Patient Perspective video at 2nd annual ISLAA symposium

Hi All,

Im back home from the 2nd Annual International Symposium on the Left Atrial Appendage held in Orlando last week. It was a very interesting and informative conference and very well attended by a broad range representing all of Cardiology. Interventional Cardiologist, Cardiovascular Surgeons as well as many EPs were in attendance and the unique perspective of all the major sub-specialties of cardiology made for a dynamic and in-depth examination of the key role that the often forgotten LAA plays in stroke, arrthymo-genesis as well as in overall cardiovascular health.

Plus, getting all these branches of the field working together toward the best solutions for patients is a huge plus and very good news for all of us going forward!

My little talk was from the patient's perspective and was slotted at the opening of the symposium. The initial morning talks got off to a bit of a delay starting around 15 minutes late or so, and as such, myself and the other morning panel speakers were asked to push our talks along as quickly as possible to help keep in sync with what was already an ambitious schedule to presentations. Hearing that made me extra aware of the clock next to my computer as I was racing along while tossing out what amounted to be around a page and a half or so of paragraphs here and there on the fly. At least, by the real-time edit job and my speaking at just south of the speed of light, I was able to squeeze most all of it in with well under 10 minutes. I hope its still mostly understandable to you all.

I was pleasantly surprised by how well it was received by many of the docs there, as I wasn't sure how well my 'Is less really more' theme might go over in that group. Apparently a large number concur with what was shared. Also, a number of EPs came up and noted their familiarity with our website and one prominent EP said that he has quite a few patients who frequent our little corner of the AFIB universe and noted that they are, by far, the most knowledgable and proactive patients he has .. which was very nice to hear!

Kudos as well to Dr DJ Lakkireddy and his whole team of smart EPs and hard working staff who not only run an excellent clinical AFIB research and ablation program, including a dedicated LAA research program at University of Kansas in Kansas City, for the super job they all did as hosts and organizers (Donita is a real Gem!) for the speakers and all the attendee's alike, and for attracting such a broad cross-section of the cardiology world to this event.

World renowned Interventional Cardiologist Dr David Holmes from Mayo Clinic noted during the conference that most of us would not recognize now during the symposium itself the significance of this melting pot of ideas around the core role of the LAA in better addressing not only the stroke issue but in better managing atrial arrhythmias as well, until much later.

Nevertheless, having surgeons like Dr James Edgerton, Steven Hoff, Marc Gillinov and Richard Whitlock, on the same faculty with Interventionalist's like Saibal Kar from Cesar Sinai and Matthew Earnest from KU as well as Dr Holmes, combined with catheter ablation EPs such as DJ Lakkiready, Andrea Natale, Randall Lee, Doug Gibson and Liuigi Di Biase as well as quite a few other well known EPs, not to mention leading researchers and clinicians like Michael Ezekowitz from New York, John Camm from St George's Univ of London, and Sam Asirvatham from Mayo Clinic, all together made for a well-rounded look from all angles at the challenges and benefits of developing this burgeoning new sub-specialty of LAA management.

We will review the symposium in more detail in the upcoming issue of The AFIB Report and in some upcoming threads on the forum. I hope this little video clip works for you all as I set it up on Google+ for the first time. It seems to work but please let me know if there are any glitches.

Patients Perspective talk - 2014 2nd Annual ISLAA symposium

Cheers!
Shannon



Edited 4 time(s). Last edit at 03/19/2014 10:19AM by Shannon.

Outstanding presentation. I really enjoyed it.

Allan

Nice job Shannon!

Shannon,

Great job communicating a very important point!

" they are by far the most knowledgable and proactive patients he has" not surprising. I know a number of afibbers who just go to their doc and take whatever is suggested without question. It takes initiative to search out other sources of information and those who are her have taken that initiative.

George

Well done, congratulations.

Thank you!!!

Shannon, Excellent presentation! I am thankful that I found this website before I had my Ablation surgery done. I am also glad we got to meet in Austin. Your knowledge is impressive and I want to personally thank you for all you have done and continue to do in this EP field of AFIB,

Great job!

Great presentation! Thank you.

Well said! Thank you, Shannon!

Louise

Impressive! Glad the professional community had a chance to hear the points you made. - Randy

Shannon, you are a great patient representative. Thank you! Do you know if Dr Wharton was at this symposium?

Jean

Less is more Ha! I almost fell for it! FIRM is a pipe dream and probably will never live up to it's hype.


McHale

Thanks folks and Im glad you liked the little blurb. At least they didn't throw any tomatoes in Orlando .

And Jean, I don't think Dr Wharton was there, its possible he could have been as I've only seen one photo of him previously a longtime ago, but I didn't recall him being there. Too bad that he missed it being in Orlando so close to his stomping ground in South Carolina.

Hope things are staying reasonably quiet the past week or so Jean?

Looks like you may have dodged a bullet there McHale...

Take care,
Shannon



Edited 1 time(s). Last edit at 03/19/2014 10:33PM by Shannon.

Excellent Shannon. Appreciate your representation

Hi Shannon,
Thank-you for being the ambassador for the rest of us in our journey for perfect SR.It was also wonderful to see the face that pens all the responses to our questions and most wanted reassurances .

Rosemarie

Thanks Shannon, yes my heart has been real quiet for about 15 or 16 days now, so I'm hoping it stays quiet after I get off Sotalol which will probably be the end of May if I don't have anymore problems.

Shannon Wrote:
-------------------------------------------------------
> Thanks folks and Im glad you liked the little
> blurb. At least they didn't throw any tomatoes in Orlando.

