What’s New?

In EP Lab Digest®’s December 2014 issue, we feature three fantastic case studies. Editor-in-Chief Emeritus Todd J. Cohen, MD and colleagues highlight the potential applications of the Reveal LINQ Insertable Cardiac Monitor (Medtronic, Inc.) for the diagnosis and treatment of syncope of unknown etiology. James Kneller, MD, MSc, PhD, FHRS, CCDS discusses his approach to PVC ablation and presents a successful case combining the principles of this workflow. Hanscy Seide, MD and Hae W. Lim, PhD examine the potential efficiencies that may be possible with the Arctic Front Advance cryoballoon system (Medtronic, Inc.) through short and predictable time usage to help maximize staff and EP lab utilization.

 

We also hear from an array of new voices! Michael McCullough, author of the blog Afibrunner.com, shares his experience living with persistent atrial fibrillation. Jerry W. Jones, MD, FACEP, FAAEM discusses courses available at the Medicus of Houston, a provider of continuing education for physicians and other medical personnel specializing in advanced ECG interpretation and dysrhythmia analysis. We also feature the EP program at Washington Regional Medical Center in a Spotlight Interview.

 

In addition, don’t miss our newly redesigned EP Lab Digest® website, including an online-exclusive multimedia section of videos from your favorite EP Lab Digest® articles. Take a look and let us know what you think!

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Achieving Certification

In two new articles in EP Lab Digest®’s October 2014 issue, authors discuss how they approached achieving certification in their medical programs. For example, Stroke Coordinator Susan Maynard, MS, RN-BC, CCNS, CCRN-CMC describes the process Mount Nittany Medical Center underwent to achieve Primary Stroke Center certification. Primary Stroke Centers were established in 2003 by The Joint Commission as a result of recommendations from the Brain Attack Coalition and the American Stroke Association. Mount Nittany Medical Center, located in State College, PA, is a 260-bed acute care facility under the umbrella of Mount Nittany Health. Because of the Medical Center’s location and demographics, in 2010, leadership recognized the need for the creation of a stroke program to ensure a future of high-quality care for the community. They achieved the Primary Stroke Center certification designation on June 19, 2014.

In another article, EP Lab Digest® speaks with William “Bill” Nesbitt, MD, a cardiac electrophysiologist on the medical staff at Texas Health Heart & Vascular Hospital Arlington, and Hoyt Frenzel, MD, Medical Director of Texas Health Arlington Memorial’s emergency department (ED) and an emergency medicine physician on the hospital’s medical staff. Texas Health Heart & Vascular Hospital Arlington, located on the campus of Texas Health Arlington Memorial Hospital, recently earned full Atrial Fibrillation Certification status from the Society of Cardiovascular Patient Care. They note that this certification was a logical step toward a unified guideline-based approach in the treatment of atrial fibrillation.

Can’t-Miss Interviews!

Our special May 2014 issue of EP Lab Digest® includes several featured interviews with KOLs in the industry. Don’t miss our interview with Dr. Vivek Reddy, Director of the Cardiac Arrhythmia Service at Mount Sinai Hospital, who discusses his use of the CIRCA S-CATH™ for helping to avoid esophageal injury during ablation of atrial fibrillation (AF). Because of its unique design, he believes the S-CATH is able to give him a better spread of what is going on and allows him to safely do AF ablation in an efficient manner.

In another exclusive interview we learn more about the multicenter CONVERGE IDE Clinical Trial, nContact’s randomized IDE Study for the treatment of persistent AF through a multidisciplinary closed-chest approach. In the interview we speak with physicians from the first two sites to enroll patients in the CONVERGE Study: John R. Onufer, MD of Virginia Cardiovascular Specialists, Levinson Heart Hospital in Richmond, Virginia, and Graham Bundy, MD of Cardiothoracic Surgical Associates, Levinson Heart Hospital in Richmond; and David R. Tschopp, MD of Austin Heart in Austin, Texas, and Faraz Kerendi, MD of Cardiothoracic and Vascular Surgeons in Austin.

Finally, we speak with Dr. Saumya Sharma from Memorial Hermann in Houston, Texas, about his tips for successful lead extraction. He performs lead extractions in the CV OR and hybrid suites using almost exclusively Cook Medical’s Evolution device.

Achieving AF Certification

In a feature article this month, Sri Sundaram, MD, FHRS and Brenda Yost, PhD, RN, PhD, NEA-BC discuss achieving atrial fibrillation (AF) certification through the Society for Cardiovascular Patient Care (SCPC). The SCPC began certifying hospitals for atrial fibrillation in 2011, with the primary goal of assisting healthcare facilities to better evaluate and manage patients with AF. Dr. Sundaram and Dr. Rost are located at Porter Adventist Hospital, part of the Centura Health care system in Denver, Colorado. Porter Adventist Hospital has a very active electrophysiology department. The approaches to patient care established as the standard of care as part of the AF certification process were applied broadly, not just at Porter Adventist, but to all hospitals in the Centura system.

