scientific's version of the leadless pacemaker|
|"Physician in Social Media" participants (L to R)|
Mr. Bob Coffield, yours truly,
John Mandrola, MD, and Edward J. Schloss, MD