Advanced Catheter Ablation: New Tips, Techniques, and Technologies for Complex Arrhythmias


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Advanced Catheter Ablation: New Tips, Techniques, and Technologies for Complex Arrhythmias

  1. 1. Mayo School of Continuous Professional Development 14th Annual Advanced Catheter Ablation New Tips, Techniques, and Technologies for Complex Arrhythmias Course Directors: William G. Stevenson, MD, FHRS Douglas L. Packer, MD, FHRS David J. Wilber, MD, FHRS, CCDS Co-sponsored by: September 8-11, 2013 Fairmont Copley Plaza | Boston, MA REGISTER ONLINE NOW!
  2. 2. Course Description Catheter ablation is an important therapy for atrial and ventricular arrhythmias. Atrial fibrillation is the most common sustained cardiac rhythm disorder observed in clinical practice, affecting an estimated 2.66 million Americans, and anticipated to increase to a staggering 12 million cases by 2050. Atrial fibrillation is an important cause of stroke and diminished quality of life. Catheter ablation is a major therapy for atrial fibrillation that is evolving rapidly with rapid evolution of methods for improving efficacy and safety. With the routine availability of implantable defibrillators, an increasing number of patients are surviving ventricular arrhythmias, but these are associated with decreased survival, increased heart failure, and diminished quality of life. Catheter ablation is increasingly needed to control episodes of ventricular tachycardia. In addition catheter ablation is now a well-established first line therapy for many supraventricular tachycardia and ventricular arrhythmias in patients with structurally normal hearts. Although the approach to many of these arrhythmias is straight forward, all practitioners encounter challenging cases due to anatomic and pathophysiologic variations. This course will provide comprehensive instruction for diagnosing common and complex cardiac arrhythmias in the electrophysiology laboratory and achieving effective and safe ablation. Case-based illustrative presentations will highlight diagnostic dilemmas and key management strategies. Experts discussing detailed patient cases provide a step-by- step analysis and an in-depth review of approaches to catheter ablation for the spectrum of cardiac arrhythmias including atrial fibrillation, complex atrial arrhythmias after AF ablation or in congenital heart disease, atrial tachycardias and atypical flutters, and ventricular arrhythmias with and without associated heart disease. Detailed discussions of relevant cardiac anatomy integrated with intracardiac ultrasound and other imaging modalities are highlighted. The program format provides opportunities for one-on-one discussions with experts in the field as well as fellow colleagues. Individuals in the early stages of their career or who desire an update in fundamentals are encouraged to attend. Participants are encouraged to bring case presentations of their own for discussion and review. Course Highlights • Live and taped video procedure discussion • Expert techniques to assist in accurate diagnosis and ablation of common and complex arrhythmias • State-of-the Art techniques for evaluating, mapping and ablating complicated arrhythmias • Imaging integrated with anatomy and electroanatomic mapping techniques • Illustrative case presentation of AT and VT Ablation procedure that highlight techniques and application of new technology and solutions for real life scenarios Course Learning Objectives Upon conclusion of this program, participants should be able to: • Recognize the mechanisms underlying cardiac arrhythmias amenable to ablation • Describe diagnostic maneuvers for accurate diagnosis of different supraventricular and ventricular arrhythmias • Distinguish both normal and abnormal cardiac anatomy and its role in the genesis of arrhythmias and ablations strategy • Describe optimal mapping and ablation techniques for specific arrhythmias and clinical circumstances • Discuss major risks associated with ablation • Assess the value and limitations of high-end technology in the ablation process • Identify the role for pre and intraprocedural imaging techniques to optimize outcomes and increase safety of ablation procedures • Summarize optimal energy sources for ablation of specific cardiac arrhythmias and understand the underlying mechanisms of action
