News Nov. 2017, No. 33

Transcription

1 News Nov. 2017, No Kim Keat Road #08-00 Singapore Phone: Fax: Chief editor: Kazuo MATSUMOTO Deputy editor: Hsuan-Ming TSAO Managing editor: Yenn-Jiang LIN Vanita ARORA Kathy LEE Yasushi MIYAUCHI Hiroshi NAKAGAWA Young Keun ON Teiichi YAMANE Kohei YAMASHIRO Giselle GERVACIO David HEAVEN Seong-Wook HAN Takashi KURITA Masataka MITSUNO Tetsuo YAGI Anil SAXENA David Chung-Wah SIU Congxin HUANG CONTENTS P1 Successful Conclusion of the 10th APHRS Scientific Session (APHRS 2017) at Yokohama: Gratitude from the Congress President P9 Welcome to APHRS 2018 P11 APHRS Public Awareness Campaign 2017: Singapore P13 APHRS Public Awareness Campaign 2017: Thailand P15 The Electrophysiology Team of the Sakurabashi Watanabe Hospital P18 Electrophysiology Fellowship in Taipei Veterans General Hospital: Leaving my comfort zones, found a new me Successful Conclusion of the 10th APHRS Scientific Session (APHRS 2017) at Yokohama: Gratitude from the Congress President Figure 1. Poster and main theme of APHRS 2017 Ken Okumura, M.D. The 10th APHRS Scientific Session Congress President Division of Cardiology, Saiseikai Kumamoto Hospital, Kumamoto, Japan I am very proud to announce to all that the 10th Asia Pacific Heart Rhythm Society Scientific Session (APHRS 2017), held in September 14 17, 2017 at Yokohama, Japan had been completed with a great success. The first APHRS Scientific Session was held in Singapore in 2008 and therefore this year APHRS 2017 was a milestone session. I would like to rejoice the success together with all members and contributors who have been making great efforts in developing the society since its foundation. In this report, I would share with you the congress achievements throughout the 4-day period.

2 Successful Conclusion of the 10th APHRS 2017 at Yokohama Overview of APHRS 2017 Ken Okumura, M.D., the 10th APHRS Scientific Session Congress President Division of Cardiology, Saiseikai Kumamoto Hospital, Kumamoto, Japan APHRS 2017 was held in conjunction with the 64th Annual Meeting of the Japanese Heart Rhythm Society (JHRS 2017) (Congress President, Prof. Kenzo Hirao, Tokyo Medical and Dental University, Japan). The main theme of APHRS 2017 was Advancing Together in Heart Rhythm (Figure 1), and in fact, the scientific sessions covered all of the recent advances in cardiac arrhythmias, electrophysiology and electrocardiology, and also included educational programs and social activities. There were 92 invited symposiums, 11 general symposiums and 8 allied medical professional sessions, and total number of sessions was 455 including company-sponsored sessions. More than 1,300 original abstracts were submitted from not only APHRS countries but United States and Europe and were discussed during the sessions. The venue of APHRS 2017 was PACIFICO Yokohama Conference Center and Exhibition Hall C and InterContinental Yokohama Grand Hotel, facing the beautiful Tokyo Bay (Figure 2). The venue was convenient in access since it takes only 30 minutes by bus from Tokyo International Airport (Haneda) and only 5 minutes on foot from the Minato Mirai Subway Station. It is also close to entertainment areas such as the largest China Town in Japan and the Motomachi shopping street. Table 1 shows the number of the participants by country. There were totally 4,860 participants, of whom 2,775 were pre-registered and the other 2,085 on-site. There were 392 invited speakers including 278 from the Asia Pacific countries, 73 from the North America and 41 from Europe. Figure 2. APHRS 2017 Venue: PACIFICO Yokohama Conference Center (above) and Exhibition Hall (next page) 2

