2017 AF Symposium: Overview
by Steve S. Ryan, PhD, Tuesday, Jan. 17, 2017, updated Feb. 3, 2017
The annual AF Symposium is an intensive and highly focused three-day scientific forum which brings together the world’s leading medical scientists, researchers and cardiologists/electrophysiologists to share the most recent advances in the treatment of atrial fibrillation.
The three-day AF Symposium started early each day at 7:00 am and was tightly scheduled with presentations which usually lasted till 5:30 or 6:00 pm (except for a shorter last day so attendees could catch a flight home). There were generous breaks and lunch times to allow attendees to interact with and visit the manufacturer’s exhibits to learn what’s new from the many vendors.
Somber Mood Pervasive
The overall mood of this year’s AF Symposium seemed to be somewhat somber. The upcoming Trump presidency seemed to cast a shadow of discouragement and even fear. Compared to other years, the presentations had very little humor. The presenters tried to stay on message, but occasionally in the discussions the profound upcoming changes would be acknowledged, especially about Obamacare.
Faculty and Feedback
The various presenters were a ‘Who’s Who’ of thought leaders in the A-Fib field. The 55 faculty members were from around the world (the U.S., England, Canada, France, Italy, Germany, Switzerland, Ireland, the Netherlands, Taiwan, South Korea, and the Czech Republic). Some did double duty and gave talks on different topics.
Again this year, the AF Symposium featured audience feedback devices at each seat. A presenter would ask a multiple choice question and invite each attendee to cast a vote. The vote tally would be flashed on the screen within seconds for further discussion.
The Venue: The Hyatt Regency in Orlando
The Hyatt Regency in Orlando hosted the AF Symposium January 12-14 and is a magnificent, vast venue more than capable of holding the many attendees (attendance seemed a bit down this year).
One does a lot of walking to get back and forth from the presentations to the exhibit/lunch area. (For those concerned, bathrooms are scarce and not well situated.)
Left Atrial Appendage
The most talked about topic at this year’s AF Symposium was the Left Atrial Appendage (LAA). This represents a major change in the way doctors now see the importance of the LAA and the LAA’s role in A-Fib. (For A-Fib patients, this is a most welcome change. All too many doctors still consider the LAA of little importance. For example, when doing an ablation, all too many EPs never look at the LAA to see if it is producing non-PV triggers.)
Several studies have come out questioning the efficacy of the FIRM mapping and ablation system. Some presentations and panels discussed these controversial findings. But they weren’t as heated as at previous AF Symposiums. See AF Symposium 2015: Critical Analysis of the FIRM Mapping System.
Presentations of live cases, via video transmissions, featured advances in catheter ablation and Left Atrial Appendage closure. This Friday morning session was particularly informative and innovative. It’s always the most attended session. (See below.)
Also very popular is the series of panel presentations. The Challenging Cases in AF Management features world renowned doctors who discuss their year’s most difficult cases. The first panel dealt with Antiarrhythmic Drugs, Anticoagulants and Clinical Decision Making. The second with Catheter Ablation for A-Fib and Left Atrial Appendage Closure.
As expected, the second day of the conference featured streaming video of live, in-progress case presentations. Watching LIVE catheter ablations on floor-to-ceiling display screens was one of the most interesting and exciting features of the AF Symposium.
There were five live video presentations (via internet streaming video) of ablations from centers around the world. The live cases came from these centers:
• Na Homolce Hospital, Prague, the Czech Republic
• University of Milan Centro Cardiologica Monzino, Milan, Italy
• Massachusetts General Hospital, Boston, Massachusetts, U.S.
• Loyola University Medical Center, Chicago, IL, U.S.
• Texas Cardiac Arrhythmia Institute, Austin, TX, U.S.
The sheer technical complexity of producing these live videos is staggering. (As someone who worked in broadcast TV at NBC for many years, I was in awe at how well they pulled off these technological feats.)
They didn’t simply present the live cases in order one by one. Rather, they would inter-cut between on-going ablations. As one center finished a particular stage in an ablation, they would cut to another center around the world.
The moderators, Dr. Jeremy Ruskin and Dr. Moussa Mansour from Mass General would talk with the various EPs doing the ablations, and even take questions from the audience (some answered by the moderators and some answered by the remote EPs). Then on-the-fly they would cut to another center or back to one ready to proceed further in their ablation task.
The Friday ‘Morning Scientific Session’ (7am-10:30am) was the most well attended session.
Agenda & Short Presentation Topics
In addition to the Featured Presentations, there were fifty-three short presentations (15 minutes), each with time for audience questions and discussions. The following general topics included several presentations.
Day 1: Thursday Topics
• Mechanisms and Genetics of Atrial Fibrillation
• Screening for Atrial Fibrillation―Rationale, Results and Clinical Impact
• Clinical Trials, Guidelines and Regulatory Issues in AF Ablation
• Clinical Trials and Regulatory Issues in LAA Closure
• Challenging Cases in AF Management I: Antiarrhythmic Drugs, Anticoagulation and Clinical Decision Making
• Challenging Cases in AF Management II: Catheter Ablation for AF and Left Atrial Appendage Closure
Day 2: Friday Topics
• Live Case Transmissions: Advances in Catheter Ablation for AF and Left Atrial Appendage Closure
• Stroke Prevention in Atrial Fibrillation
• Mapping and Ablation of Atrial Fibrillation I: Lesion Formation and Durability in AF Ablation
• Late Breaking Clinical Trials and First Report Investigations
Day 3: Saturday Topics
• Mapping and Ablation of Atrial Fibrillation II: Beyond PVI Mechanistic Insights and Impact on Ablation Strategies
• Mapping and Ablation of Atrial Fibrillation II: Beyond PVI Mechanistic
• Mapping and Catheter Ablation for Atrial Fibrillation III: Outcomes, Safety, and Economic Impact
Why I Attend
Each year I attend the AF Symposium to learn and ‘absorb’ the presentations and research findings. Attending the sessions gives me a thorough and practical view of the current state of the art in the field of A-Fib. I then sort through this newly acquired knowledge and understanding for what’s relevant to patients and their families.
Over the next weeks and months, I will post 15+ reports for readers of A-Fib.com.
To learn more about the AF Symposium see What is the ‘AF Symposium’ and Why it’s Important to Patients
Next Time: My Summary Reports