This January the ESC Council on Stroke held its second international conference “ESC Heart & Stroke 2019”. After the success of its first meeting in Prague last year, the meeting moved to Berlin and was under the direction of Prof W. Doehner. Almost 280 delegates from across the globe attended.
Cardiologists, neurologists, vascular surgeons, interventional neuroradiologists, and a range of other disciplines were all represented on a high quality agenda. Entertaining debates on contentious areas were discussed. Drs G. Hindricks and M. Köhrmann debated the validity of the ESUS concept in light of recent negative trials. Dr A. Sohaib argued that AF ablation can prevent stroke with Prof G. Boriani arguing against. These debates were light hearted and entertaining with the evidence generally favouring one side of the argument. While delivered in an equally unique manner, but more contentious, was the debate between past Council chair Prof P. Widimsky and Dr C. Cognard on the role of interventional cardiologists in the treatment of stroke. The duration of training required for experienced interventional cardiologists, the perceived need for cardiologists involved, the level of interventional training were all areas which were discussed. What was clear was the large geographical disparities in access to the treatment, with provision in some European countries better than others. Improved access to this evidence-based treatment is required.
The final debate session discussed the role of PFO closure in cryptogenic stroke with Dr S. Stortecky in favour and Dr G. Häusler against. While many of the randomised controlled trials had suggested the benefit in stroke may be limited, meta-analyses of this data more supportive. In addition to the great debates, there were useful updates looking at the role of left atrial appendage closure, and current clinical trials underway to evaluate its use. Detection of atrial fibrillation by a range of different devices is a growing field and particularly important in stroke and was the focus of a range of presentations. A series of interactive workshops on day 2 built on some of the themes in the lectures including the management of anticoagulation in complex patients, and intervention for carotid disease.
New to the programme this year was an abstract submission programme and 79 high quality posters were presented. 15 young ESC Council on Stroke members with accepted posters were offered grants to attend the meeting. This is clearly a growing field and tomorrow's cardiologists are likely to have an increasing role in care of stroke patients, so it was great to see such great engagement from younger members of the Council. Overall the meeting was a resounding success thanks to great support from the ESC, and meeting sponsors. The meeting moves to the warmer climate of Barcelona next year and should hopefully be even bigger and better!
Afzal Sohaib (Barts Heart Centre, London, UK)