3 When looking at the number by country, that from Japan was the largest 3,555 (73% of all), followed by 246 from China, 172 from Taiwan, 159 from Korea, 120 from the United States, 119 from Thailand, 93 from Australia, 51 from India, 46 from Hong Kong, 40 from Singapore, 38 from Vietnam, 37 from Indonesia, 32 from Malaysia, 20 from Philippines, 15 from Germany, 15 from Italy, 10 from Canada, 10 from Myanmar, and 10 from the United Kingdom. In this year APHRS, therefore, there were 1,305 attendees (27% of all) from the countries other than the host country, Japan. Many company staffs also attended the scientific session. With 1,300 Exhibitor/Sponsor badges being distributed throughout the 4-day period, there seems to be more than 6,000 attendees in APHRS 2017 (Figure 3). Figure 4 shows the table of program at a glance which was created in March, 2017 in advance, and actually the program was proceeded in the 22 meeting rooms for oral presentation and poster session in another area. The detailed timetable of sessions by meeting room can be viewed in the homepage of APHRS 2017 ( There were 455 scientific sessions in total including companysponsored sessions. Some of the sessions for the allied medical professionals were proceeded in Japanese. Successful Conclusion of the 10th APHRS 2017 at Yokohama 3

4 Successful Conclusion of the 10th APHRS 2017 at Yokohama Table 1. Number of participants by country Country Pre-registration On-site registration Total Australia Belgium Brunei 3 3 Cambodia 2 2 Canada China Czech Republic 1 1 Egypt 1 1 France 6 6 Germany Guatemala 1 1 Hong Kong India Indonesia Islamic Republic of Iran 1 1 Israel 3 3 Italy Japan 1,573 1,982 3,555 Korea Malaysia Monaco 1 1 Mongolia 1 1 Myanmar Netherlands 5 5 New Zealand Oman 1 1 Pakistan 5 5 Philippines Saudi Arabia Singapore South Africa 1 1 Spain 3 3 Sri Lanka 8 8 Sweden 1 1 Switzerland 2 2 Taiwan Thailand Tunisia 1 1 Turkey 2 2 United Kingdom United States Viet Nam Unknown 3 3 Total 2,775 2,085 4,860 Japan 1,573 1,982 3,555 Outside of Japan 1, ,305 4

5 Figure 3. Snapshots of the congress Successful Conclusion of the 10th APHRS 2017 at Yokohama Figure 4. Table of program at a glance 5

6 Successful Conclusion of the 10th APHRS 2017 at Yokohama Figure 5. Core Curriculum Session 1 Highlights of the Core Curriculum Sessions There were many interesting, instructive and stimulating lectures and abstracts presented during the congress. Here, three representative Core Curriculum Sessions (CCS) are shown. On September 15, at the beginning of the scientific session, CCS 1 (President Session) was held under the chairmanship of Professors Wee Siong Teo, Akihiko Shimizu, and Young-Hoon Kim. At first, Professor Albert L. Waldo gave a lecture entitled The History of Cardioversion (Figure 5). Consecutively, the APHRS Congress President Ken Okumura gave a lecture entitled Entrainment Characteristics of Atrial and Ventricular Tachycardia. Last but not least, JHRS Congress President Kenzo Hirao gave a lecture entitled Para-Hisian Pacing to Differentiate the Mechanism of the Tachycardia. On September 16, CCS 3 was held under the chairmanship of Professors Kenzo Hirao, Ken Okumura, and Shih-Ann Chen (Figure 6). The title of this session was Ask the Legend. Firstly, Professor Warren Jackman gave a lecture on AVNRT. Next, Professor Andreas Metzner talked about accessory pathways, and Professor Yoshito Iesaka talked about tachycardias originating from the peri-av nodal region. Professor Francis Marchlinski concluded the session with a lecture on refractory ventricular tachycardias. On September 17, CCS 5 entitled World Guidelines for the Management of Atrial Fibrillation was held. In this session, the latest Guidelines and Statements published from each continental society and Taiwan and Japanese societies were presented, including 2017 Consensus of the Asia Pacific Heart Rhythm Society on Stroke Prevention in Atrial Fibrillation by Professor Chern-En Chiang, Heart Rhythm Society by Professor Hugh Calkins, European Society of Cardiology by Professor John Camm, Japanese Heart Rhythm Society by Professor Teiichi Yamane, and Taiwan Heart Rhythm Society by Professor Shih-Ann Chen. Figure 6. Core Curriculum Session 3 6