The authors’ interest in this process began after seeing EP Lab Digest®’s interview with Genesis HealthCare System from February 2012. Cathy Huggins, MSN, RN, CNL, CCRN and colleagues from Genesis HealthCare System in Zanesville, Ohio wrote that by going through the AF certification process, they put their whole EP program under a microscope and found certain areas that were functioning very well and others that needed development. The final result of the certification process was a higher understanding of what an ideal AF program should look like.

Freezing Temperatures

Screen Shot 2014-01-23 at 2.03.14 PMThe new buzzword these days seems to be “polar vortex”, an arctic blast that is currently sending freezing temperatures to much of the U.S.

In the January issue of EP Lab Digest®, Andrew Wickliffe, MD and Dan Dan, MD from Piedmont Heart Institute in Atlanta, Georgia, present an article on another type of deep freeze: cryoablation. They describe a case of a 64-year-old male who was diagnosed with paroxysmal atrial fibrillation about 5 years ago. The patient initially underwent pulmonary vein isolation using irrigated radiofrequency energy, which was was acutely successful. However, the patient later required a repeat ablation, and underwent a balloon cryoablation approximately 1 year ago. Since then, he has continued to have no evidence of symptoms of recurrent atrial fibrillation, which has been confirmed by an ILR monitor.

The authors conclude that balloon cryoablation for paroxysmal atrial fibrillation is a safe and effective therapy. Their institution has noted significant decreases in procedure time, fluoroscopy time, and left atrial dwell time when compared to traditional radiofrequency pulmonary vein isolation procedures.

Upcoming AF Symposium

The upcoming 19th Annual Boston AF Symposium is scheduled to take place January 9-11, 2014 at the Orlando World Center Marriott in Florida. This symposium, which was initiated in 1995, has become a major scientific forum for health care professionals to learn about the most recent advances in the field of atrial fibrillation. We look forward to this year’s scientific program! Just some of the highlights include sessions on Alternative Therapies for Atrial Fibrillation (presented by Eric Prystowsky, MD), The Ablation Lesion or the Atrial Disease: Lessons Learned from DECAAF (presented by Nassir Marrouche, MD), and Renal Denervation for AF – Physiology, Mechanisms of Action and Rationale in AF (presented by Vivek Reddy, MD). The meeting will also include satellite case presentations on topics such as Individualized Cryoballoon Ablation for PAF (presented by Boris Schmidt, MD and KR Julian Chun, MD) and Thermal Balloon Ablation for Paroxysmal AF (presented by David Haines, MD). Other hot topics from this year’s meeting include Left Atrial Appendage Closure Devices for Stroke Prevention and Current Clinical Trials and Registries in Atrial Fibrillation.

For additional information on various featured topics from the meeting, please check out articles in the January issue of EP Lab Digest®, including Dr. Khan Pohlel and Dr. Kent R. Nilsson’s case on LAA exclusion using the LARIAT suture delivery device (SentreHeart, Inc.) or the clinical trial overview of the CardioFocus HeartLight® Ablation System from Dr. Frank A. Cuoco and colleagues.

In addition, while you’re attending the meeting, don’t forget to stop by EP Lab Digest@’s booth (#617)! See you there!

Atrial Fibrillation Initiatives

In EP Lab Digest®’s December issue, Dr. Christian Ruff tells us about the North American Thrombosis Forum’s (NATF) Atrial Fibrillation Action Initiative, created to identify multidisciplinary best practices for stroke prevention in atrial fibrillation (AF). Dr. Ruff is the AF Action Initiative Co-Chair, Investigator at the TIMI Study Group, Associate Physician in the Cardiovascular Medicine Division at Brigham and Women’s Hospital, and Instructor in Medicine at Harvard Medical School. The AF Action Initiative brings together a group of experts from the cardiology, neurology, hematology, primary care, emergency medicine, gastroenterology, and pharmacology fields to discuss the new landscape of stroke prevention and atrial fibrillation. In May 2014, the consensus group will convene in Boston to finalize a consensus document that will include contributions from all of the participants in the AF Action Initiative.

In addition, check out our article on 1 Mission 1 Million – Getting to the Heart of Stroke in next month’s issue. This is a global initiative set up to raise awareness of atrial fibrillation and its link to stroke. The 1 Mission 1 Million – Getting to the Heart of Stroke initiative was funded by Boehringer Ingelheim as part of its global commitment to improving disease awareness in atrial fibrillation.