  3. 3. Attendance at this course does not indicate nor guarantee competence or proficiency in the performance of any procedures which may be discussed or taught in this course. Intended Audience The course is of interest for electrophysiologists, electrophysiology fellows, cardiologists, cardiac surgeons, technologists, physician’s assistants and nurses/nurse practitioners. Credit College of Medicine, Mayo Clinic, is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. College of Medicine, Mayo Clinic, designates this live activity for a maximum of 30 AMA PRA Category 1 Credits™. Physicians should claim only the credit commensurate with the extent of their participation in the activity. Other Health Care Professionals A certificate of attendance will be provided to other health care professionals for requesting credits in accordance with state nursing boards, specialty societies, or other professional associations. Date and Location The 14th Annual Advanced Ablation Course will be held September 8 - 11, 2013. The course will be held at the Fairmont Copley Plaza, 138 St James Ave., Boston, MA. This historic landmark hotel is centrally located in Boston’s historic Back Bay, and sits steps away from the Boston Public Library, historic Beacon Hill, and the Freedom Trail. Lodging Accommodations Guest rooms have been reserved for attendees and their guests with special course rates at the following hotel. In order to receive the special rate, reservations must be made before the room block is filled or before the expiration date of August 7, 2013, whichever comes first. Reservations will be taken following this date based on space and rate availability. Please identify yourself as a participant of the Catheter Ablation Course 2013 when making your reservation. Fairmont Copley Plaza $309.00 single/double 138 St. James Ave. Global Reservations: 1-800-441-1414 Boston, MA 02116 Check-in time is 3:00 p.m.. Every effort is made to accommodate guests arriving before check-in time; however, rooms may not be available. Check-out time is 12:00 noon. Lodging arrangements are the sole responsibility of the individual registrant. Mayo Clinic is not responsible for expenses incurred by an individual who is not confirmed and for whom space is not available at the meeting. Costs incurred by the registrant such as airline or hotel fees or penalties are the responsibility of the registrant. Parking Parking is available at the hotel. The cost for parking is not included in the registration fee.
  4. 4. Faculty Course Directors William G. Stevenson, M.D. Brigham and Women’s Hospital Boston, Massachusetts Douglas L. Packer, M.D. Professor of Medicine Mayo Clinic, Rochester, Minnesota David J. Wilber, M.D. Loyola University Health System Maywood, Illinois Mayo Faculty Samuel J. Asirvatham, M.D. Professor of Medicine and Pediatrics Mayo Clinic, Rochester, MN Guest Faculty David J. Callans, M.D. Penn Medicine Philadelphia, Pennsylvania Warren M. Jackman, M.D. University of Oklahoma Health Sciences Center Oklahoma City, Oklahoma Gregory F. Michaud, M.D. Brigham and Women’s Hospital Boston, Massachusetts Andrea Natale, M.D. Texas Cardiac Arrhythmia Institute, St. David’s Medical Center Austin, Texas Vivek Y. Reddy, M.D. Mount Sinai Hospital New York, New York Edward P. Walsh, M.D. Children’s Hospital Boston Boston, Massachusetts Faculty Disclosure As a provider accredited by ACCME, College of Medicine, Mayo Clinic (Mayo School of Continuous Professional Development) must ensure balance, independence, objectivity and scientific rigor in its educational activities. Course director(s), planning committee, faculty, and all others who are in a position to control the content of this educational activity are required to disclose all relevant financial relationships with any commercial interest related to the subject matter of the educational activity. Safeguards against commercial bias have been put in place. Faculty also will disclose any off-label and/or investigational use of pharmaceuticals or instruments discussed in their presentation. Disclosure of this information will be published in course materials so those participants in the activity may formulate their own judgments regarding the presentation. Mayo Clinic Live Case Team Thomas Munger, M.D. Yong Mei Cha, M.D. Paul Friedman, M.D.