7 Successful Conclusion of the 10th APHRS 2017 at Yokohama Gala Dinner On September 16, the Gala Dinner was held and all attendees were invited to attend. During the party, JHRS special band livened up the dinner party, and also a Japanese festival atmosphere was re-created by having different Japanese food stalls, unique demonstrations and traditional Bon dancing under a festival tower (Figure 7). The attendees were delighted in the experience of a typical Japanese summer festival, laughing with old and new colleagues old as they enjoyed the evening. Figure 7. Snapshots of Gala Dinner 7

8 Successful Conclusion of the 10th APHRS 2017 at Yokohama Figure 8. Passing over of the APHRS Flag from Professor Ken Okumura to the APHRS 2018 Congress Chairman Professor TJ Wu, Taichung, Taiwan Closing Ceremony: Passing of the APHRS Flag to Taiwan The 4-day APHRS 2017 Scientific Session was completed in the afternoon of September 17 with a great success and without any troubles. Typhoon No. 18 known as Talim came to Japan in the evening of September 17 and it did not affect the congress. As the final program of the congress, a closing ceremony was held and the APHRS flag was passed from Japan to Taiwan (Figure 8). The 11the APHRS (APHRS 2018) will be held in Taipei, Taiwan, from October 17 to October 20 in 2018 and the Congress Chairman Professor Tsu-Juey Wu, Taichung, Taiwan, will welcome all of you. The APHRS members and guests all are encouraged to get together again in Taipei next year to enjoy the APHRS I look forward to seeing all of you at Taipei. Acknowledgements On behalf of the 10th APHRS Local Organizing Committee, I would like to express my sincere appreciation to the all sponsor companies for their great contribution and support to the congress, especially to our PLATINUM SPONSORs Abbott and Medtronic, GOLD SPONSORs Daiichi-Sankyo and Japan Lifeline, SILVER SPONSORs Biosense Webster and Boston Scientific, SPECIAL SPONSORs Biotronik and Bristol-Myers Squibb and Pfizer, and EDUCATIONAL SPONSORs Bayer and Boehringer Ingelheim. 8

9 Dear colleagues and friends, It is a great pleasure and privilege to invite you to attend the 11th Asia Pacific Heart Rhythm Society Scientific Session (APHRS 2018), which will take place in Taipei, Taiwan during October It s also our honor to host APHRS congress again after holding APHRS 2012 in Taipei! Welcome to APHRS 2018 Welcome to APHRS 2018 To host the one of the top medical congress in the field of arrhythmia around the world, it s indeed our responsibility to be more inspiring and innovative to keep improving for the future development of heart rhythm science. Together with the Local Organizing Committee and the International Program Committee, we have prepared an exciting program with cuttingedge topics in the fields of cardiac electrophysiology and arrhythmia management, hope all of you can join us to share experiences, new ideas and best practices. Easily accessible from across Asia Pacific and the world, Taipei is a vibrant and hospitable city that merges traditional and modern lifestyles in an unforgettable manner. After enjoying our outstanding scientific program, you will be spoiled with native cuisine and sightseeing opportunities while experiencing the city s lively nightlife! We look forward to seeing you in Taipei in October 2018! With best regards, Advisor of Local Organizing Committee Shih-Ann CHEN APHRS 2018 Congress Chairman Tsu-Juey WU THRS President Mien-Cheng CHEN 9

10 Welcome to APHRS 2018 Highlights Advanced Precision Medicine Prestigious Invited Faculties Hot Topic Joint Symposium Realistic Virtual Theater (VR) Superb Live-Demonstration Exceeding 300 Scientific Session 25 Parallel Session More than 500 Invited Faculties 3,000 Expected Attendees CATEGORY SESSIONS Allied Professional 6 Basic/Translational Science 34 Cardiovascular Implantable Electronic Devices 54 Catheter Ablation 29 Chinese Session 8 Clinical Electrophysiology 49 Education Course 16 Heart Failure 12 Joint Symposium 12 Pediatric Arrhythmia 4 Policy/Practice/Guidelines 44 Special Session 40 Young EP/YIA 7 Total

