The 60th Annual Congress of the European Society of Cardiology, held during 25th–29th August 2012, in Munich, was an impressive affair, designed for drama and to accommodate 28000 cardiologists. It was exciting to see how doctors take advantage of every element, from use of computers, large sessions to posters and case studies. It took tremendous effort and effective planning on the part of the ESC staff and leadership to make the meeting a success.
What was particularly notable was the shift from research to CME presentations in this year's Congress. A number of programmes were devoted to updated guidelines in six areas of cardiology, covering prevention, heart failure, myocardial infarction (2), valvular heart disease and atrial fibrillation. Not neglected were reports on late-breaking trials of drugs and invasive procedures. While no dramatic breakthroughs were reported, clinicians attending seemed satisfied with updates that reinforced their current practices, or in some cases gave them new knowledge to take home.
The ESC Congress did an excellent job of highlighting controversies, through a series of debates on Hot Topics. Here are some examples:
Should a defibrillator threshold test (DFT) be routinely performed at the time of implantable cardioverter-defibrillator implantation (ICD)? Dr. Jeff Healey of the US said Yes, Dr. Fernando Arribas of Spain said only in specific cases. He noted that there is not much evidence in favour of either position, but noted that Dr. Healey is expected to answer the question with the results of a major study to be completed in 2013.
Should Vernakalant i.v. be first choice for converting rapid-onset atrial fibrillation? Prof. Alessandro Cappucci of Italy said Yes, it is both safe and effective. Prof. Christian Torp-Pedersen of Denmark said other antiarrhythmic drugs should not be neglected, and all should be used with great caution in patients with heart failure. Both agreed that it was an important alternative and that cost-effectiveness should be taken into account.
Is ticagrelor the first choice in myocardial infarction? This turned out to be a non-debate, since Dr. H. A. Katus of Germany compared ticagrelor only to clopidogrel, which is an outdated therapy, whereas his “opponent”, Dr. G. Montalescot of Paris specially compared ticagrelor to prasugrel, never mentioned by Dr. Katus, and considered perhaps a better choice. His position was supported by the audience!
Among the many offerings, most popular were those updating the ESC Guidelines, and those dealing with grey zones in therapy, such as when to treat hypertension in patients with Type 2 diabetes and issues in percutaneous cardiovascular intervention (PCI).
Industry not only had two exhibit halls, but also sponsored a number of scientific sessions and hands-on tutorials, popular with many clinicians. And constituent societies of ESC – national and subspecialty – were well represented. Many work jointly with ESC to sponsor local programmes of CME.
Delegates could earn up to 21 credits, issued by the European Board for Accreditation in Cardiology (EBAC) and equal to 21 ECMEC credits from the European Accreditation Council for CME (EACCME). Each delegate was required to complete an EBAC questionnaire in the registration area in order to receive a certificate, which could also be done post-Congress via email to EBAC. Onsite, the delegate's badge was scanned, but if the certificate were requested post-Congress only presence on the ESC registration list was required.
US delegates could convert their EBAC credits to AMA credits, thanks to the reciprocal agreement with EACCME, by applying online and paying a fee.
Eight industry-sponsored satellite symposia were accredited as EBAC Accredited Educational Programmes (EBAC AEP). Each industry partner or CME provider must apply to ESC, and the application is then forwarded to EBAC for review and approval.
Looking ahead to the 2013 Congress, to be held during 31st August–4th September in Amsterdam, the programme chair promises exciting innovations. Dr. Keith Fox of Edinburgh explains that the theme will be “the heart interacting with other organ systems”. Speakers from other specialties will join with leading cardiologists to follow the patient journey from initial presentation to what the patient may need over time. Rather than standard reviews of new guidelines, the guidelines will be presented within the context of treating patients with comorbidities. The goal, says Dr. Fox, is to provide cardiologists with support for their practices and patients 365 days a year.