EPI Congress 2011 Preview: Advancing Device Technologies and Techniques in Rhythm Management

Interview by Jodie Elrod
Interview by Jodie Elrod

The second-annual EPI Congress, taking place September 9–11, 2011 in Washington, DC, is the key scientific event for what’s new in cardiac device therapy. Learn more about the 2011 program here from Course Co-Directors Seth J. Worley, MD, FHRS, FACC and Kenneth A. Ellenbogen, MD, FACC, FHRS.

Why have a meeting focusing solely on cardiac device technologies and techniques?

Worley: There are several excellent conferences focused primarily on ablation, but few courses on devices. We look forward to presenting information on the advances in interventional device implantation techniques that implanting physicians are interested in learning more about.
Ellenbogen: There are really no other meetings like the EPI Congress, which is solely focused on the management of patients with devices and new techniques for patients with devices. There are a lot of other meetings that have to do with catheter ablation or a combination of catheter ablation and devices. So this meeting is very unique, and I think it fulfills a need.

Who should attend the EPI Congress? What will the meeting offer for attendees to bring home to their individual facilities?

Ellenbogen: This meeting will offer attendees an opportunity to learn more about device therapy, including a new way of thinking on how to manage patients with devices as well as a particular focus on new invasive techniques for implanted devices. The meeting is not so much for those who are beginning fellowship training. Instead, this meeting is intended for those who are either finishing an EP fellowship or who already implant devices and want advanced training in techniques and an up-to-date review of what’s new in device therapy.

What new features will be highlighted at the second-annual EPI Congress? What changes were made to the 2011 program?

Ellenbogen: Some of the new information featured in the 2011 program will include the type of material that is difficult to learn about at any other meeting. We will spend a lot of time talking about a variety of topics, but plan on really focusing on how to get CS leads in the right place, how to do venoplasty, how to use snares, and how to use advanced implantation techniques to get leads to the heart. We will spend a lot of time talking about extraction, femoral and laser extraction and review techniques. From a didactic point of view we will talk about how to avoid ICD shocks, the prognostic significance of appropriate and inappropriate shocks, avoiding appropriate or unnecessary shocks, and LV lead positioning and management of nonresponders, coronary sinus, and subclavian venoplasty.

Tell us about the new session on how to do the right thing for the device patient, which is being presented from a legal perspective.

Worley: With the recent DOJ investigation into the use of devices outside of the guidelines, there is a lot of concern among implanting physicians because many patients who seem to need a device have some feature in their history that does not match the guidelines. It is important to remember that the patients enrolled in the clinical trials on which the guidelines are based were highly selective. Most of the patients who were screened for the clinical trials did not qualify. We are asked to make difficult decisions about device implantation in a real-world patient population. It helps to hear how other physicians are dealing with the situation.

What type of information will be presented on subcutaneous ICDs and MRI-safe devices?

Worley: The world experience and technical tips on implantation of subcutaneous ICDs will be presented. With regard to MRI-safe pacemakers/leads, we will discuss how the technology was developed, its limitations and in which patients they might be the most appropriate.
Ellenbogen: These are two of the areas that weren’t discussed at last year’s meeting. We’re going to talk about the implications of MRI-compatible devices, some of the design concerns, how to manage patients with devices who need MRI, subcutaneous implantation techniques, and personal experience with subcutaneous ICDs.

How will EP allied professionals also benefit from this program?

Worley: The implanting physician in most hospitals does not have EP fellows and thus depends heavily on their allied professional support. The allied professional, in effect, becomes the EP fellow. Their thoughtful input and support is essential to a high-caliber EP program. So, to answer your question, the allied professional benefits in the same way as the implanting physician. It helps them take better care of their patients both directly and through support of the implanting physician.

What are some of the most exciting advances in the use of devices for the management of cardiac patients?

Worley: There are so many exciting advances, it is hard to know where to start. Advances in interventional implant techniques now make it possible to implant the LV lead in less than 15 minutes in the majority of patients and reduce implant failure from around 10% to less than 1%.

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

Ellenbogen: This year’s invited faculty are experts in all areas — EP professionals who are renowned for their work. Having this top-notch faculty will give attendees the opportunity to ask a variety of questions.

Is there anything else you’d like to add?

Worley: The information covered in this program will the make the day-to-day practice of allied professionals and physicians more fulfilling. In addition, implementation of some of the implant techniques discussed may make procedures quicker and easier.

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