11 APHRS Public Awareness Campaign 2017: Singapore Dr. Wee Siong Teo Dr Kelvin Wong presenting his talk on Understanding and preventing sudden cardiac death. APHRS partnered with the Singapore Heart Foundation (SHF) to initiate a public forum to raise awareness on AF and Sudden cardiac death. The public forum was held on 9 th September 2017 and was conducted in both English and Mandarin language sessions. The session was well received and the public were intrigued by the forum. During the forum, Cardiologists from various institutions presented a short education talk on AF and SCD to the public. Guest-of-honour, Member of Parliament (Tanjong Pagar GRC), Ms Joan Pereira was at the forum to express her support for the public forum, she shared the government s concern for Singaporeans heart health. This advocates Singaporeans to take steps towards a healthy heart lifestyle, recognising the possibilities and features of AF and SCD, as well as undertaking necessary precautions. APHRS Public Awareness Campaign 2017: Singapore Dr Teo Wee Siong and Dr Lim Toon Wei at the exhibition booth Participant trying out CPR at the exhibition booth. 11

12 APHRS Public Awareness Campaign 2017: Singapore Ask the Experts session. (L-R) Dr Kelvin Wong Cheok Keng, Dr Teo Wee Siong, Adj Asst Prof Ho Kah Leng The Q&A session gave the participants an opportunity to direct questions to the experts to deepen their understanding to the topic. Booth exhibitors located outside the hall were heart health related, providing exposure to the public to several health products and engaging them with hands-on experience on CPR and use of AED. APHRS in partnership with the Singapore Cardiac Society (SCS) also launch a GP Forum directed at general practitioners, educating on AF and SCD. The GP Forum was held on the 23 rd September 2017, and many general physicians and cardiologists attended the forum. The forum focused on the current management and necessary prevention for AF and SCD. Audience posing a question during the Ask the Experts Session GP Forum 12

13 APHRS Public Awareness Campaign 2017: Thailand On 30th September 2017, under the leadership of Prof. Taworn Suithichaiyakul (President of the Thai Heart Association), Assoc Prof. Dr. Buncha Sunsaneewitayakul (President of the EP Club) and Assoc Prof. Dr. Kanchit Likitthanasombat (President elected of the Thai Heart Association), Thailand organised an interactive, yet educative AF Day family run and mini marathon to increase public awareness on AF. The event then progressed on to the AP Forum, which was carried through on the stage by guest speaker, Mr. Prapat Sornlum (Well-known formal news anchor) and Mr. Rheum Maneetham (Retired vice dean from faculty of Physical Health Kasetsart University). Public Health Minister, Prof. Dr. Piyasakon Sakolsattayatorn, participated in the event and commenced the opening ceremony of AF Day. In addition to the 1,973 registered participants, there were many more who joined on the day itself, constituting to the success of the event. Dr Tachapong Ngarmukos Public Health Minister Prof. Dr. Piyasakon Sakolsattayator Open Ceremony APHRS Public Awareness Campaign 2017: Thailand Start of the Marathon (L-R) Prof. Taworn Suithichaiyakul, Prof. Dr. Piyasakon Sakolsattayator, Assoc Prof. Dr. Buncha Sunsaneewitayak, Assoc Prof. Dr. Kanchit Likitthanasombat AF Forum 13

14 APHRS Public Awareness Campaign 2017: Thailand EP fellows teaching attendees to check their pulse using a portable handheld ECG Three key messages of the AF Day: (1) AF causes stroke (2) AF can be detected by you or your family and (3) Stroke from AF can be prevented Runners receiving trophies Prior to the event, complementing efforts to connect and stimulate greater awareness for the mass public towards AF were communicated through newspaper, TV and YouTube clip. The information includes methods to detect AF, such as the demonstration of a self-pulse check. YouTube clip on Self-pulse check 14

