Hi, this is Eric Prostowski. Welcome to another segment of EP on EP. And what a delight it is for me to do this segment, because it's a friend for many years and your immediate past president, I'm sure she loves that title now, Dr. Andrea Russo, who's also professor of medicine at Cooper Medical School. So Andrea, welcome to EP on EP. Thanks, Eric. Great to be here. So we're going to talk about a very different thing today. And I'm going to start with a very famous quote from Thomas Paine from a very different era with a crisis. And it's actually from his pamphlet called The Crisis. So let me just read this a moment. It was in December 23, 1776, when he said the following, these are the times that try men's souls. The summer soldier and the sunshine patriot will, in this crisis, shrink from the service of their country. But he that stands by it now deserves the love and thanks of man and woman. And it's a wonderful pamphlet if you want to go back and read it. So this isn't quite that bad, COVID-19. But you as president were geared up for a fabulous meeting. I knew I was listening to all the things you guys were doing. And suddenly, it's an oh my god moment. So what I'd like you to do for the listeners today is take us through this very unusual situation as you sat as president. So for example, at what point did you kind of realize, oh, we may not have a face to face meeting? Yeah. So we weren't sure for a while. As you know, the program committee plans for months and months in advance. Starts planning right after we have our annual session in one year from 2019. Starts planning 2020. We've been doing this for 40 years, for many years right now. And then it came, we were in March, and it was starting to look as it was going to be a problem. It was going to be a problem throughout the United States. There's a problem with travel. Travel was actually halted. And we're thinking, well, by the time May comes around, maybe things will get better. But then starting to realize things weren't getting better. There were different regions of the country being more impacted by the pandemic. And starting to think, okay, maybe we have to change gear, but still not being really certain that that would be necessary. But, you know, one of the things I have to say is, you know, there was a lot of resilience. Resilience among the staff, among the volunteers to just kind of start to say, well, just in case, what else do we have planned? We have done this year, have done a strategic plan. And one of the very important parts of our strategic plan is the digital aspect of it. And our staff have been really working hard for years, even longer than that, on Heart Rhythm 365, and really creating a more user-friendly platform, a great interface for education. And so that thought process, and certainly by March, and then even a little bit earlier than that, perhaps in February, thinking where are we going to be in a few months? So I get that, and it is unbelievably, I won't say lucky, let's say fortunate of the foresight that you had this digital platform going. I can only tell you, we didn't have any, you know, sort of virtual platform for our own office, and we were caught with our hands in our pocket, right, when we had to do, and I'm sure we weren't the only ones around the country, so at least you were ready. But at some point, it had to hit you, like, it's not just a question we're ready, it's like, this is going to be it. And there was a lot of stuff, I don't participate in the chat room, as you know, I'm not a chatter chat room guy, but I read it, and there was a lot of people back and forth, what's going on? Why aren't they doing something? There must have been a plan you had, and there was a reason that you were taking it step by step. Could you walk us through that a little? Yeah, sure. So we had to, we couldn't suddenly just change gear, because out of, you can't just cancel a whole big meeting, and this is a big deal for HRS, as you know, it's a big deal for members, it's a big deal for the society to gather together, to have education, to network, it's more than just the education, right, it's the networking and sharing ideas, sharing research and really getting things going, to just abruptly say, for sure, we're not going to have it, not knowing what's going to happen in a month or two, we couldn't just cancel. So we had to look at things step by step. And plus, you have to think of, you know, logically, if you cancel, what ramifications that has on the society and financially, what does all that mean? But you have to plan for what may be very likely. So certainly by, you know, end of March, beginning of April, it was not looking really positive, although the Convention Center and the plans in San Diego was the planned site, they were not willing to say we're not having a meeting. And actually, so we had to wait, we had to wait until the time was right to really do the best thing for our members, our society before actually absolutely canceling. But in the meantime, beginning to say, what do we need to do digitally to create, you know, not just completely replicating what we would do face to face, we couldn't obviously do that at the last minute, or would we want to perhaps, but to do something that will fulfill members needs. So people still need education, right, they still want that we have our late breakers, they have done this incredible research for years and years and need to present that need to get that information out and then started to think, well, in some ways, maybe, you know, in some ways, it