> Looks like you may have dodged a bullet there
> McHale...
>
> Take care,
> Shannon

You think........I was closer than you know if it wasn't for your persistence and patience with me........
Man did I get caught up in all the hype and convinced myself it was the only way to go!
All I will say right now FIRM without PVI is a pipe dream!
I would never throw a tomatoe at you........

McHale



Edited 1 time(s). Last edit at 03/19/2014 10:32PM by Shannon.

Hi McHale,

I still hope that we learn some valuable things from FIRM rotor mapping, and very likely will, even if one of them is not to ditch the PVI too precipitously.

But I agree that Id be a little leery of going for a FIRM only approach with the object of just getting the quickest acute intra-ablation termination of AFIB and then calling it all a success for the long term. No doubt there will be some folks who will get a pretty long term reprieve from their arrhythmia when zapping a few key spots, just like there have been some percentage of those getting a decent period of mostly quiet from a well-executed CAFE-only ablation, but more durable success for the long term in a more significant cross section and percentage of Afibbers is another kettle of fish and requires far better replicable results than we have seen so far before people ought to line up for ablations using any of these new phase-mapping systems alone to define the only targets for ablation and thus throw out the PVI too quickly that has been a cornerstone for the superior results in AFIB ablation (when properly and transmurally executed) in addition to ablating any and all required non-PV sources that are found to be active triggers.

Its in this later area of locating non-PV triggers that these new systems may well offer some assistance and possible benefit for many EPs. Especially those who are more reticent and less skilled at ferreting out such areas to ablate with real-time applied electrophysiology. But hopely in also proving to be a handy tool for top tier ablationist as well who already have excellent success in tracking down said non-PV sources with 3D EAM mapping.

If things like FIRM prove a valuable time saver for even the elite EPs, even if there isn't an appreciable increase in their success rates overall, and if having such a tool will encourage more of the less experienced and bold EPs to venture beyond only doing PVIs alone, then it will earn a good role in the EP Lab.

It just seems they may have gotten a little ahead of themselves in early marketing 'enthusiasm' as so often seems to happen in this and other technically-oriented fields.

Time will tell just where these new systems will fit in, but I imagine there will be some role to play in this whole equation. Just be very cautious of all the hype stories early on whether they be with drugs or new technology until there is a strong body of experience to support those kind of big claims.

The key here is that when you see the big boys in this field start to adopt something, en mass, then you'll know there is likely something significant behind it. For example, look at how quickly all the big fish like Natale and his whole group, as well as many other top centers, have adopted the new contact force catheters. They were using them under FDA pre-approval clinical trials for some months before the recent formal approval of the BioSense Webster SmartTouch CF catheter and soon to come (if its not been approved already) will be the TactiCath from St Jude. This was a clear case of a solid solution to a defined issue and thus those top EPs most in the know wasted no time at all in jumping on the bandwagon.

I'm watching closely Bordeaux's experience with the Cardio-insight vest as integrated with their CARTO 3D EAM and combined as well with their wealth of long time clinical and ablation skills and prowess to see how just much such a hybrid mapping approach might buy us anything. But I don't see them rushing to dump their segmental PVIs yet or not use other tools as well in planning their ablation strategies for a given patient.

I suspect too these phase mapping systems might prove a little more helpful to those EPs and centers who use more of a 'linear line' approach to non-PV areas rather than a wel thought out and executed CAFE approach to finding and determining which triggers to ablate beyond the PVs.

Will be interesting to see how it all shakes out in the coming years. But I'm very glad you made the choice you did when it was your time for an index ablation McHale and not jump too early into something that was still in its infancy. You couldn't have made a better choice in my book and Im very pleased to see that at 10 months post ablation with the maestro things are ticking right along in blessed NSR. That seems to be a very consistent story we hear around here.

Cheers!
Shannon



Edited 1 time(s). Last edit at 03/20/2014 01:12PM by Shannon.

Shannon - that was an excellent and impressive presentation! Thank you for putting our concerns and issues into powerful words and helping to ensure that the medical community has a better understanding of this from multiple perspectives. You managed to fit a lot into the short time they gave you, and the fact that you are so knowledgeable at good at communicating surely made those with a "higher pay grade" really sit up and pay attention to what you had to say.

Thank you for representing the rest of us Afibbers, and sharing all that you are learning. We are all truly blessed to have found this website and people likeYOU, Hans, Jackie, George, etc.

~ Barb

Thank you Shannon. It was a well-presented and much-needed point of view. Much appreciated.
judianne

Thank you, Shannon. Top marks for speed-talking!

______________
Lone paroxysmal vagal atrial fibrillation. Age 62, female, no risk factors. Autonomic instability since severe Paxil withdrawal in 2004, including extreme sensitivity to neuro-active drugs, supplements, foods. Monthly tachycardia started 1/11, happened only at night, during sleep, or when waking, bouts of 5-15 hours. Changed to afib about a year ago, same pattern. Frequency increased over last 6 months, apparently with sensitivity to more triggers. Ablation 6/27/13 by Steven Hao.

Wow. Very eloquent, Shannon. Thank you so much for sharing your time and gifts on behalf of the afib community.

Doreen

Kudos, S... what a professional presentation... you nailed it!

/L

Thanks Shannon,

I just got around to listening to this presentation. Well done! It was nice to see you and put a face with a name.

Thanks for all you do to help afibbers. You are such a wealth of knowledge.

Deb

Thanks again Friends,

Am glad you enjoyed the little talk, was grateful for the opportunity to share some of our views with a large group of EPs and cardiologist and get a bit of exposure for our little haven here.

Take care all,
Shannon