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Healthcare costs and innovative solutions for arrhythmia care

In an increasingly difficult economic climate, it is more important than ever to develop innovative solutions to the rising cost of healthcare. Professor Richard Schilling, President Elect of the British Heart Rhythm Society (Barts Health NHS Trust, London), proposed novel solutions to the rising cost of arrhythmia care during the plenary session. He highlighted the need to simplify the patient journey by empowering paramedics to treat supraventricular tachycardias (SVTs) and reduce hospital admissions; having a national online resource for patients with intelligent information delivery.

Professor Richard Schilling

Professor Richard Schilling (Barts Health NHS Trust, London)

Professor Schilling emphasised the need to reduce variation in practice – for example the standardisation of ablation procedures for persistent atrial fibrillation (AF) (pulmonary vein isolation only as per the evidence from the STAR-AF II trial) thereby reducing procedure times and fluoroscopy dose. The need to get greater value from technology was addressed as well as encouragement of patient leadership. Finally, a call for open audit was made to drive innovation and improvement, and challenge us to learn from colleagues about best practice.

Dr Aaisha Opel (London) discussed data during an oral abstract presentation on the use of day case cryoablation for paroxysmal AF in the district general hospital setting. She noted that if performed by experienced operators in high volume centres, this was a safe and effective treatment strategy. Work of this nature will take on increasing significance if the demand for AF ablation increases. The catheter ablation vs. anti-arrhythmic drug therapy for AF (CABANA) trial is due to report next year on whether catheter ablation is superior to drug therapy in reducing a composite of total mortality, disabling stroke, serious bleeding or cardiac arrest. A positive outcome is likely to increase the demand for AF ablation.

Professor Silvia Priori (University of Pavia, Italy) described an exciting approach using gene therapy to treat inherited arrhythmia syndromes. Her work involved a mouse model of catecholaminergic polymorphic ventricular tachycardia (CPVT) and used the delivery of miRNA via an adenovirus vector to silence the mutant gene, reduce mutant transcripts and break the arrhythmogenic substrate. The pre-clinical studies appeared promising and may represent an alternative approach to treat inherited cardiac arrhythmias.

Published on: November 8, 2016

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  • ArrhythmiaAlliance
  • Stars
  • Anticoagulation Europe
  • Atrial Fibrillation Association

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