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2024 AF Symposium

My Summary Reports Written for Atrial Fibrillation Patients

By Steve S. Ryan, PhD

The 29th annual AF Symposium was held in Boston Feb. 1-3, 2024. (Where the AF Symposium originally started back in 1995). This intense 3-day seminar took place at the Omni Seaport hotel, a well-designed, ultra-modern conference venue (one of the best I’ve ever attended).

This Symposium featured presentations by 85 leaders in A-Fib Research and Clinical Practice from all over the world. These stellar medical scientists, clinicians, and researchers shared recent developments in the A-Fib field in a major scientific forum unmatched by any other conference. This year the Symposium attracted over 1200 participants from all corners of the globe.

In the words of Dr. Jeremy Ruskin who started the AF Symposium back in 1995, “This intensive, highly focused three-day symposium brings together the world’s leading medical scientists to share in a highly interactive environment the most recent advances in the field of atrial fibrillation.”

Why I Attend Every Year

As always, I attend and write my reports to offer A-Fib.com readers the most up-to-date research and developments that may impact their treatment choices. All reports are written in plain language for A-Fib patients and their families. Look for my reports here with links to the specific reports.

The sessions were intense with each of the three days starting at 7:30 AM. Sessions continued until 7:00 PM on Thursday, 6:30 PM on Friday and 3:30 PM on Saturday (to allow attendees time to catch their plane home).

My 20th AF Symposium

This is the 20th time I have attended the annual AF Symposium. Observing and adequately reporting on it is both a challenge and a privilege. I learn more in three days than in a year of reading A-Fib research reports.

The Conference Venue

The Omni Seaport hotel has become one of the best convention centers in the US. The hotel features 100,000 square feet of indoor/outdoor meeting and event space. The facility is well designed and very accommodating to convention participants. The room rates for attendees were reasonable. The rooms themselves were well designed with little wasted space. The staff was top notch, very helpful and friendly.

To welcome guests, The hotel gave out tickets for free drinks. As part of the Symposium package, we were given tickets for lunches which were excellent. We also got snacks and plenty of coffee, etc. The convention meeting hall was huge and easily fit in the 1,200+ Symposium attendees.

The well-designed exhibit hall was on the floor below and was easily accessible via escalators and elevators. And there was another huge hall where the many abstract session “posters” were displayed. The Omni hotel was easily accessible from Logan airport via a free shuttle (Silver Line), though one did have to walk a short distance to the Omni hotel entrance. (Going back to Logan airport on the same shuttle cost $2.50.)

Exciting Breakthroughs: A New World of A-Fib Care

Pierre Jais MD

Pierre Jais MD

The predominant mood or tone of this year’s Symposium was one of excitement about the extraordinary amount of new and more effective tools now (or soon to be available) to Electrophysiologists (EPs) for treating us patients.

To me the sheer number of new catheters, devices, etc. presented was almost overwhelming. As Dr. Pierre Jais of the French Bordeaux group (LYRIC) said, this a “great era!” There is now an incredible number of new tools EPs can choose from.

BTW: Dr. Pierre Jais is one of the Bordeaux EPs who cured my A-Fib back in 1998.

One may wonder, will some of these new tools fall by the wayside and not become industry accepted? I personally don’t think this will happen to any great extent. All the ones I saw presented were well designed and looked very effective, even if they were still in some development stage.

Dr Andrea Natale

Andrea Natale, MD

As Dr. Andrea Natale from Texas Cardiac Arrhythmia Institute asserted “the future is looking bright.” This symposium featured major breakthroughs and signaled the arrival of a whole new world of A-Fib care.

Artificial Intelligence and Contact Force Sensing

As at last year’s AF Symposium, we saw how Artificial Intelligence (AI) is being applied to various treatments of Atrial Fibrillation.

One major change at this year’s AF Symposium was that Contact Force Sensing, to a limited extent, is now being applied to Pulse Field Ablation (PFA). (This was surprising to me. I didn’t think actual contact was necessary for good PFA lesions. But it seems that good contact does make for better PFA ablations.)

Major Focus: Pulsed Field Ablation Again

As at last year’s AF Symposium, Pulsed Field Ablation (PFA) was a major focus. This year, I counted 26 talks on PFA.

Most Noteworthy Quote

Perhaps the most important quote of the AF Symposium was about the future and potential of Pulse Field Ablation (PFA). In the words of Dr. Moussa Mansour of Mass General, the various research and clinical studies such as at this year’s AF Symposium “will lead to the adoption of PFA as the only energy source for PVI”.

It certainly looks like this is the direction A-Fib catheter ablation is moving towards, if not already there now (as it is in Europe).

In this context it was announced the day before the Symposium opened that the FDA had approved the Farapulse PFA catheter system January 31, 2024 (Boston Scientific). The FDA had previously approved the PulseSelect PFA system (Medtronic) December 13, 2023. Several other PFA systems are currently in the FDA pipeline waiting approval. (It’s discouraging how slow the FDA moves as compared to PFA systems approved for years in Europe and elsewhere.)