15 The Electrophysiology Team of the Sakurabashi Watanabe Hospital Koichi Inoue, MD PhD Director of the Electrophysiology Laboratory Sakurabashi Watanabe Hospital, Cardiovascular Center Hospital Overview The Sakurabashi Watanabe Hospital (Figure 1; Right Top) is a private hospital that was established by Dr Shuji Watanabe in The hospital sits at the center of the metropolitan area of Osaka, the second largest city in Japan (Figure 1; Right Bottom), and serves more than 5 million people living within a 20-kilometer radius. We offer highly specialized services, focusing on cardiovascular disorders, with sub-specialty teams in emergency care, cardiovascular surgery, anaesthesiology, intensive care, cardiovascular imaging, coronary and peripheral artery disease, and heart rhythm disorders. In the current era, our focus on cardiovascular disease is increasingly relevant due to the aging society in Japan, which is leading to an unprecedented increase in the prevalence of these disorders. Notably, arrhythmias like atrial fibrillation are becoming a particular problem. We provide a range of cardiovascular interventions, including percutaneous coronary and peripheral intervention, catheter ablation, device implantation, and cardiovascular surgery, that have contributed to improved patient care and public health in the Osaka metropolitan area. In addition, because our doctors and staff are internationally recognized experts in the diagnosis and treatment of heart disease, difficult cases and treatment failures are often referred from other medical institutions. Figure 1. Location of Osaka city (Top) and a picture of the Sakurabashi Watanabe Hospital (Bottom) The Electrophysiology Team of the Sakurabashi Watanabe Hospital Electrophysiology Laboratory Our electrophysiology team was established in 2003 by a former team directed, Dr Toshiya Kurotobi, who also established and is currently working at the Kurotobi Heart Clinic in Osaka I now oversee an established electrophysiology team of 5 faculties and 3 trainees (Figure 2) that has expertise in treating arrhythmias by catheter ablation, implantable devices, and other methods. Of note, our catheter ablation team is among the most distinguished in Japan. We exclusively use a catheter laboratory and share another catheter laboratory with coronary intervention team. We have the capacity to use both the CARTO system and the Ensite-NaVX system that allow complex arrhythmias to be mapped. Either of these systems can be used based on the procedure and the preference of the attending doctor. More recently, we have also started cryoballoon ablation for the treatment of paroxysmal atrial fibrillation, and have amassed experience in more than four hundred cases. 15

16 The Electrophysiology Team of the Sakurabashi Watanabe Hospital Figure 2. The members of the electrophysiology team in the Sakurabashi Watanabe Hospital In Japan, the number of cases treated by catheter ablation has been increasing by almost 10% per year, with more than 63,000 ablations performed nationwide in Our focus has increasingly been on atrial fibrillation, and Figure 3 shows the transition in the number of ablation cases over recent years. We performed more than 800 ablation procedures at our laboratory in 2016, and expect this number to increase this year. The number of patients with atrial fibrillation has increased drastically in Japan over recent year, with the disorder now accounting for about 75% of all ablations. By contrast, the incidence of myocardial infarction remains relatively low in Japan and most cases are successfully treated by emergency percutaneous coronary intervention, especially in the urban area. As a result, the prevalence of ventricular tachycardia remains low and ablation procedures for this arrhythmia are relatively few in number, accounting for less than 5% of all ablation procedure. Our strength in electrophysiology treatments lies primarily in our extensive experience of ablation procedures for atrial fibrillation. A focus of the electrophysiology team has been standardization of pulmonary vein isolation (PVI), using the CARTO system with the CARTOSOUND, CARTOMERGE, and VisiTag modules (Figure 4). We have provided detailed methods for this in an open access article (Int J Arrhythm. 2017;18(1):27-32) to ensure it benefits the specialism as widely as possible. Thanks to our continued strength in this area, among others, doctors from a several Asian countries have come to observe us perform ablations for atrial fibrillation at our hospital. Indeed, some of these opportunities are offered as an official educational course of the Asian-Pacific Heart Rhythm Society (Figure 5). We also perform approximately 200 device implantations or implantable device exchanges per year, and about 70 involve high-power devices such as transvenous or subcutaneous intracardiac defibrillators and cardiac resynchronization therapy defibrillators. Figure 3. Number of catheter ablation procedures in the Sakurabashi Watanabe Hospital 16

17 Figure 4. Our EASY Atrial fibrillation ablation using the CARTOSOUND (Left), CARTOMERGE (Middle), and VisiTag (Right) Academic Activity Although the Sakurabashi Watanabe Hospital is not an academic institute, the electrophysiology team conduct clinical research on a regular basis to contribute to medical science in our field. The results of our research have been published in the following esteemed journals over recent years: European Journal of Cardiology, Circulation Arrhythmia and Electrophysiology, Heart Rhythm, International Journal of Cardiology, Circulation Journal, Europace, American Journal of Cardiology, Journal of Cardiology, Journal of Arrhythmia, and International Journal of Arrhythmia. At present, we are conducting a large-scale multicenter randomized controlled trial (Study ID; UMIN ) aiming to elucidate the noninferiority of PVI alone compared with substrate modification plus PVI. This is being done in conjunction with the Osaka Cardiovascular Conference (OCVC), which consists of cardiologists from either the Osaka University Graduate School of Medicine or one of 30 affiliated hospitals in Osaka. In the present study, members of seven high-volume hospitals are participating as an OCVC-arrhythmia team. Patient recruitment has already finished and the results are expected to be announced in Figure 5. Pictures of APHRS educational course (Top) and certificate of completion (Bottom) The Electrophysiology Team of the Sakurabashi Watanabe Hospital HOSPITAL INFORMATION Address: Umeda, Kita, Osaka, Japan Postal code: Tel:

