Advanced Catheter Ablation: New Tips, Techniques, and Technologies for Complex Arrhythmias
Mayo School of Continuous Professional Development14th AnnualAdvancedCatheter AblationNew Tips, Techniques,and Technologies forComplex ArrhythmiasCourse Directors:William G. Stevenson, MD, FHRSDouglas L. Packer, MD, FHRSDavid J. Wilber, MD, FHRS, CCDSCo-sponsored by:September 8-11, 2013Fairmont Copley Plaza | Boston, MAREGISTER ONLINE NOW!http://www.mayo.edu/cme/cardiovascular-diseases-2013r137
Course DescriptionCatheter ablation is an important therapy for atrial and ventricular arrhythmias. Atrialfibrillation is the most common sustained cardiac rhythm disorder observed in clinicalpractice, affecting an estimated 2.66 million Americans, and anticipated to increase to astaggering 12 million cases by 2050. Atrial fibrillation is an important cause of stroke anddiminished quality of life. Catheter ablation is a major therapy for atrial fibrillation that isevolving rapidly with rapid evolution of methods for improving efficacy and safety. Withthe routine availability of implantable defibrillators, an increasing number of patients aresurviving ventricular arrhythmias, but these are associated with decreased survival,increased heart failure, and diminished quality of life. Catheter ablation is increasinglyneeded to control episodes of ventricular tachycardia. In addition catheter ablation isnow a well-established first line therapy for many supraventricular tachycardia andventricular arrhythmias in patients with structurally normal hearts. Although theapproach to many of these arrhythmias is straight forward, all practitioners encounterchallenging cases due to anatomic and pathophysiologic variations.This course will provide comprehensive instruction for diagnosing common and complexcardiac arrhythmias in the electrophysiology laboratory and achieving effective and safeablation. Case-based illustrative presentations will highlight diagnostic dilemmas andkey 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 spectrumof cardiac arrhythmias including atrial fibrillation, complex atrial arrhythmias after AFablation or in congenital heart disease, atrial tachycardias and atypical flutters, andventricular arrhythmias with and without associated heart disease. Detailed discussionsof relevant cardiac anatomy integrated with intracardiac ultrasound and other imagingmodalities are highlighted.The program format provides opportunities for one-on-one discussions with experts inthe field as well as fellow colleagues. Individuals in the early stages of their career orwho desire an update in fundamentals are encouraged to attend. Participants areencouraged 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 complexarrhythmias• State-of-the Art techniques for evaluating, mapping and ablating complicatedarrhythmias• Imaging integrated with anatomy and electroanatomic mapping techniques• Illustrative case presentation of AT and VT Ablation procedure that highlighttechniques and application of new technology and solutions for real life scenariosCourse Learning ObjectivesUpon 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 andventricular arrhythmias• Distinguish both normal and abnormal cardiac anatomy and its role in the genesis ofarrhythmias and ablations strategy• Describe optimal mapping and ablation techniques for specific arrhythmias and clinicalcircumstances• 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 outcomesand increase safety of ablation procedures• Summarize optimal energy sources for ablation of specific cardiac arrhythmias andunderstand the underlying mechanisms of action
Attendance at this course does not indicate nor guarantee competence or proficiency inthe performance of any procedures which may be discussed or taught in this course.Intended AudienceThe course is of interest for electrophysiologists, electrophysiology fellows, cardiologists,cardiac surgeons, technologists, physician’s assistants and nurses/nurse practitioners.CreditCollege of Medicine, Mayo Clinic, is accredited by the Accreditation Council forContinuing Medical Education to provide continuing medical education for physicians.College of Medicine, Mayo Clinic, designates this live activity for a maximum of 30 AMAPRA Category 1 Credits™. Physicians should claim only the credit commensurate with theextent of their participation in the activity.Other Health Care ProfessionalsA certificate of attendance will be provided to other health care professionals forrequesting credits in accordance with state nursing boards, specialty societies, or otherprofessional associations.Date and LocationThe 14th Annual Advanced Ablation Course will be held September 8 - 11, 2013. Thecourse will be held at the Fairmont Copley Plaza, 138 St James Ave., Boston, MA. Thishistoric landmark hotel is centrally located in Boston’s historic Back Bay, and sits stepsaway from the Boston Public Library, historic Beacon Hill, and the Freedom Trail.Lodging AccommodationsGuest rooms have been reserved for attendees and their guests with special course ratesat the following hotel. In order to receive the special rate, reservations must be madebefore the room block is filled or before the expiration date of August 7, 2013, whichevercomes first. Reservations will be taken following this date based on space and rateavailability. Please identify yourself as a participant of the Catheter Ablation Course 2013when making your reservation.Fairmont Copley Plaza $309.00 single/double138 St. James Ave. Global Reservations: 1-800-441-1414Boston, MA 02116 Check-in time is 3:00 p.m.. Every effort is made to accommodate guests arriving beforecheck-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 notconfirmed and for whom space is not available at the meeting. Costs incurred by theregistrant such as airline or hotel fees or penalties are the responsibility of the registrant.ParkingParking is available at the hotel. The cost for parking is not included in the registrationfee.
FacultyCourse DirectorsWilliam G. Stevenson, M.D.Brigham and Women’sHospitalBoston, MassachusettsDouglas L. Packer, M.D.Professor of MedicineMayo Clinic, Rochester,MinnesotaDavid J. Wilber, M.D.Loyola University HealthSystemMaywood, IllinoisMayo FacultySamuel J. Asirvatham, M.D.Professor of Medicine and PediatricsMayo Clinic, Rochester, MNGuest FacultyDavid J. Callans, M.D.Penn MedicinePhiladelphia, PennsylvaniaWarren M. Jackman, M.D.University of Oklahoma Health SciencesCenterOklahoma City, OklahomaGregory F. Michaud, M.D.Brigham and Women’s HospitalBoston, MassachusettsAndrea Natale, M.D.Texas Cardiac Arrhythmia Institute,St. David’s Medical CenterAustin, TexasVivek Y. Reddy, M.D.Mount Sinai HospitalNew York, New YorkEdward P. Walsh, M.D.Children’s Hospital BostonBoston, MassachusettsFaculty DisclosureAs a provider accredited by ACCME, College of Medicine, Mayo Clinic (MayoSchool of Continuous Professional Development) must ensure balance,independence, objectivity and scientific rigor in its educational activities. Coursedirector(s), planning committee, faculty, and all others who are in a position tocontrol the content of this educational activity are required to disclose all relevantfinancial relationships with any commercial interest related to the subject matter ofthe educational activity. Safeguards against commercial bias have been put inplace. Faculty also will disclose any off-label and/or investigational use ofpharmaceuticals or instruments discussed in their presentation. Disclosure of thisinformation will be published in course materials so those participants in theactivity may formulate their own judgments regarding the presentation.Mayo Clinic Live Case TeamThomas Munger, M.D.Yong Mei Cha, M.D.Paul Friedman, M.D.
Advanced Ablation Course Program ScheduleSunday, September 8, 20137:15 a.m. Registration and Continental Breakfast7:45 a.m. Welcome Introduction William G. Stevenson, M.D.Fundamentals and Supraventricular TachycardiasModerator: William G. Stevenson, M.D.8:00 a.m. Mapping Fundamentals, Electrograms and EntrainmentPitfalls 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 Break9:45 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. Lunch1:00 p.m. Contact Force Sensing: How it Teaches Us to Apply Biophysicsfor 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 Faculty5:30 p.m. Adjourn
Advanced Ablation Course Program ScheduleMonday, September 9, 20137:15 a.m. Continental BreakfastVentricular TachycardiaModerator: 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 Break9:55 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, CCDS12:00 p.m. Lunch1:00 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 Break3:15 p.m. Substrate Mapping Techniques for Scar Related VT: VoltageMaps 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 RVCardiomyopathies David J. Callans, M.D.6:00 p.m. Adjourn
Advanced Ablation Course Program ScheduleTuesday, September 10, 20137:15 a.m. Continental Breakfast7:55 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 Ablation10:15 a.m. Refreshment BreakAtrial 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. Lunch1:15 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 Break3:45 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 Sayand 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
Advanced Ablation Course Program ScheduleWednesday, September 11, 20137:15 a.m. Continental Breakfast7:45 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. Break9:45 a.m. Live Cases from Mayo Clinic Moderator: Douglas L. Packer, M.D. Panel: Drs. Reddy, Wilber, Michaud, and Stevenson11:15 a.m. Dealing with the Perils of Government Regulations,Reimbursements, Performance, Measurement and PublicReporting Douglas L. Packer, M.D.11:45 a.m. Wrap–up and Closing Comments William G. Stevenson, M.D.12:00 p.m. Adjourn
REGISTRATIONRegister online:http://www.mayo.edu/cme/cardiovascular-diseases-2013R137Registration Fee:Course Registration (MD, PhD, DO, PharmD) $995.00Reduced Course Registration (Fellow, RN, NP, PA) $825.00* Pre-register for Anatomy Session during on-line registrationThe registration fee includes tuition, electronic course syllabus, continentalbreakfasts, break refreshments, and lunch. Although it is not Mayo School ofContinuous Professional Development (CPD) policy to limit the number ofregistrants for a course, conference room facilities may necessitate closing ofenrollment; therefore, early registration is advised.Mayo Clinic Division of Cardiology has recently implemented an onlineconference registration system. If this is your first time using the online system,you will need to create a profile and login account. Returning participants willuse the profile created with previous registration.Register by entering the url: http://www.mayo.edu/cme/cardiovascular-diseases-2013R137 and click on Register Now. The system will step you throughthe profile and login process. An email address is required upon registration. Aletter of confirmation will be forwarded to this address upon receipt of paymentand submitted registration. Present this letter of confirmation when checking inat the meeting registration desk.CANCELLATION POLICYIf you cancel your participation in this course, your registration fee, less a$75 administrative fee, will be refunded when written notification is receivedby Mayo School of CPD before August 25, 2013. (email@example.com 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 tounforeseen circumstances. In the unlikely event Mayo School of CPD mustcancel or postpone this course, Mayo School of CPD will refund the registrationfee, but is not responsible for any related costs, charges, or expenses toparticipants, including fees assessed by airline/travel/lodging agencies.For additional information, contact:Cardiovascular Continuing Education E-mail: firstname.lastname@example.org First Street SW - Gonda 6 Phone: 800-283-6296 or 507-266-0677Rochester, MN 55905 Website: www.mayo.edu/cme/cardiovascular-diseases