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Heart Rhythm Society (HRS) 2023: A changing dialogue

June 12, 2023
Business Affairs Cardiology
By Lars Thording

Heart Rhythm Society’s annual conference, held this year in New Orleans, May 19-21, represents the premier event for physicians, technologists, scientists, managers, and vendors associated with electrophysiology. This year — as usual — the exhibit hall was abuzz with the excited voices of physicians hearing about new technologies, fellows eagerly learning the fundamentals of the specialty, and vendors eagerly demonstrating their new products. Compared with the last two years, attendance was impressive, with lots of traffic and discussions happening at the exhibit booths. In fact, we saw about twice as much traffic at our booth this year compared to the year before, a sign that we are now back to a prepandemic normalcy — at least in the world of trade shows.

This year’s conference, in most ways, was no different from other years: large medtech companies launching new technologies and long sessions about breakthroughs in technology and methodology to treat patients with atrial fibrillation and other heart conditions. Electrophysiology is no longer a new area of clinical treatment, but the medtech companies are not slowing down their rapid pace of new technology development: Every year, every big technology company has a new revolution to introduce.

This year, for example, Biosense Webster introduced its OPTRELL Mapping Catheter, yet another advanced mapping catheter with new functionality to offer to the discerning electrophysiologist. Meanwhile, Biosense Webster already has other mapping catheters, and you would think that this launch would simply cannibalize Biosense Webster’s own products. However, in electrophysiology, everything is about physician choice, and the company with the most technologies, catheters, and systems wins.

For the same reason, Biosense Webster also presented about pulsed field ablation (PFA), which is all the rage in electrophysiology these days, and about new radiofrequency ablation technology. The other giants of electrophysiology technology — Abbott, Medtronic, Philips, and Boston Scientific — typically follow the same recipe: Launch a new product and present studies that demonstrate you are on the cutting edge with that new technology.

With PFA, you simply have to participate. However, compared to the past two years, when PFA took physicians by storm, the discussions this year around this new ablation technology were more sober and realistic. It’s an interesting pattern of innovation to observe: The initial introduction of a promising new technology creates a lot of excitement and expectations about paradigmatic change in the industry — and then, when the studies and the devices start coming out, a more practical and realistic tone comes to characterize the discussions. Innovations take a long time to change an industry where physicians have learned and succeeded with known technologies. It takes more than a “better” technology to drive mass adoption to a brand-new technology. It takes time, and it takes a lot of money.

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