could even be better to deliver digitally, you could reach more people. So trying to balance all those out in a very short period of time. And I have to say, you know, our CEO, our lead executive staff, were amazing and trying to say, look at these different alternatives and plan as if we might be having a digital meeting. And then how do we want to do that? What do we think of next? Do we want to do it all at once? Do we want to do it in stages we've been talking about actually for a long time, you know, with continuous learning throughout the year in addition to the meeting? So how do we get a jumpstart, you know, a real jumpstart on this? And so that's how the planning process, you know, occurred, although we didn't have a lot of time. Well, I think you did a phenomenal job. I mean, I got involved in a couple of the things that you guys planned. I had a ball with them. So take me to the next steps. I'm sure that this was the whole planning committee. So now you kind of know you're going to have to do it even if you can't announce it. I mean, I have to be honest, because people I just know a lot of people. I can't tell you how many texts is I got, Eric, what's going on with HRS? And I said, I was president, I think it was 2001. Why are you calling me, you know, call Andrea, but I just think they were like, I don't understand this. But you know, I think everyone knew it. And you knew it. And there were things you had to go through. So having said all that, now you have this huge multiple day meeting, and you got to shrink it. So I've enjoyed I mean, I think you guys did a great job looking at what I looked at. But there were a lot of things that must have gone to the to the wayside. So how did you actually decide? I mean, some things are obvious, right, late breakers, but how did you decide with all this other wonderful material that you could, how did you hone in on what you were going to do? Yeah, no. And by the way, they did. The sponsors, a lot of our sponsors were really supportive. And they did call they didn't, you know, text and call. And we did discuss that. So people were on board and understanding, and they've been incredibly supportive throughout the whole process. But what we did, you know, we had actually our program chair, you know, had actually, you know, kind of changed gear, you know, completely our chair and our abstract chair, you know, Fred Kusumoto, and Andrew Kron, and the program committee, staff had to say, okay, well, we just planned all this now, what can we do in a reasonable period of time to plan for the more, you know, urgent things we had to get the late that was clear, late breakers how to get out, they have to be able to publish their papers. We can't hold that up. And we, you know, we need to respect that timing, and then certain other things. And then do we want to do or can we do a good job? Can we do it justice in just a few weeks to get all the sessions at once. And we decided, you know, because a lot of people were at home, and they were working, and they wouldn't be necessarily still allotting that period of time to go to a meeting, because now they're home and working, right. So we decided that the best way to look at this isn't kind of breaking it up in pieces. And so we have three different portions of, you know, heart rhythm of HRS 2020 science. So the first part was in May, the second part will be in June, and the third part will be in July. So we actually have, you know, a time of year that, you know, people may want to do learning when they want to, right, they may be really busy now, or maybe it's quiet now, and they can have time, but they could do some of this real time during the sessions during the meetings, or they could do it, you know, later in the week, and people are still looking at the May, at the May sessions, you know, we're still getting a lot of hits on those sites, and that was open, and that was a free part of the meeting. And so I think, you know, it's just, you know, what do you want to do for the long term, and this will really, will help us actually implement our strategic plan, because our strategic plan is to have more longitudinal learning throughout the year, and, you know, but we still, again, hope to, you know, to have that basic meeting that we can, you know, still collaborate, meet in person, and share ideas. So one of, wonderful segue, it was the last part of what my discussion was to be with you today. So first of all, let me do a bit of feedback for you. One of the frustrations I've had, and I've been to 40 meetings, right, I was there from the first one, in the earliest days, you could get to everything, because there wasn't that much. I mean, you know, there was very small meetings, and you could kind of get to everything you wanted to. Later on, there's been a very hustle bustle meeting, and I could never get to all the late breakers. This year, I did. I have to tell you, there were parts of this, while I missed greatly having a cup of coffee with you, and meeting my friends from around the world, I gotta say, it was relaxing to watch the meeting, and it was extraordinarily well done. Kudos to you guys for the way you laid it out, but it actually was nice to see a session or two of late breakers, cup of coffee, maybe go do something else, come back to it. That leads me into the next phase, which is, how does 2021 play out? I mean, hopefully, you'll have the meeting on site, and it's always a great meeting, but I must tell you that I like the fact that I could also, in a timely manner, see things when I