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International Society For Minimally Invasive Cardiothoracic Surgery

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Electro Heart Team-a Modern Approach for Old Problem
Radoslaw Litwinowicz, Artur Bartoszcze
Department of Cardiovascular Surgery and Transplantology, Jagiellonian University Medical College, J, Kraków, Poland

BACKGROUND: Atrial fibrillation remains a complex disease that requires multifaceted and multidisciplinary management. Based on the new European Society of Cardiology (ESC)/ European Association of Cardio-Thoracic Surgery (EACTS) guideline on atrial fibrillation published in August 2020. In high-volume centers, Electro Heart Teams (EHT) should therefore be created to support advanced AF management. Similar solutions are observed in other areas of cardiology such as heart failure management and transcatheter procedures. Herein we present our Electro Heart Team rules, protocol and annual results. METHODS: In August, the EHT was established at Jagiellonian University Medical College and John Paul II hospital and consists of an electrocardiologist, a cardiac surgeon and a cardiologist. Team meetings are held once a month. Patients are qualified using special qualification protocol. RESULTS: After the first few months of operation of the medical team, despite the COVID -19 pandemic, EHT qualified about 30 patients for procedures including endocardial ablation, epicardial ablation, endocardial LAAO procedure and hybrid approaches to AF management. CONCLUSIONS:In high-volume centers, Electro Heart Teams should therefore be created to support advanced AF management. The roles of Electro Heart Team are: 1. complex rhythm control therapy, e.g., failure of catheter ablation to control symptomatic AF, consideration of AF surgery, or situations that compromise rhythm control therapy. 2. limiting persistent ablations performed by less experienced centers 3. complex stroke prevention, e.g., contraindication to anticoagulation or need for left atrial appendage closure 4. relief from the daily tasks of traditional Heart Team.


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