2018 International AF Symposium: My Overview
By Steve S. Ryan, PhD

I made it to every presentation despite being sick with some kind of a virus I caught on the plane to Orlando. I was running on fumes.
The annual International AF Symposium is an intensive and highly focused three-day scientific forum which brings together the world’s leading medical scientists, researchers, cardiologists and electrophysiologists to share the most recent advances in the treatment of atrial fibrillation.
Long, Full Days: Held Jan. 11-13, 2018 in Orlando, the AF Symposium days started early each day at 7:00 am and were 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).
Live Streaming Video: There were six live procedures presented via internet streaming video. This year they were scheduled throughout the days depending on what topic they related to. (Previously all the live cases were scheduled back-to-back in one morning.)
Networking: The generous breaks and lunches allowed attendees to interact with and visit the manufacturer’s exhibits to learn what’s new from the many vendors. I made a point of visiting each vendor.


Faculty and Feedback
The 45 distinguished faculty were leaders in the A-Fib field from around the world (the U.S., England, Canada, France, Italy, Germany, Switzerland, Ireland, The Netherlands, Russia, Taiwan, South Korea, the Czech Republic, and two members of the U.S. FDA [Food and Drug Administration].)
Interactive Feedback: Audience feedback was done this year through the Cloud. Presenters would pose multiple choice questions 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 is a magnificent, vast venue. 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.)
HOT TOPICS
Kiss of Death for FIRM?
In a late-breaking presentation, the interim results of REAFFIRM were presented by Dr. John Hummel from the Ohio State University Wexner Medical Center. The success rate for PVI plus FIRM was not significantly different (78%) for patients receiving only a standard PVI (70%).
Barring further research, this may mean the end of the FIRM system as an effective player in A-Fib ablation. See my upcoming report for more.
Focus on Left Atrial Appendage
Like last year, there was great interest in and examination of the importance of the Left Atrial Appendage (LAA). Four of the six live case presentations dealt with the LAA. Ten of the more than 62 presentations focused on the LAA.
Live Cases via Streaming Video
• Prague, The Czech Republic: Na Homolce Hospital
• Milan, Italy: University of Milan Centro Cardiologica Monzino
• Boston, Massachusetts: Massachusetts General Hospital
• Aalst, Belgium: Cardiovascular Center Aalst. OLV Hospital
• Austin, TX: Texas Cardiac Arrhythmia Institute
• Chicago, IL: Northwestern Memorial Hospital
The sheer technical complexity of producing these live video events 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.) Each live case came off without a hitch and was integrated seamlessly into the topics and other presentations.
Topics and Agenda
The following general topics included several 15 minute presentations on each topic, followed by time for audience questions and discussions.
Day 1, Thursday January 11
• Pathophysioloogy, Risk Factors and Genetics
• Stroke Prevention in and Screening for Atrial Fibrillation
• Left Atrial Appendage Closure & Case Transmissions
• If I Had Permanent AF and Previous Intracranial Hemorrhage, I Would Choose? (Endocardial LAA Closure, Epicardial LAA Closure, or Apixaban (Eliquis) 5mg B.I.D.)
• Challenging Cases in AF Management I: Antiarrhythmic Drugs, Anticoagulation, and Clinical Decision Making
Day 2, Friday January 12
• Physiology and Experimental Insights: Implications for AF Ablation
• Mechanism-Guided Ablation of Atrial Fibrillation and Case Transmissions
• New Technologies, Late Breaking Trials, First Report Investigations in AF Ablation and Case Transmissions
• New Technologies for AF Ablation (Continued)
Day 3, Saturday January 13
• Clinical Trials, Guidelines and Regulatory Issues in AF Management
• Evolving Strategies to Improve the Success and Safety of AF Ablation
• Challenging Cases in AF Management II: Catheter Ablation and Left Atrial Appendage Closure


Excellent Presentations But Attendance Discouraging
The presentations were excellent, as usual, and well coordinated by topics. Attendance this year was down (about 700 attendees vs. 1,000+). I heard that this was due to new financial regulations in Europe which prevented many from attending. The low attendance was surprising and, discouraging. Can the wonderful AF Symposium continue with such a reduced attendance?
As someone who has been attending the AF Symposium for 15 years, it’s unique and invaluable. It provides info and discussions on A-Fib unlike any other conferences. Each day one comes away with incredible insights into A-Fib.
Why I Attend: Expect My Reports
It’s a privilege to be able to attend presentations by the best clinicians and researchers working in A-Fib today. I learn more in three days than in a year of reading the various A-Fib research reports.
I’m especially blessed by being able to ask questions of the presenters and dialogue with them.
I will share the current state of the art in A-Fib research and treatments. Look for my reports on what’s relevant to patients and their families. (I already have 8 reports to share.)
If you find any errors on this page, email us. Y Last updated: Wednesday, February 21, 2018
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