wanted to see them. So, are you planning some amalgam, some kind of a mixture? I mean, I'm just curious. You may not be there yet, but I'm curious, what's it look like next year? No, you're perfect timing, and we've just had discussions, actually, last night, and we had a call the night before also, is to kind of think of what are the different possibilities? Are we having a meeting alone? That's not really what is likely, right? You want to have a meeting plus having this online web-based education, and some of this heart rhythm, 2021 science, or whatever we wind up naming it at the time, or do you want to go all virtual? Well, I think that at least the vision or the hope is that there'll be a combination of both. Again, we don't know where we're going to be with COVID. Now, throughout this whole thing, obviously, not only were we planning the meeting, where the staff and volunteers planning the meeting, we're really working with COVID, right? Because one of the biggest things, and you're on, and you're actually on the COVID Rapid Response Task Force, was getting education out about COVID, about your EP practices, and writing, putting together documents. We've put together several documents, one on the startup of COVID, and then two other documents should be out shortly, one on monitoring and trying to get a jumpstart of where we'll be with monitoring in the future, and then also with just how to reboot our EP work. All of this is going on simultaneously, so it wasn't just the meeting we were planning. I think that looking ahead, this does really fit in very well with our strategic plan that we planned in the beginning. The first few months of the year, we spent working on strategic planning. We had a lot of our Pathfinders, younger, earlier, mid-career volunteers working with us, planning for what they want to see, and some of what we're doing is actually the vision of what the strategic plan was doing. I think the vision of having, getting back to your question, a combination of this virtual learning, web-based learning, plus a face-to-face meeting is what I think most of us envision happening for 2021. That's a wonderful game plan. As you know, I put on a course for 33 years, and I was really bummed that I was not going to, because it's always at HRS, and it usually retracts maybe 250 people, a lot of around the world, my one-day unknown course, Electrograms. I was bummed, and the reason I bring this up is that I had a long discussion with Medtronic about it, and I said, can we try to do a virtual, let's see, give it a try, and they were really nice about it. They said, yes. I'm in the same boat as you are, in a sense, because 250 people would pretty much come to my meeting. This year, 1,100 showed up on a Saturday morning, six continents, and I was bummed no penguins showed up, but that's just the way it is. It got me thinking. I was able, in just one course, which is the same, which is, of course, you did the same for an entire meeting, I was able to reach so many more people, but I didn't have that fun person-to-person interaction. I will tell you, I hope you're going to be doing what I'm thinking of doing, which is to try to meld the two. There are so many people who talked to me and said, I wasn't going to be able to come to your course, Eric, because it wasn't my year to go to the meeting. I thought, well, now anyone can come. I hope I'll see next year, I hope, the meeting, because that's so much fun. Let's say for those members around the world who can't make it that year, they can jump on like we did this year and see the high-level stuff, not six weeks later, but actually contemporaneously. I hope so, because I think that would be a great new addition to the educational tradition of HRS. That's a silver lining to this, we could reach more people. The other silver lining, I have to say, was really dramatic, the collaboration among the societies with our multi-society, multinational document, one of ours is going to be coming out. It's the collaboration among the leaders of other societies, ACC, AHA, ERA, LAHRS, APHRS. In a different way, in this time, created this very altruistic behavior among everyone wanting to share. We had a webinar with you also with learning about QT intervals, but other ways to share education throughout the year. We had a webinar with Asia, with Heart Rhythm TV is another new educational resource that we've also initiated this year. I think some really good things came out of it. It's obviously a crisis, but there is a silver lining. I'm going to end by telling you personally, because we've known each other for many, many years, but the membership, that thankfully, you're not a summer soldier or a sunshine patriot, and you pulled together a remarkable feat. I remember the year I did this, and thankfully, I didn't have to do what you did. You had a great year, you navigated the very turbulent waters of MOC, which I know is a never ending story, but you did it with great finesse. I think what you pulled off with the meeting and the end of your presidency was remarkable. I think that I certainly will say thank you, and the society owes you a big thank you for your great year as president. Thanks for doing this interview, and as always, I wish you well. Well, thank you, Eric. It was really, it certainly was my pleasure and honor. Thank you for inviting me to talk about this, but certainly being this year was a great experience and certainly an honor. Thank you. Thanks.

Heart Rhythm Society

annual meeting

COVID-19 pandemic

virtual meeting

digital platform