18 Electrophysiology Fellowship in Taipei Veterans General Hospital Electrophysiology Fellowship in Taipei Veterans General Hospital: Leaving my comfort zones, found a new me This August, I am halfway into my fellowship training in Taipei Veterans General Hospital, led by Professor Shih-Ann Chen. A long flashback ensued from the memories created during the fellowship training here. It began when I received the from APHRS to its members about the opportunity of scholarship. It entailed an application to an unfamiliar environment, acquiring a Visa, independently settling into a new country, and exposure to a new workplace with a different atmosphere. Even though much to be dismayed upon, with the help from the local fellows, the journey in the first month was pleasant, and progressed surprisingly fast. Before personally experiencing this training, the majority of feedback that I heard from those who have attended the training previously, was hard. We have about EP cases per week, a tracing meeting, a journal reading meeting, homework every week, and also constructing our weekly summary. During the day, we have a full session of work, while after work we spent our evening time reviewing the tracings we have done in the morning and discussing among the fellows on our opinions if we were to handle the case on our own. Dr. Simon Salim, Indonesia When we have spare time in the weekend, I am motivated to read more pages in the textbooks or journals to keep me in pace with the teachers. Professor Shih-Ann Chen hosted a series of training programs and live demonstration courses endorsed by APHRS which inspired me in the learning of EP knowledge. There are times when I feel dejected especially when I fail to carry out the procedure up to their expectations, or when I struggle to build a deserving article to cover a topic needed. But through these experiences, I noticed that I learnt more from my failures than my successes. Above all these physically and mentally demanding things, I learn about honesty and integrity in the field of Electrophysiology. There are not many fields in medicine that are by far as fascinating and thrilling as ours, and getting discouraged will not get us to anywhere. These great teachers not only teach me their skills and their way of conceptualizing the cases, they also teach me to love this field, have passion in it, to accept and learn from our lack of knowledge, and to diligently pursue the answers. These values acquired are things that I might have forgotten during my daily work. Training at Taipei Veteran General Hospital with Fellows 18

19 Applying to a high volume centre also have its own advantages, the variability of cases, encountering phenomena where I would only have read before in textbooks, watching various technique and procedure, and being exposed to many kinds of researches. When I look back now, I never regret applying for scholarship to Taipei. I noticed the difference in me from before, and the new me upon returning back to my country. The new me would never have existed if I have not applied for this fellowship in this great centre. It is not unusual to have the fear Meet the Masters 2017, Taipei Table 1. Fellowship Structure Fellowship Title Fellowship Supervisor Location : city, hospital Length of Fellowship Adult Electrophysiology Fellowship Chen Shih Ann Taipei Veteran General Hospital, Taipei, Taiwan 12 months Start date March 1, 2017 Number of Fellows Accommodation Salary Requirement What was particularly good? Conference Vacation 2-4 new fellows per year, different starting date Hospital dormitory available near the hospital : NTD / month No stipend provided regularly. In some circumstances some fellows might get some stipend helping in an event Completed adult cardiovascular residency / additional electrophysiology experience will be beneficial Educational fellowship with high volume and diversity of cases. Hands on training Multiple conference, fully supported by the Cardiology Foundation Following Taiwan National Holidays of stepping out of one s comfort zone, and being away from our friends and family, but I realized that to have courage is not about having no fears but it is about walking the path albeit you still feel the fear. And through this fearful journey, I can assure you that we will be able to encounter new workplaces, new friends, and new families. Most of all, you can even discover a new you along the way. My advice for those that are still contemplating over taking this fellowship is, not to linger for too long worrying over it, but rather start to act by preparing for it. Electrophysiology Fellowship in Taipei Veterans General Hospital 19

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