Public Health Red Flag Alert

Shaan Khurshid MD

Dr. Shaan Khurshid of Mass General declared what I would consider a public health and red flag alert. He reiterated the fact that “25 percent of A-Fib is undiagnosed”. In practical terms, many people are suffering strokes, A-Fib arrhythmias, heart damage, etc. without being aware that they are suffering from a major heart disease (such as A-Fib) and without being treated for it. This is a major public health disaster.

The tragedy is that A-Fib today is treatable and curable. How do we identify those 25% of patients with undiagnosed A-Fib? Perhaps an added test during annual physical exams? I wonder if it’s possible during annual physical exams for persons of a certain age to automatically be tested for heart arrhythmias such as A-Fib? (This seems achievable, especially considering how good monitoring devices are today, including DIY devices like the Apple Watch or Kardia system!)

Too Much of a Good Thing?

Dr. Pierre Jais of the French Bordeaux group (LYRIC) expressed a concern and a warning that “it’s possible to kill the left atrium” by too much ablation so that it no longer contracts and functions properly. One reason for possibly using too much ablation is how relatively easy PFA is to perform.

From Spotlight Session to Center Stage

At last year’s AF Symposium, I reported on a Spotlight presentation about the Laminar Left Atrial Appendage (LAA) closure/elimination device. I wrote back then that it was perhaps the most innovative and potentially ground-breaking presentation at the 2023 Symposium.

Imagine my surprise when at this year’s AF Symposium, the Laminar device was featured in a case presentation by Dr. Devi Nair of St. Bernard’s Heart & Vascular Center, Jonesboro, AR. In talking with attendees, many were already well aware of the Laminar device.

Illustration: Laminar LAA Closure/Elimination Device

In just one year, the Laminar device has moved from a Spotlight session to being accepted as an important tool for EPs. I don’t think I’ve ever seen an innovation get mainstream acceptance so fast.

The Laminar device features what is called a “rhythm ball”. It is inserted into the LAA, then twisted counterclockwise to the point where the LAA opening (ostium) is screwed together so tightly that the ostium and LAA disappear. Then, this ball is locked in place to prevent it from unwinding.

2024 Spotlight Sessions

The Spotlight sessions are often fascinating and reflect what the future may hold for A-Fib treatment. The ones that stood out to me were:

  1. A nasal spray (Etripamil) which uses a calcium channel blocker to quickly reduce heart rate within minutes.
  2. A holographic system (Santiar) for viewing ablation screens which can then be projected and referenced from anywhere in the cath lab.
  3. An innovative esophageal deviation device (S4 Medical) to move the esophagus away from the back of the posterior wall where an EP may be ablating.
  4. A technology (Vector Vmap) used outside the body to locate where in the heart A-Fib signals are coming from.

Tribute to Dr. Albert Waldo

For those of us who have been attending the AF Symposium for years, we appreciated the tribute to Dr. Albert Waldo who passed away in 2023. He was a wonderful, warm person as well as a pioneer researcher and clinician. He will certainly be missed.

Live and Pre-recorded Transmissions

We were treated to 19 various A-Fib ablation and device case demos both live and pre-recorded. These events seemed to go off without any problems, even though many of the cases were from overseas. It was a marvel of technology.

I was in awe of the session moderator, Dr. Moussa Mansour, who made everything flow seamlessly. He made sure the presenters stayed on schedule and at the same time helped the attendees understand the presenters and their objectives. A master showman.

A Year in the Planning

We later learned about the year-long planning it takes before each symposium. Throughout the year, Dr. Mansour and Dr. Jeremy Ruskin would meet on weekends to analyze and select which talks and subjects for the upcoming Symposium.

Dr Moussa Mansour

Moussa Mansour. MD

Jeremy Ruskin, MD

They have done a terrific job at this for many years. We are most grateful to them for the incredible amount of time and effort they have put into making each AF Symposium so insightful and relevant. Dr. Mansour and others made a point of thanking Executive Directors Muriel Corcoran and Robert Matthews for their great work in setting up and organizing the AF Symposium.

Challenging Case by Dr. Young-Hoon Kim

The last presentations on Saturday were the Challenging Cases in AF Management and Stroke Prevention. Dr. Young-Hoon Kim from Korea University in Seoul, South Korea gave a noteworthy presentation on how he saved a patient from an Atrial Esophageal Fistula even though there was no surgeon available to care for the patient. As Dr. Kim explained, normally that patient would have died. But Dr. Kim saved the patient’s life. How? I’ll describe that in an upcoming report.

More Reports To Come

Look for more of my reports from the 2024 AF Symposium in the next weeks and months. I’ll try to share with you the current state of the art in A-Fib research and clinical practice, what’s relevant to A-Fib patients and their families and friends.

In the meantime, you may want to browse my reports from the 2023 AF Symposium, or
the Archive of AF Symposiums Summaries by Year

If you find any errors on this page, email us. Y Last updated: Sunday, March 10, 2024

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