Program chair previews HRS.19 highlights

The Heart Rhythm Society (HRS) is leveraging timing and location for its 2019 scientific sessions. The May 8-11 conference will be held in San Francisco, a venue that enabled the program committee to tap into Silicon Valley’s expertise with digital health, emerging technology and innovation. HRS.19 Program Director Christine Albert, MD, MPH, director of the Center for Arrhythmia Prevention at Brigham and Women’s Hospital and professor of medicine at Harvard Medical School, gave Cardiovascular Business a preview of meeting highlights.

HRS announced 21 late-breaking clinical trials to be presented over three days. Any predictions about the trials most likely to impact practice?

Our late-breaking trials sessions include important clinical trials and initial presentation of new innovative technologies for the treatment of patients with arrhythmias. For the last decade, there has been tantalizing evidence on the potential use of autonomic modulation for treating patients with atrial fibrillation (AFib) or patients with heart failure. TREAT-AF evaluates whether a simple noninvasive treatment that changes autonomic tone will reduce AFib, and BeAT-HF will report on whether an implantable device that changes the balance between parasympathetic tone and sympathetic tone will improve symptoms in patients with heart failure. Among the many new technologic innovations to be presented, CAPTURE will present first-in-human results for a permanently implanted carotid artery filter designed for prophylactic stroke prevention in AFib patients.

HRS will kick off the scientific sessions with three summits?

Yes, summits are an HRS tradition where attendees have the opportunity to get immersed in a topic. This year we’re looking to the future with two new summits. The Digital Health Summit is being offered in partnership with European Heart Rhythm Association, and we’ve included several medical and consumer technology companies to cover topics such as the wearables revolution and what it means for practice as well as how we’ll use artificial intelligence. There will be an entrepreneurial aspect for physicians who are thinking of startup ideas.

Emerging Therapeutics is the other new summit. This summit isn’t specific to any disease process but will cover the gamut of electrophysiology. The morning will focus on what’s new in device therapy, what’s coming in five years, where the technology should go; then we’ll cover biologics and pharmacotherapy during the lunch symposium; and the afternoon will be dedicated to ablation.

Third is the popular Atrial Fibrillation Summit—everything that’s new and impacting practice right now in AFib management and therapy. In addition to state-of-the-art lectures and debates, journal editors will highlight the most important articles from the past year.

How do attendees access the summits?

Attendees who register for the premier package will have access to all three summits. They can select symposia from any of the summits according to their interests, and they’ll also receive access to both the Heart Rhythm On Demand and Summits On Demand products. For example, if you are interested in ventricular tachycardia (VT), you can go to the VT portion of the AFib summit, the mapping portion of Emerging Therapeutics and maybe pop into part of the Digital Health Summit. We pace the summit agendas to be complementary so, for example, the ablation sections occur at different times.

What’s on the docket for live cases?

We have two institutions, each performing two cases. Dr. William Stevenson and his team at Vanderbilt University will be presenting a VT case and a left atrial appendage (LAA) closure procedure on Thursday. On Friday, Geisinger Heart Institute will first show us how they do His bundle pacing and then place a transseptal lead to directly capture the left bundle branch.

HRS is hosting several joint sessions with other cardiology societies. What’s your approach to achieving such diversity? 

There are about 20 joint sessions this year, which demonstrates how we view ourselves—as an international society, committed to collaborating with other societies from around the globe. Our partners look forward to the HRS meeting, too, so they submit proposals for joint sessions.

The diversity of sessions also reflects the HRS membership. We’re a conglomeration of individuals from more than 70 countries who are interested in heart rhythm disturbances, not necessarily all electrophysiologists. We have basic scientists, pathologists, clinical trialists and so on. The joint sessions reflect that diversity. For instance, some disease processes are more prevalent in some parts of the world, such as in Latin America, where there’s much more Chagas disease and rheumatic heart disease than in the U.S. The joint sessions also give us opportunities to tap into the expertise in countries that are ahead of the U.S. with certain technologies. We highlight those leaders in both the joint and the core sessions.

What are some questions or controversies HRS.19 will tackle?

The sessions will reflect how rapidly the field is moving and answer attendees’ questions. In addition to the topics covered in the summits, there will be sessions on the CABANA trial and its impact on patient care (JAMA, online March 15, 2019); many sessions on new technologies, such as LAA closure and newer ablation therapies; a featured session on AFib screening; and a forum on big data and population health in electrophysiology.

In response to attendee feedback, we’re weaving both basic and translational science into several sessions. The idea is that audience members who may be primarily interested in clinical work can still get some cutting-edge basic research and learn how it might eventually impact their practice.

You’re offering a physician leadership program?

Yes, on Tuesday evening. This is a case-based session designed for anyone coming into a leadership position or struggling with issues in their own leadership or thinking about it. Also back this year is the HRS Women in EP Luncheon. We’re highlighting the woman investigator and our excellent women faculty who have helped to grow electrophysiology.

Speaking of growing, this is a milestone anniversary?

Yes, this is HRS’s 40th anniversary, and we’re celebrating the occasion with a special plenary session featuring NPR journalist Guy Raz. In the spirit of his popular How I Built This podcast, Guy will interview past, present and future electrophysiology leaders on how HRS and our field got to where we are and where we’ll go in the next 10 to 15 years.

We want to seize this opportunity to honor our leaders, so some of the sessions will include a history talk given by a luminary in the field, and special displays will showcase our history and tell the story of how electrophysiology advanced.