Highlights from 9th Annual Electrophysiology Symposium at Staten Island University Hospital

On October 23, 2013, the 9th Annual Electrophysiology Cardiac Symposium took place at Staten Island University Hospital, in the recently opened, state-of-the-art Regina M. McGinn, MD Medical Education Center. The event was led by course directors Dr. Soad Bekheit and Dr. Marcin Kowalski.

The theme of topics selected for the symposium considered the need of the local community and the current developments in the field of electrophysiology. Eminent and nationally known speakers attended the symposium. This year the CME accredited (3.0 hours) symposium was comprehensive, addressing two of the most common cardiac problems: heart failure and atrial fibrillation.

The opening remarks from course director Dr. Bekheit set the stage for the symposium, and although sessions were carefully planned to cover the most recent advances in the field, Dr. Bekheit’s major emphasis was on the urgent need for the initiation of a dedicated heart failure team for the community of Staten Island. 

The first part of the symposium covered the detailed approach of managing heart failure from an early stage, to the utilization of cardiac assist devices as well as cardiac transplant. The first speaker, Dr. Garrie Haas from the Ohio State University Medical Center, discussed the different nuances and advances in the field of heart failure. He presented novel approaches on diagnosing and monitoring progress of the disease as well as on patient compliance. He also addressed the current literature and guidelines pertaining to heart failure management. He pointed out the underutilization of medications such as aldosterone receptor antagonists and advanced therapies such as cardiac resynchronization therapy (CRT) in the management of heart failure. He ended his presentation by displaying a blueprint of a successful dedicated heart failure team approach led by a nurse practitioner and guided by expert medical subspecialists.

This was followed by an exciting and live presentation by Dr. Mark Zucker from Newark Beth Israel Medical Center. Dr. Zucker outlined different surgical modalities currently available to patients with advanced heart failure. He explained the newest models of LVADs and RVADs such as the HeartMate II and HeartMate III (Thoratec Corporation), the INCOR^® System (Berlin Heart), and the DuraHeart^™ LVAS (Terumo Heart, Inc.), to name a few. In view of the rapid improvements in initial assist device systems and better experience, he urged the audience to seriously consider these advanced approaches for patients with end-stage heart failure. He projected that with availability of these new devices, an increasing number of patients will eventually qualify for cardiac transplant and have better quality of life during the waiting period. His anecdotal experiences and humorous remarks added to the enthusiasm he carried.

The second half of the symposium was chaired by Dr. Kowalski focusing on state-of-the-art and cutting-edge technological advances in the management of atrial fibrillation. The next two speakers discussed the present status and the promising future prospects for the treatment of atrial fibrillation.

Dr. Michael Ezekowitz from Thomas Jefferson Medical College began by stressing the importance of anticoagulation in atrial fibrillation. He elaborated on the use of instruments to assess stroke and bleeding risk such as CHADS₂, CHA₂DS₂-VASc, ATRIA, and the HAS-BLED scores. He then emphasized the importance of using the CHA₂DS₂-VASc score in low-risk AF patients. He gave a detailed yet focused presentation about various aspects of novel oral anticoagulants including trials such as RE-LY, ROCKET-AF and ARISTOTLE. In addition to FDA-approved agents, he briefly discussed upcoming agents such as edoxaban (Daiichi Sankyo) and betrixaban (Portola Pharmaceuticals). In his presentation on the role of aspirin therapy, he changed the previous notion that aspirin can be used as an acceptable alternative to anticoagulation in low-risk atrial fibrillation patients. He summarized his presentation with a powerful message: “ASA as an anticoagulant therapy in AF is like a placebo; it’s more for you rather than for the patients.” 

This was followed by a thought-provoking presentation by Dr. Jay Koneru of Virginia Commonwealth University, illustrating the novel methods being implemented for effective ablation. He provided an in-depth description on the different technologies currently used for ablation. His presentation on appropriate patient selection for ablation was invaluable. He demonstrated his success with ablation by sharing a few of the cases he and his team had recently performed. His message to the audience was very clear: “Start treating your AF patients early!”

The symposium ended with closing remarks from the course directors summarizing key points. The audience left the symposium filled with the knowledge of the latest in the field of electrophysiology, with positive feedback including requests for specific topics for the upcoming symposium in 2014.

About The Staten Island University Hospital

The Heart Institute at Staten Island University Hospital is one of the nation’s foremost and upcoming cardiac centers. As a non-profit organization, it serves the need of Staten Island and surrounding communities. It provides the full spectrum of cutting-edge procedures across a range of cardiac services including cardiac surgery, interventional cardiology, and electrophysiology. Patients turn to the Heart Institute for the most progressive cardiac diagnostics, treatment and cardiac prevention programs. For more information, please visit: www.theheartinstituteny.com/