Day 1 :
Keynote Forum
Ovidio Alberto Garcia Villarreal
Hospital Zambrano-Hellion, Mexico
Keynote: Why maze procedure should be performed during Cardiac Surgery
Time : 10:30-11:15 AM
Biography:
Ovidio A. Garcia Villarreal is a cardiac surgeon dedicated to the private practice, retired from the social medicine surgery. He has been working on the mitral, aortic and tricuspid reconstruction for more than 25 years. He has been spearheading in the field of Cardiac arrhythmia surgery, particularly in atrial fibrillation surgery (Cox-maze procedure) as well as in aortic valve sparing operations in Mexico. He has executed national surgical models for valvular heart reconstruction and maze procedure. He has been also dedicated to clinical research, with more than 50 international publications in PubMed. Editor-in-Chief of the journal Cirugia Cardiaca en Mexico, and analyst in more than 15 international journals. He is active member of the Mexican Society of Cardiac Surgery, Society of Thoracic Surgeons, European Association of Cardiothoracic Surgery, amongst others.
Abstract:
Background: Pulmonary vein (PV) isolation has been the cornerstone in the treatment of atrial fibrillation (AF). Many doubts exist about permanent total disconnection of the PV after catheter-based techniques. Surgical division of the PV is the most convincing technique to avoid any further reconnection. We believe this way is the clearest one to investigate how effective PV isolation alone is in the treatment for atrial fibrillation.
Material and methods: From 1998 to 2010, we operated on 120 adult patients having rheumatic mitral valve disease and concomitant AF. All of them had long-standing persistent AF (> 1 year of duration). PV isolation was performed surgically by means of cut-and-sew in all these cases of mitral valve surgery. All patients were analyzed at 3 months, 6 months, 1 year, and once yearly after operation. Registers were recorded arising from Holter and echocardiographic study during the follow-up to 7 years.
Results: Follow up completed at 93 % for seven years. There was only 1 operative death (0.8%) and 7 more along the follow-up. The endpoint was free from any AF, flutter or atrial tachyarrhythmia. Any type of tachyarrhythmia was present at 39%, 47%, 63%, 68% and 70% at 3 months, 1 year, 3 years, 5 years and 7 years. The odds ratio for AF recurrence at 7 years was 2.33 (95% CI, 1.46-3.71; p < 0.001). Left atrial size > 6.5 cm in diameter was directly related to AF recurrence at 7 years after surgery (odds ratio= 8.25 [95 % CI, 2.84-24.25; p < 0.001).
Conclusions: By dividing PV surgically, there is no doubt about definitive and complete PV disconnection. Surgical isolation of the PV is not enough to eliminate long-standing persistent AF. More complex procedures such as maze procedure should be considered to treat surgically the AF, especially long-standing persistent AF.
Keynote Forum
Oleksii Vynogradov
Heartin Inc, United States
Keynote: Using smart ECG t-shirt with AI based arrhythmia detection
Time : 11:30-12:30
Biography:
I'm a serial entrepreneur and investor with twenty-five years’ experience. I have created nine companies and have done couple exits so far. My professional background is business and team development, software/hardware engineering, sales, and finance.
For last eight years I have been focusing on healthcare area with a company called HeartIn. My company is creating a unique smart Garment with built-in sensors that brings wellness solutions and cardio-diagnostic to the mass market. The product has user-friendly comfortable design.
Abstract:
Our team used smart ECG t-shirt with real customers while workout to understand mass market screening case. We have 1789 records from 96 users. Quantity of records:
• Up to 10 seconds length - 97
• 10-60 seconds length - 187
• 60-300 seconds length - 167
• more than 300 seconds length – 224
Customers has no real arrhythmia detection. Algorithm has false positive detection:
• Up to 10 seconds length: None
• 10-60 seconds length - 2 Sinus bradycardia
• 60-300 seconds length 37 Sinus tachycardia and 13 Sinus bradycardias
• more than 300 seconds length 1975 Ventricular tachycardia 1356
Sinus tachycardia 496 Supraventricular ectopy or tachycardia 85 Sinus bradycardia 37 Ventricular trigeminy 15 Asystole 4 Ventricular bigeminy.