Boston Atrial Fibrillation Symposium: 2012 Preview

Interview by Jodie Elrod

Interview by Jodie Elrod

The Boston Atrial Fibrillation Symposium is taking place January 12-14, 2012. In this interview we speak with Course Director Jeremy N. Ruskin, MD.

Congratulations on the success of the Boston Atrial Fibrillation Symposium, which is in its 17th year! Tell us about how the meeting was originally started. What is the history behind this meeting?

The meeting started in 1995 and was, to the best of my knowledge, the first stand-alone meeting devoted exclusively to the topic of atrial fibrillation (AF). At the time, atrial fibrillation was not of great interest to most electrophysiologists. I think that AF was considered by many to be a nuisance arrhythmia, and one for which subspecialists had little to offer over what general cardiologists and internists could provide for their patients.

It seemed evident to us, however, that atrial fibrillation was a looming epidemic and that electrophysiologists were going to have to take the lead in its management. That meant that it would become necessary to devote time, energy and resources to furthering our very limited understanding of the basic mechanisms and pathophysiology of atrial fibrillation. In addition, those were the early days of the surgical Cox Maze procedure as well as the earliest days of attempts to mimic the Cox Maze procedure with catheter-based radiofrequency ablation. While catheter ablation for AF was in its infancy at the time, it appeared that the procedure held not only great challenge but also great promise. So it seemed like a good time to gather a group of experts together in a collegial environment to present early research, particularly in the area of catheter ablation, and to share ideas about the many aspects of AF that required further basic and clinical investigation to move the field to a new level. We anticipated that the meeting might run annually for about five years, after which the topic would become boring. We could not have been more wrong.

Describe some of the ways that the meeting and program has changed over the years.

The first Boston AF Symposium was very small compared to the current size of the meeting. The 1995 meeting was one day long and there were about 150 attendees. Since then, the meeting has grown to more than 1,000 attendees and is now three full days in length. In addition, the scientific agenda has been greatly expanded to include a broad range of basic science topics, in-depth mini symposia on all aspects of catheter and surgical ablation for atrial fibrillation and flutter, new enabling technologies, and a major focus on pharmacologic and nonpharmacologic strategies for stroke prevention in AF. In addition, we added satellite case transmissions using some of the most advanced technologies several years ago and, more recently, pre-recorded teaching cases, both of which have become extremely popular vehicles for educating physicians about this extremely complex and rapidly evolving field.

What new features will be highlighted at the 17th annual Boston Atrial Fibrillation Symposium? What changes were made to the 2012 program?

The 2012 Boston AF Symposium will include a significantly expanded session on stroke prevention in view of the dramatic recent advances in this area. In addition, the program contains a number of integrated mini-symposia focusing on topics such as pulmonary vein reconnection, the role of rotors in experimental and human atrial fibrillation, advances in management of persistent atrial fibrillation, lesion monitoring during catheter ablation of AF, and discussions of AF guidelines and regulatory issues. Whenever possible, relevant basic science talks have been integrated with clinical presentations. In addition, the program contains presentations on advances in antiarrhythmic drug therapy, the minimization and management of complications of AF ablation, an update on clinical trials in AF ablation, reviews of selected basic and clinical science papers on AF for 2011, and several sessions comprising case presentations in a variety of different formats, all of which will involve audience-faculty interaction. We are also planning to have a daily newsletter at the 2012 symposium that will highlight selected aspects of each day’s proceedings.

Why should people attend this meeting?

I think that anyone interested in an intensive educational experience focused exclusively on atrial fibrillation and taught by many of the leading international experts in the field will enjoy and benefit from this meeting. Attendees seem to appreciate the breadth and depth of the topics and faculty, as well as the fact that the entire meeting takes place in one location without the need to choose among multiple simultaneous sessions. The meeting is three days of intensive hard work, but most people find the effort to be educationally worthwhile and rewarding.

To what do you attribute the success of this meeting?

I attribute the success of the meeting to countless hours of hard work, exceptionally valuable scientific input and advice from the co-directors and program committee, particularly my colleague Dr. Moussa Mansour, with whom I work most closely on this meeting, the participation of a superbly talented and enthusiastic world-class faculty, and the unparalleled organizational and technical leadership and support provided by Muriel Corcoran and Rob Matthews. Everyone involved in this meeting is committed to providing an educational experience of the highest quality in as seamless a way as possible and in a collegial environment. There is an exceptionally high level of audience interaction with the faculty, both formal and informal, that has come to characterize this meeting. The faculty members go out of their way to make themselves accessible to the attendees throughout the three-day symposium, and this has created an atmosphere of informality and collegiality that everyone enjoys. To the extent that the meeting has achieved these goals, participation in its organization and growth has been extremely gratifying.

What are some of the most exciting advances today in the treatment of atrial fibrillation?

It would be hard to list all of the exciting advances in our understanding of and ability to treat atrial fibrillation. Much has been learned about basic mechanisms, including the role of the pulmonary veins and atrial substrate in the triggering, evolution and perpetuation of AF. There have been important advances in genetics that may yield further insights into mechanisms in the future. Among advances in therapeutics, there is a rapidly evolving revolution in pharmacologic therapies for stroke prevention, a major focus of the 2012 meeting. Investigational new devices for stroke prevention are also generating considerable interest. Important advances in catheter ablation for both paroxysmal and persistent atrial fibrillation, including new energy sources, the application of advanced imaging techniques such as delayed enhancement MRI and the use of a variety of new technologies for lesion monitoring, are likely to improve the efficacy, durability, and safety of these procedures.

Tell us about the extensive faculty presenting at this year’s meeting.

The 2012 faculty comprises more than 40 basic and clinical scientists from all over the world. Each year we attempt to draw from among the most active investigators and best teachers in the field. It is a privilege to work with a faculty of this stature. I cannot imagine a more highly qualified and talented group of individuals to address the state of the art of AF management in 2012.

Is there anything else you’d like to add?

I do want to mention that the upcoming Boston AF meeting will be preceded by a one-day Biotechnology and Medical Device Symposium on January 11, 2012. I think that people who plan to attend the Boston AF Symposium will find this specialized technology symposium to be of great interest. A more detailed description of the meeting can be found at: www.bmdsymposium.com 

For more information, please visit: www.afsymposium.com