Highlights from the Europace 2015 congress


Europace 2015 in Milan was a good opportunity to reacquaint with old friends, customers and colleagues,  and to establish new relationships. 

In the past decade, things became leadless, wireless, remote and paperless in the world cardiac device therapy and diagnostics.

It's impressive to see the progress in pacing; in the field of Brady pacing it's with miniaturized leadless pacing devices entering the (European) market from St. Jude (Nanostim) and Medtronic (Micra) and Boston Scientific expected to follow suit.  Cardiac Resynchronization Therapy with ICD devices benefited from a steady stream of study data that was in the works 10 years ago, and has since been followed by guideline changes that have contributed to more and more patients getting access to this therapy, according to the data in the 2015 EHRA White book on implantable devices and EP. There's still work to do on the non- responders and device setting optimization, but the overall clinical data show increase in quality of life and reduction of mortality.

Wireless device data transmission to home monitoring stations (once pioneered by Biotronik)  and onwards to the physician over the internet , allow for an ever expanding base of implantables and disposables to watch over you, or helping understand what is wrong with you, all while in a home setting with the doctor keeping an eye on you from a remote location.

The catheter delivered CardioMEMS pulmonary artery pressure sensor from St Jude allows physicians to gain a week or even more of advanced warning time in HF patients heading towards a hemodynamic crisis, compared to remote monitoring based on just weight gain from fluid retention.

The Medtronic SEEQ disposable and Reveal LINQ implantable diagnostics are just the first in a field of fascinating diagnostics for catching the hard cases in AF, syncope and associated spells of dizziness.  What about a diagnostic stick, the MyDiagnostick, that you just take in your hands after receiving it from your GP, to detect silent AF?

And it's no longer just the device being sold in the box, but the whole servicing infrastructure on offer, saving doctors and cardiac technician’s time, taking away worry and burden, that add to the value of the product. Paperless and seamless integration of data into patient files is everywhere now, from your EP station, to the device programming, or from your remote or ambulatory diagnostics, implantable or disposable.

While most of these diagnostics are rhythm-related when non-invasive, I was happy to have had meaningful discussions with industry partners on what noninvasive hemodynamic monitoring as with Hemologic will be able to bring to the field of cardiac monitoring.  The discussions confirmed the potential we had already identified.

If Hemologic gets where it wants to be in the near future, we hope to be adding  new noninvasive hemodynamics technology to the tools of a cardiologist to detect cardiac abnormalities while on your first outpatient clinic appointment, sooner than before with existing diagnostics, or immediately afterwards while the you have freedom of movement.