  5. 5. Advanced Ablation Course Program Schedule Sunday, September 8, 2013 7:15 a.m. Registration and Continental Breakfast 7:45 a.m. Welcome Introduction William G. Stevenson, M.D. Fundamentals and Supraventricular Tachycardias Moderator: William G. Stevenson, M.D. 8:00 a.m. Mapping Fundamentals, Electrograms and Entrainment Pitfalls William G. Stevenson, M.D. 8:45 a.m. Diagnostic Maneuvers for SVT/AVNRT/Accessory Pathways Gregory F. Michaud, M.D. 9:30 a.m. Refreshment Break 9:45 a.m. Case Studies of Ablation of AVNRT: When Slow Pathway Ablation is not Enough Warren M. Jackman, M.D. 10:15 a.m. Ablation of WPW - Free Wall Accessory Pathways David J. Callans, M.D. 10:45 a.m. Case Studies in Ablation of Septal Accessory Pathways Warren M. Jackman, M.D. 11:30 a.m. Atriofasicular Pathways: Mahaim or Mahem Warren M. Jackman, M.D. 12:00 p.m. Lunch 1:00 p.m. Contact Force Sensing: How it Teaches Us to Apply Biophysics for Better RF Ablation Problems Douglas L. Packer, M.D. 1:30 p.m. Cavotricuspid Isthmus Dependent Atrial Flutter: Tough Cases Gregory F. Michaud, M.D. 2:15 p.m. Refreshment Break 2:30 p.m. Focal Atrial Tachycardia David J. Wilber, M.D. 3:00 p.m. Catheter Ablation of Supraventricular Arrhythmias in Children Edward P. Walsh, M.D. 3:30 p.m. Anatomy of the Conduction System Relevant to Ablation Samuel J. Asirvatham, M.D. 4:00 p.m. Hands on Cardiac Anatomy – Pre-registration requested Samuel J. Asirvatham, M.D. and Faculty 5:30 p.m. Adjourn
  6. 6. Advanced Ablation Course Program Schedule Monday, September 9, 2013 7:15 a.m. Continental Breakfast Ventricular Tachycardia Moderator: William G. Stevenson, M.D. 8:00 a.m. Anatomy of the Outflow Tracts Relevant to Ablation: Integrating Anatomy and Imaging Tools Samuel J. Asirvatham, M.D. and Douglas L. Packer, M.D. 9:00 a.m. RV Outflow Tract Tachycardias David J. Callans, M.D. 9:40 a.m. Refreshment Break 9:55 a.m. LV Outflow Tract and Aortic Tachycardias David J. Wilber, M.D. 10:35 a.m. LV Interfascicular and Papillary Muscle Tachycardias Samuel J. Asirvatham, M.D. 11:15 a.m. Congenital Heart Disease VT in Children and Adults Edward P. Walsh, MD, CCDS 12:00 p.m. Lunch 1:00 p.m. Anatomy and Imaging Integration for VT in Heart Disease Samuel J. Asirvatham, M.D. and Douglas L. Packer, M.D. 2:00 p.m. Epicardial Mapping and Ablation Techniques Andrea Natale, M.D. 2:30 p.m. Mapping During VT for Scar-Related VTs: Defining Circuits William G. Stevenson, M.D. 3:00 p.m. Refreshment Break 3:15 p.m. Substrate Mapping Techniques for Scar Related VT: Voltage Maps and Pace-Mapping David J. Wilber, M.D. 3:45 p.m. Targeting Isolated Potentials for Scar – Related VT Warren M. Jackman, M.D. 4:15 p.m. Ablative Homogenization for Scar – VTs Andrea Natale, M.D. 4:45 p.m. Hemodynamic Support for VT/VF Ablation Vivek Y. Reddy, M.D. 5:15 p.m. Special Considerations in Nonischemic and RV Cardiomyopathies David J. Callans, M.D. 6:00 p.m. Adjourn
  7. 7. Advanced Ablation Course Program Schedule Tuesday, September 10, 2013 7:15 a.m. Continental Breakfast 7:55 a.m. Introduction and Comments Moderator: William G. Stevenson, M.D. 8:00 a.m. Catheter Ablation for Polymorphic VT/VF Andrea Natale, M.D. 8:45 a.m. Live Cases from Brigham and Women’s Hospital Putting it all Together Moderator: William G. Stevenson, M.D. Panel: Drs. Wilber, Callans, Natale, Reddy Case 1: Post AF Ablation Flutter Case 2: VT/VF Ablation 10:15 a.m. Refreshment Break Atrial Fibrillation Moderator: David J. Wilber, M.D. 10:30 a.m. The Atria: Integrating Anatomy and Imaging Samuel J. Asirvatham, M.D. and Douglas L. Packer, M.D. 11:30 p.m. Pulmonary Vein Isolation: Interpreting Electrograms, Achieving and Assessing Permanent RF Lesions Gregory F. Michaud, M.D. 12:15 p.m. Lunch 1:15 p.m. Video Case Based: Ancillary Ablation Beyond PV Isolation Linear Lesions, CFAE, Rotors, and Focal Targets David J. Wilber, M.D. 2:00 p.m. A Case of Ablation for Persistent AF: The Austin Approach Andrea Natale, M.D. 2:30 p.m. A Case of Ablation for Persistent AF: The Penn Approach David J. Callans, M.D. 3:00 p.m. Beyond PV Isolation: Neural targets for AF Warren M. Jackman, M.D. 3:30 p.m. Refreshment Break 3:45 p.m. Managing Risks of AF Ablation: Protecting the Brain, Esophagus and Phrenic nerve Vivek Y. Reddy, M.D. 4:15 p.m. Efficacy Outcomes of AF Ablation: What the Trials Say and Don’t Say Should Change Your Practice Now Douglas L. Packer, M.D. 4:45 p.m. Emerging Technologies and Approaches for AF Ablation Vivek Y. Reddy, M.D. 5:15 p.m. Robotic Navigation for Ablation: What Does it Add? Andrea Natale, M.D. 5:45 p.m. Adjourn
