www.healthcare-in-europe.com CARDIOLOGY 7 1 0 2 N E W S A N D T E C H N O L O G Y U P D A T E S F O R C A R D I A C C A R E B A R C E L O N A S PA I N 2 6 A U G – 3 0 A U G 2 0 1 7 The ESC Congress 2017 With 4,500 accepted abstracts, 600 sessions and 30,000 expected attendees, ESC Congress 2017 is undoubtedly the world’s largest cardiovascular event. European Hospital correspondent Mélisande Rouger asked Dr Stephan Achenbach, Congress Program Committee Chairperson, for an overview of issues and events unfolding in Barcelona from August 26-30 the Congress, explained During Stephan Achenbach, the ESC issues guidelines on how to manage patients with cardiovascular disease. ‘In 2017 the guidelines focus on how to treat ST myocardial infarc- tion, valve disease, peripheral artery disease and dual antiplatelet thera- py, which is very important in coro- nary intervention. ‘The Hot Lines presentations are late clinical trials; we have very promising publications, especially in the field of prevention – both primary and secondary. ‘We also commemorate the anniversary of percutaneous coronary intervention. Forty years ago, Andreas Grüntzig performed the first balloon angio- plasty of coronary artery stenosis. ‘This year, we’ll learn a lot that’s new about the connection between heart disease and inflammation, considering the huge amount of abstracts received on the topic. ‘Many of our sessions are joint sessions with partners, for instance sister associations such as the American College of Cardiology, the American Heart Association, the Japanese circulatory society, and the Indian and Chinese cardiac societies. ‘We will also have sessions with subspecialty societies, including European Society of Hypertension and the European Society of CardioVascular Surgery, but also with genetics cardiology, pediatric cardiology, etc. ‘Last, but not least, we will have very interesting sessions with the New England Journal of Medicine, JAG and the Lancet. ‘This is a new addition because digital health is really becoming important in cardiology. We’re coop- erating with Mobile World Capital Barcelona, a tremendously large congress on mobile technologies. We will have interactive lecturers sharing their experience of mobile technology in cardiology.’ ‘Our challenges arise from the opportunities. Today we have many more options to treat and pre- vent cardiovascular disease, but they are expensive and we need to find resources and to direct those resources to patients who really need it. I think that’s the challenge. As our opportunities become more complex we have to ensure that they remain economically viable. European research focuses on many aspects, but mainly on the develop- ment of percutaneous valve disease treatment, really advancing percuta- neous catheter-based treatment of aortic stenosis and percutaneous treatment of other valve disease. Europe really has a leading role there. ‘Personally I am also involved with imaging, in the context of these new valve treatments, to pre- pare and guide the procedure and to decide which strategy to use in which patient. ‘Imaging is tremendously impor- tant to fix heart disease. There’s a growing interest among cardiolo- gists to use imaging and high-end imaging using computed tomogra- phy or magnetic resonance.’’ ‘Europe has this very wide spectrum of high and low- income countries, so the field is very heterogeneous. The ESC has to cater to all these countries. ‘In terms of trends, Europeans are traditionally early adopters of new technologies, treatments and diag- nostic methods. They need to make these strategies economically viable.’ ‘Issues of data sharing and pri- vacy, and selecting meaningful data are very important in cardiology as in any other field. ‘The ESC has a working group on e-cardiology and the congress will feature sessions on e-cardiology and big data. Data is both a major opportunity and a problem.’ ‘The most important and promis- ing indication for wearable devices use is screening for atrial fibrillation because it predisposes to stroke. Some research at the ESC will focus on that aspect. ‘If you can find fibrillation early, you can prevent stroke, so this is a major opportunity for wearable technology, and it has not been looked at extensively yet. In the Stephan Achenbach MD graduated from the University of Erlangen Medical School in Germany in 1993. Today he is still there, as Professor of Medicine and chairman of its cardiology department. He has not only held posts in Erlangen, but also in Boston, Maryland, USA, and Giessen, Germany. With main clinical interests in interventional cardiology, general cardiology as well as cardiac imaging and intensive care medicine, Achenbach has authored around 550 publications listed in Medline. Between 2014-2016 he served as Vice President of the European Society of Cardiology (ESC) and is currently a Board Member and Chairperson of the ESC Congress Program Committee. future there will be other indica- tions, and there will be indications for cardiovascular risk factors such as diabetes and hypertension. ‘There’s also a new generation of devices that are implanted in patients to monitor physiologi- cal parameters. CardioMEMS, for instance, is implanted in one of the lungs of a patient to measure blood pressure inside the organ. It has been shown that patients with heart failure benefit from having such devices implanted.’ ‘We don’t know how to control the monster we created’ Will software steal the heart of cardiology? Celebrating 40 years of PCI, car- diologists fret over their future with big data, machine learning and robots, John Brosky reports Software may replace cardiologists one day, but never the hands-on work of interventional cardiologists and their armatorium of hardware. That was the curious consensus at the start of the 2017 EuroPCR congress, which saw the arrival of a robot performing catheter-based procedures and advances in com- puter-assisted diagnostic tools to aid guidewire operators with clinical decisions, such as whether to stent or not to stent. This confident view among panel- lists at the conference came during a session dedicated to teasing out the ‘Next Big Thing in Cardio-Vascular Medicine’ at the largest European gathering of interventional cardiolo- gists. As with this year’s congress of the European Society of Cardiology (ESC), the EuroPCR meeting cel- ebrated the 40th anniversary of the first angioplasty procedure, which opened a new specialisation for interventional cardiology. Many of the leading members of ESC are contemporaries of the pioneer for percutaneous coronary interventions (PCI), the German radiologist Andreas Grüntzig who re-opened a clogged artery using a hard wire catheter in 1977 at the University Hospital of Zurich. Today there are almost 8,000 mem- bers of the European Association of Percutaneous Cardiovascular Interventions (EAPCI), making this the second largest of the asso- ciations within the legal structure of the ESC, surpassed only by the Heart Failure Association. By 2015 the worldwide market for PCI had grown to $6.3 billion according to the Dublin-based firm Research and Markets. Grüntzig’s primitive tool opened what EuroPCR keynote speaker Stephen Oesterle called the vascular highway that enables interventional cardiologists, ‘to go anywhere you need to go in the body.’ The field today covers 30 proce- dures that can be performed over- the-wire to place stents or treat vessels with drug-eluting balloons. And this does not take into account the growing practice of structural valve repair that is also performed over-the-wire. www.healthcare-in-europe.com k c o t s r e t t u h S / g n i r p s t h g i L : e c r u o S ‘Heart failure and mitral repair are two areas where developers are currently working to create catheter- based treatments,’ he said. Yet, we are still treating end-stage disease, he told colleagues, suggest- ing new catheter-based procedures could be developed for preventive strategies, such as implanting sen- sors to monitor blood pressure or glucose levels. A practicing cardiologist for 25 years, Oesterle worked for 15 years Continued on page 2