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Rebecca Yapejian, MSN, FNP-C, CCDS, AACC, discusses her session ahead of Heart Rhythm 2024, which takes place May 16-19, 2024.

Please introduce yourself and your focus of work. 

My name is Rebecca Yapejian. I am an electrophysiology (EP) nurse practitioner. I have been in the world of EP for a little over 7 years now. The majority of that time was spent with Duke University Health System, where I got to learn from some of the greatest in EP. More recently, I've moved into the remote monitoring space, where I have been working with remote monitoring companies on not only reading remotes, but I have a prior background in software engineering, so I have been able to do some work on the back end of software to help put a clinician's perspective on products that are being developed so that they are clinician-friendly and not cumbersome or add to the burden of what is already out there.

What are some of the ways in which AI and digital health are transforming the EP practice? Describe some of the presentations being featured during this upcoming session.

Digital health is a very broad concept. We've been doing digital health with EP since remote monitoring came about. So, that's an all-encompassing phrase. But AI specifically is the new “hotness”. Everybody wants a piece of it. What I am seeing is a lot of focus spent on using AI to better interpret ECGs, because as you know, we can get these printed out immediate interpretations that are absolutely incorrect or so far off from what the actual rhythm is. So, there has been a ton of work being done in the world of improving ECG quality as well as improving predicting outcomes for both EP and non-EP related events. 

I have the privilege of co-chairing a session with Dr Richard Page at the University of Vermont. He is far distinguished and I'm so privileged to be able to sit next to him and chair this session. I don't want to give away too much about the oral abstracts that we're going to see, because I want those who worked so hard on them to be able to share their findings. But I will say the abstracts are very interesting. Again, a lot of them are focused on ECG interpretation, but for things that you may not expect. So, not just predicting who is more likely to get ventricular arrhythmias or who might make for a better ICD candidate, but also for pregnant women and the possibility of developing preeclampsia. They're finding signs on ECGs that might indicate that some women are maybe at a higher risk for developing preeclampsia. I am super excited for us to be able to show not just how AI can help EP, but how AI can help cardiology and non-cardiology. It can help a lot of people and lot of different areas. 

So, I'm looking forward to it. Like I said, I don't want to give away too much because these people have worked so hard and their abstracts are so good, and I'm thrilled for people to be able to see them. I also feel so honored to sit on the stage with them and share in their knowledge sharing.

In what ways have you seen AI and digital health make an impact on personalized care at your institution, including diagnostic accuracy or treatment planning?

Remote monitoring is the biggest thing right now in EP. It was a huge deal last year at HRS, and it's going to continue to be a huge deal because we need it. We need it to better care for our patients who don't have easy access to high-quality EP or cardiology care in general. What I have seen is it has enabled us to detect arrhythmias. With remote monitoring, we can find events coming in and flag them sooner for clinics and hospitalists, and pass that information along in a quick and timely manner, so that they can actually intervene a lot sooner and improve patient care.

For example, one of the things that I'm seeing is we are picking up on increasing burdens of even short runs of non-sustained VT, seeing more and more of them in a patient, that allows us to notify the physician or  clinician who is caring for those patients that there have been more frequent events and maybe something new has developed and needs to be evaluated. So, it's helping us get the right patients back into clinic sooner so that the in-clinic providers are focusing on patients that need the most immediate and acute care, rather than only normal device checks and simple visits. It's making a big difference in helping to reduce the burden on the clinics themselves by being able to take away some of these non-issue transmissions, the ones that are nothing new or special. It’s saving them a lot of time, and besides improving patient care, it's also helping the clinicians avoid alert fatigue so that they can really focus and harness their attention on the patients in front of them, the ones that need to be seen in person, and not necessarily be bothered by non-issue transmission. We want our clinical teams to be able to see the abnormal and let us handle the normals and make sure that those patients are being closely monitored. 

What are you looking forward to at Heart Rhythm 2024?

I have marked some sessions that I really want to see. Obviously, I'm super excited about mine. But I think the thing I love most about HRS is catching up with friends and colleagues. We don't get to see each other a lot a lot of times. It is only HRS where we get to see each other. With the addition of HRX, we've added 2 visits a year, but that may be the only time I get to see a lot of these people. So, I can't wait to catch up with friends and colleagues. I go to HRS and I do attend a lot of the sessions, but I also plan to then follow up with them afterward with the recorded sessions and watch some of the ones that I wasn't able to catch.

The transcripts have been edited for clarity and length.