Atrial Signals 2021

The Atrial Signals 2021 agenda comprises more than 60 invited talks by renowned experts in the field.

The sessions will cover the following topics:

The Arrhythmogenic Substrate

We will learn more about the interplay of myocytes, myofibroblasts, and fibroblasts and the role of collagen and fatty infiltrations. We will focus on the term “fibrosis”: is it one word for many different entities? We want to better understand the term “remodeling”, how it is promoted, and how it can be reversed. Finally, we want to see the latest results of microscopic computer modeling of the arrhythmogenic substrate. What can we learn from computer modeling of the arrhythmogenic substrate?

Atrial Signals – Novel Technologies

We will give major players in the field the chance to present their latest technical achievements for the EP-lab. We will invite Biosense, Abbott, and Boston Scientific for scientific lectures. Also, we are curious to hear from emerging companies about their different approach. In addition, we want to learn how ECG-Imaging can contribute to non-invasive mapping.

Is Multimodal Mapping the Key to Success?

In this session, we will zoom into the various options of mapping: LAT map, voltage map, phase map, conduction velocity map, CFAE map, dominant frequency map, impedance map…. We want to learn more about the influence of electrode size, shape and configuration on the various maps – how can we compare maps that are acquired with different multichannel electrode systems. Which uncertainties do we have to consider in these maps? How can frequent artefacts be tackled? Which map is essential and which one is only “nice to have”? Is LGE-MRI crucial or can it even replace EP mapping?

Depolarization Patterns of AFlut and AFib

We observe many publications about depolarization patterns like focal sources, breakthroughs, rotors, micro-reentries, U-turns around lines of block, wave breaks, …. Which of these do we really see in clinical practice and how often? How stable are these patterns? Which patterns are most essential for understanding the underlying arrhythmia? Uncovering these depolarization patterns demands for advanced techniques of spatio-temporal biosignal analysis – what are the latest achievements in this respect? Do areas of low voltage always go hand in hand with areas of slow conduction? What is the role of areas of high dominant frequency and what do areas of “high dispersion” mean?

The Best Mapping Strategy

Is it better to map AFib patients in sinus rhythm or during the ongoing arrhythmia? What do we learn from stimulated maps? Which mapping strategy fits the individual patient best?

Creating the Best Ablation Lesion

Is high power short duration really better? How can we monitor the process of ablation during the procedure to achieve a perfect ablation scar? Can impedance based monitoring solve the problem? Where and when is cryoablation the better choice? What is the future role of RF balloon ablation?

The Best Ablation Targets and the Best Ablation Strategy

The final goal is obvious: stop AFlut and AFib and prevent recurrence. But how do we get there? What should be done if PVI was not successful? Chasing fibrotic areas? Chasing rotors? How can computer modeling support the cardiologist in finding the best personalized ablation strategy?

The Future of Diagnosis and Therapy of AFlut and AFib

We will have a critical look at the hypes and flops of the past years. And we will try to look ahead: what is really promising in respect of technology and data acquisition, software and visualization, mapping strategies, ablation strategies …

Oral Anti-Coagulation and Pharmacological Therapies

We will discuss the various NOAK concepts. Is the appendage occluder an alternative to anti-coagulation? We will take a look at pharmacological therapies for AFib. What aspects have to be taken into account with patients suffering from diabetes mellitus or adiposity?

Innovative Technologies for the EP lab

How can we compare voltage maps that are acquired with different mapping systems? How can we achieve reliable conduction velocity maps? How are maps of rotors, reentry circuits, and phase singularity points calculated and how reliable is the result? How are maps of dominant frequency created, are they robust and reliable, and what do they tell us? How can we better remove ventricular far fields and how can we recognize atrial far fields? How can machine learning support the cardiologist in the EP lab?

The P-wave and AFlut / AFib

How can machine learning support the annotation of the 12-lead ECG? Are mobile devices like a cardio-watch suited for AFlut and AFib screening?