HRS.13: Expanding Knowledge & Partnerships

Anne M. Gillis, MD, president of the Heart Rhythm Society 
and a professor at the University of Calgary, discussed highlights of Heart Rhythm 2013 that starts May 8 in Denver and how the scientific sessions continue to evolve.

What lessons from previous scientific sessions did you apply to this year’s event?

Overall, the main focus of our scientific sessions is science discovery and innovation. We always try to link the hot topics at a given meeting that inform us about directions to be thinking about as we start planning the next scientific sessions.

We get feedback from individual attendees as we network throughout the meeting and l get emails from members. They are generally positive but sometimes someone identifies an area that perhaps wasn’t covered as broadly as it should be. We do an attendee survey as well. During the summer we invite members to submit suggestions, or even to put together a session with topics and faculty for the program committee to consider for the next year.

Can you give an example?

One of the suggestions was safety in the workplace. Last year we had done a featured session. It was well received and there is another session this coming year. An area that is new that came from feedback is the Lead Management Forum. Lead survivability or failure is a topic of interest in our field because the pacing or ICD [implantable cardioverter-defibrillator] lead is the weakest link in device therapy. We decided to put together a lead forum again to reinforce issues around lead management. 

Besides the Lead Management Forum, there also is a VT/VF Summit. What’s included there?

There is more emerging technology around ablation for VT/VF [ventricular tachyarrhythmia/ventricular fibrillation] and an increasing need for ablation to manage patients who are having frequent ventricular tachyarrhythmia despite ICD therapy. To date, there are no new, exciting antiarrhythmic drugs helping us to manage those issues. As the technology is advancing, we felt that it was timely to again offer a VT/VF summit.

Lead management is important for physicians who have a focus on managing patients with lead-related issues, whether it is failing leads or an infected system and the need to do a lead extraction. This covers the broad scope of patient management, from the pediatric patient to the frail and elderly patient.

Do the joint sessions reflect increasing collaboration among societies and their members?

We initially started the joint sessions in 2010 and we have expanded them each year. The joint sessions with partners such as the American College of Cardiology, the American Heart Association and the Society of Thoracic Surgeons reflect the fact that they are important organizations with whom we collaborate on scientific and clinical documents as well as advocacy, public awareness and patient education. One of the most important things that we do is partner on guidelines. Doing these joint sessions is a way of highlighting these partnerships for our members.

Does this differ from what you are doing with international societies?

The international joint sessions are quite varied in topics and speakers. Over 40 percent of attendees at Heart Rhythm are international. These international joint sessions allow us to recognize the international leaders who have contributed to advancing our field, whether it be in research, education or other areas of leadership.

These partnerships are extremely important if we are going to improve access to heart rhythm care and improve the quality of care for patients with heart rhythm disorders around the world. We have this audacious goal of ending death and suffering due to heart rhythm disorders and we can only do that through global collaboration.

Are they also a way to learn best practices?

Absolutely. To be able to exchange ideas and the challenges people face, issues related to access of care, better informs us and helps us improve the quality of our day-to-day practice.

Are there options for physicians who cannot attend?

Heart Rhythm on Demand is a website link where our members and nonmembers can order scientific sessions after the meeting. We experimented in 2011 with the virtual meeting concept. It wasn’t overwhelmingly popular. People [tell us they] want face-to-face meetings with the ability to network, exchange ideas and meet leaders in the field as opposed to just listening to them speak. Future opportunities may be to consider regional meetings where we may be able to offer components of what was presented at Heart Rhythm.

You will be leading a joint session in clinical registries. Can you discuss the current and future role of registries?

We are going to talk about the cardiovascular registry programs and how they potentially will play a role in healthcare reform. The Affordable Care Act has a number of requirements moving forward, some that will link reimbursement to physician performance. Some ways that will be measured will be looking at physicians’ participation in registries.

There are a number of cardiovascular registries but the one I am most knowledgeable about is the ICD registry that was mandated when CMS [Centers for Medicare & Medicaid Services] approved expansion of ICD implantation for primary prevention of sudden cardiac death in 2005. The expectation was that a registry would be developed. Important observations have come from that registry, for instance, reporting on complications associated with device implantation. That type of information can be used for benchmarking.

Another interesting observation that has come out of registries to date is on geographic implantation of single chamber vs. dual chamber ICDs. Observations like this can help inform health policy decisions as we move forward.

Registries of course have limitations because they only collect a certain amount of data. The accuracy of the data is important so that the quality of the registry will depend upon the accuracy of the data entry. Longitudinal follow-up may be important in terms of evaluating some components of quality care.

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