We've traveled too far, and our momentum has taken over
Postmodernist English playwright Tom Stoppard embodies the current trajectory of electrophysiology, as represented by the multitude of trials and clinical data that emerged last week at the Heart Rhythm Society (HRS) annual conference in Denver.

The proliferation of atrial fibrillation (AF), compounded by the constant reaffirming data associated with the use of AF ablation, is convincing well-trained EPs to intervene more often and earlier in a patient’s care continuum, HRS President Dr. Richard L. Page told Cardiovascular Business News in a video interview.

Also, physicians are just beginning to have a better understanding of the benefits and considerations with AF ablation, which has been performed for the last decade. For instance, Dr. John D. Day from the Intermountain Medical Center revealed study findings that AF ablation could also reduce the risk of stroke, mortality, Alzheimer's disease and other forms of dementia.

Also, a new innovative and inexpensive technique with AF ablation might hold promise for better outcomes with the procedure. Dr. Daniel P. Melby from the Minneapolis Heart Institute revealed positive results with his pilot study, which tested the feasibility of administering a bolus of generic steroid following AF ablation, as a means of reducing inflammation to lessen post-procedural complications.

Like with so many other complicated procedures, AF ablation outcomes benefit from higher volumes. Both mortality and complication rates of catheter-based ablations for arrhythmia appear to decrease as total procedure volume at a given center increases, according to poster study presented by Dr. Russell Heath, who told Cardiovascular Business News that the data is “suggestive” that these procedures should only be performed in centers of excellence.

However, the momentum behind electrophysiology doesn’t cease at AF ablation, as many therapies loom on the horizon for those patients with heart rhythm disorders. For instance, the STOP-AF trial showed promise for the use of cryoablation to treat paroxysmal atrial fibrillation rather than anti-arrhythmic drug therapy to add to quality of life, reduce AF events and result in high success rates.

Also, in addition, please view the cover story for the May issue of Cardiovascular Business  on the ever-expanding armamentarium of therapies to treat AF patients.

Interestingly, the only force that could potentially stop this momentum for electrophysiology is the unknown consequences of the healthcare reform bill, as expressed by Dr. Richard I. Fogel from the Care Group, during a heated discussion about the legislation.

On this topic, or any other, please feel free to contact me.

Justine Cadet