As an attending in my first year of practice, there have been a lot of firsts. First transseptal puncture, first and second supraventricular tachycardia ablations (Mahaim atriofascicular pathway, Ebstein’s anomaly with pathways), first ventricular tachycardia ablation, and so on. This week will mark my first Heart Rhythm Society (HRS) meeting as a board-certified, practicing electrophysiologist.
As we head into HRS 2024, I eagerly anticipate reconnecting with friends, former colleagues, and mentors in addition to learning about the newest studies, techniques, and technologies. At prior HRS meetings, I found the sessions about pulsed field ablation (PFA), conduction system pacing, and cardioneural ablation most exciting. These therapies were the future of our field, and we can realistically say that the future has arrived. Now, at this year’s HRS, a new future awaits.
One of the most surprising comments I heard this year was from a fellow who said he may never perform another cryoablation after he graduates. His new group will have already acquired a PFA system. It’s mind-boggling that such a consequential technology could rapidly become obsolete. More electrophysiologists are performing PFA for atrial fibrillation, atrial flutter, and even focal atrial tachycardias overlying the phrenic nerve! I am excited to get hands-on at the companies’ booths and to hear early impressions from colleagues who have been using PFA.
I vividly remember the sessions on cardiac devices last year. In addition to the new guidelines on conduction system pacing, the data on outcomes with left bundle pacing vs left ventricular pacing in patients with heart failure directly impacted my practice. I anticipate that late breaking clinical trials and new data from this week’s meeting will also shape my practice.
As a fellow, I was exposed to different approaches to perform procedures from my mentors. Now that I am in practice, I look forward to being able to share notes with other early career members to learn how their procedural skills and techniques evolved in their first few years of practice and how this may inform my own practice.
The last year of my electrophysiology fellowship and the first year of practice have been the best 2 years of my career, in large part owing to the rapid growth in cardiac electrophysiology. This year’s HRS will be my most exciting yet, and I am thrilled to see where our field goes next.