March 14, Sunday 4:30 PM to 6:00 PM   At ACC.09, the controversies in implantable cardioverter defibrillator (ICD) therapy included: Misuse of SCD-HeFT dataProphylactic ICDs in the elderly and patients with comorbidities, and ICD therapy in the era of genetic testing  At ACC.10, the controversial topics in ICD therapy include: Update in risk stratification for sudden cardiac deathAppropriate patient selection for cardiac resynchronization therapyManagement of patients with frequent appropriate and inappropriate ICD shocksUpdate in lead extraction: indications, techniques and management

March 14, Sunday 2:30 PM to 3:30 PM   Ventricular tachycardia that lasts at least 30 seconds is termed sustained VT. It generally requires termination by anti-arrhythmia drugs, anti-tachycardia pacing techniques or electrical cardioversion. The most commonly used drugs are amiodarone, lidocaine and procainamide.   Sustained VT can occur in conjunction with some other cardiac dysfunction such as ischemic MI and the patient can be hemodynamically stable or unstable. How do EPs determine the best course of treatment?

Sunday, March 14, 9:30 AM -12:30 PM   Lead management and placement has taken center stage in the last few years. In fact, the INCREMENTAL trial found that echo-targeted placement of leads for ischemic cardiomyopathy patients receiving a cardiac resynchronization therapy (CRT) device improved cardiac function and survival.   A study by Patterson et al found that the use of rotational angiography to construct a 3D model of the patients heart facilitated lead placement in a similar patient population receiving a CRT device (J Invasive Cardiol 2010;22:E27E29).

Sunday, March 14, 8:39 AM - 8:52 AM   In this state-of-the-art imaging symposium, Joao A. Lima, MD, from John Hopkins University will elucidate how cardiac MR can help EPs before and after procedures. Lima penned a state-of-the-art paper on this topic back in 2004 in the Journal of the American College of Cardiology. Since the publication of that article, many technological advances have taken place regarding MRI and Lima has been at the forefront of that field. Attendees will surely learn how to best use cardiac MR to enhance procedural success and patient safety. 

March 14, Sunday 8:00 AM to 9:30 AM   This session might be one of the more exciting gatherings of electrophysiologists at ACC.10. It will pit experts against experts, debating the pros and cons of particular therapies on particular patients. Are there specific benefits of catheter ablation relative to drug therapy for some patients? How can EPs identify and distinguish which patients with paroxysmal atrial fibrillation (AF) are optimal candidates for ablation or drug therapy? While these questions may not be resolved, they will be thoroughly discussed, with antagonist and protagonist case witnesses lending their support. In addition, the audience can join the fun via the audience response system.

The field of electrophysiology (EP), particularly pertaining to ablations, has been reported to be growing faster than coronary interventions, and there are no signs that it will slow down. While the volume of coronary cath procedures has remained somewhat flat over the past year, EP labs have been expanding and adding new technology. For this reason alone, it behooves attendees at ACC.10, which begins on Saturday, March 13, to take in some of the exciting EP lectures being presented at the conference.   One of the biggest topics in EP is whether transcatheter ablation should be the first-line treatment over anti-arrhythmic drugs in patients with atrial fibrillation (AF). First results of the pilot CABANA study, being released in a late-breaking clinical trial session, could potentially indicate a new direction for this debate (see below for session details).READ MORE

The use of CT colonography is usefuland safefor a preoperative exam of the proximal colon in patients who have been treated with metallic stents due to colon obstruction caused by colorectal cancer, according to a study published in the March issue of Radiology.

A standard test of implantable cardioverter-defibrillators (ICDs) is linked to significant thought-processing problems that improve for most patients within a year after the device is inserted, according to a study published in the March 2 issue of Circulation: Arrhythmia and Electrophysiology.