  8. 8. Advanced Ablation Course Program Schedule Wednesday, September 11, 2013 7:15 a.m. Continental Breakfast 7:45 a.m. Introduction and Comments Moderator: Douglas L. Packer, M.D. 8:00 a.m. Post AF Ablation Atrial Tachycardias: A Systematic Approach Gregory F. Michaud, M.D. 8:30 a.m. Appendage Occlusion Devices Vivek Y. Reddy, M.D. 9:00 a.m. Atrial Arrhythmias in Repaired Congenital Heart Disease Edward P. Walsh, M.D. 9:30 a.m. Break 9:45 a.m. Live Cases from Mayo Clinic Moderator: Douglas L. Packer, M.D. Panel: Drs. Reddy, Wilber, Michaud, and Stevenson 11:15 a.m. Dealing with the Perils of Government Regulations, Reimbursements, Performance, Measurement and Public Reporting Douglas L. Packer, M.D. 11:45 a.m. Wrap–up and Closing Comments William G. Stevenson, M.D. 12:00 p.m. Adjourn
  9. 9. REGISTRATION Register online: Registration Fee: Course Registration (MD, PhD, DO, PharmD) $995.00 Reduced Course Registration (Fellow, RN, NP, PA) $825.00 * Pre-register for Anatomy Session during on-line registration The registration fee includes tuition, electronic course syllabus, continental breakfasts, break refreshments, and lunch. Although it is not Mayo School of Continuous Professional Development (CPD) policy to limit the number of registrants for a course, conference room facilities may necessitate closing of enrollment; therefore, early registration is advised. Mayo Clinic Division of Cardiology has recently implemented an online conference registration system. If this is your first time using the online system, you will need to create a profile and login account. Returning participants will use the profile created with previous registration. Register by entering the url: diseases-2013R137 and click on Register Now. The system will step you through the profile and login process. An email address is required upon registration. A letter of confirmation will be forwarded to this address upon receipt of payment and submitted registration. Present this letter of confirmation when checking in at the meeting registration desk. CANCELLATION POLICY If you cancel your participation in this course, your registration fee, less a $75 administrative fee, will be refunded when written notification is received by Mayo School of CPD before August 25, 2013. ( or fax: 507-538-0146). No refunds will be made on or after August 25, 2013. Canceled registrations are non-transferable. Mayo School of CPD reserves the right to cancel or postpone any course due to unforeseen circumstances. In the unlikely event Mayo School of CPD must cancel or postpone this course, Mayo School of CPD will refund the registration fee, but is not responsible for any related costs, charges, or expenses to participants, including fees assessed by airline/travel/lodging agencies. For additional information, contact: Cardiovascular Continuing Education E-mail: 200 First Street SW - Gonda 6 Phone: 800-283-6296 or 507-266-0677 Rochester, MN 55905 Website:
  10. 10. ©2013MayoFoundationforMedicalEducationandResearchMC4111-106rev0413 • ExpertTechniquestoassistinaccuratediagnosisandablationof commonandcomplexarrhythmias • Integrationofultrasound,fluoroscopicandpre-procedureimaging withelectroanatomicmappingtechniques • CasepresentationsofAF,VT,andSVTAblationproceduresthat highlightkeytechniquesandapplicationsofnewtechnologyand solutionsforreal-timescenarios Ifyoualreadyreceivedacopyofthisbrochure, pleasegivethisbrochuretoaninterestedcolleague. MAYOCLINIC 200FirstStreetSW Rochester,MN55905 MayoSchoolofContinuousProfessionalDevelopment AdvancedCatheterAblation NewTips,Techniques,andTechnologiesforComplexArrhythmias September8-11,2013 FairmontCopleyPlaza Boston,MA REGISTER ONLINE NOW! Co-sponsoredby: