In this session, several consensus documents of the European Heart Rhythm Association (EHRA), already published over the last year, or currently ongoing, were discussed.
Prof Etienne Aliot, from Nancy, summarized the current status of different aspects of ablation of ventricular tahycardias (VT), reviewing how to approach the problem, the mechanisms of different VT, technical aspects, and the endpoints to be achieved with the procedure. Finally, he listed the indications for VT ablation in different clinical situations.
Dr Vijgen, from Hasselt, stressed the importance of this document due to the growing number of patients with implantable cardioverter defibrillator (ICD). He categorised the drivers as ‘private’ drivers and ‘professional’ drivers, according to the number of kilometres and hours per year, and the weight of the vehicle. He provided a formula for calculating the ‘Risk of Harm’ while driving, depending on the time spent driving, the type of vehicle, the risk of sudden cardiac incapacitation and the probability that such an event resulted in a fatal or injury-producing accident. According to this, they provided different recommendations for private and professional drivers, in different indications (primary prevention or secondary prevention), different clinical situations, such as after ICD therapy, or different interventions (ICD implantation, ICD replacement or lead replacement). The authors acknowledge that the regulations in different countries throughout Europe are different and hope that this document could be to try to homogenize regulations across Europe.
Dr Brignole, from Lavagna, gave an overview of the current status of this technology, and divided the indications into different categories: established indications (the study of patients with syncope or palpitations) and non established indications (the study of patients with atrial fibrillation or for risk stratification). He provided a detailed summary of the data published in the literature for each situation and, according to these data, he defined the different recommendations for each situation.
Dr Blomström-Lundqvist, from Uppsala, acknowledged the increasing use of imaging techniques for electrophysiological procedures, especially for atrial fibrillation and ventricular tachycardia (VT) ablation. She performed a review of its role in defining the anatomy, especially for atrial fibrillation ablation, and the definition of scars for VT on patients with structural heart disease. She stressed that due to its increasing use, it is important to define which technique is more adequate in every case, when it should be used, what is the value and cost effectiveness. For these reasons, she said, a consensus document defining these aspects is needed, and she announced that the EHRA consensus document on ‘Imaging in electrophsoiology and devices’ is ongoing. This session gave an excellent overview and summary of the most important aspects of these consensus documents.
Highlights of the European Heart Rhythm Association's consensus documents
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