Day 1 ESC — Cardiac Pacing, MRIs and RV lead position

I thought I loved Germany, but this is ridiculous. I love Amsterdam! Yesterday, Michael O’Riordan and I decided to embrace the Dutch mode of transportation. Mike is a real journalist who works for theHeart.org. He’s also a fellow endurance athlete. We got off the congested tram yesterday and decided to rent bikes. This, my friends, was a great decision. Riding the 6k from the hotel to the congress made all the difference. My mind was clearer; my body felt better. There was something intangible going on. The meeting here is huge. ESC is the largest cardiology meeting in the world. The press room stretches a hundred or more meters. TheHeart.org has a big squad of North American and European journalists. The website is already well-populated with stories. My first post concerned cardiac pacing–an old school topic. The two issues I found interesting here involved 1) where exactly in the right ventricle to place the pacing lead, and 2) whether MRI scans can be safely performed in patients with cardiac devices. It’s a medically heavy post, but I liked the two topics because they bring medical decision-making to the fore. In other words, they make you think. Specifically, concerning the issue of MRIs and devices, the old dogma holds that MRIs are not safe for patients with metal devices. Would you be surprised if I told you the evidence behind this dogma is essentially non-existent. Today I wrote about AF ablation. An interesting multinational MRI study called DECAAF was released today. The jolting trial studied the relationship between scar tissue in the atria and ablation success. What was most exciting, however, was that post ablation scans taught us something new about AF mechanisms. I just sent this post to the editors and will expect publication soon. I also attended a superb pro/con debate today. You will like this: Endurance sport exerts arrhythmogenic effects. The two discussants are giants in the field. Professors Sanjay Sharma (UK) and Louis Mont (Spain) ended up agreeing on most issues. I will have a forthcoming report on this matter. By the way, the session was held in a huge conference room, and it was filled. A teaser: think… the obvious. In other cardiology matters, there were a number of noteworthy trials released today. The details are on theHeart.org ESC page. Fellow THO blogger, Melissa Walton Shirley, a known anti-smoking zealot, posted this provocative piece linking her visit to the Anne Frank house and a cardiology session entitled the Smoking room. Get this:

We must never underestimate the impact of the carnage imposed by the tobacco plague. It has permanently eroded our world and continues to etch a swathe of death, destruction, and poverty in its perpetual march across our planet.

My wife Staci says writing is most compelling when the author cares about which they say. MWS surely cares about the scourge of smoking. Okay, I’m getting ready for my commute back to the hotel and evening strategy sessions with my colleagues. JMM