Coping with cardiology and Covid-19

Conference Preview

Irish Cardiac Society 72nd Annual Scientific Meeting, virtual, 7-9 October 2021

Ahead of the Irish Cardiac Society’s 72nd Annual Scientific Meeting, Prof Vincent Maher speaks with Pat Kelly about delivering cardiac care and heading the Society in the middle of a pandemic

The upcoming Annual Scientific Meeting of the Irish Cardiac Society (ICS), which runs from 7-9 October, again brings
together luminaries both national and international in the field of cardiology to share their expertise in a range of topics, including devices, the latest advances in procedures, and research. The meeting was held virtually last year due to Covid and this year will again be hosted virtually, but with a core group of Council members on site.

Prof Vincent Maher, Consultant Cardiologist at Tallaght University Hospital and President of the ICS, was upbeat despite the challenges posed by Covid. “It’s been pretty much the same for every society,” he told the Medical Independent (MI). “We were all suddenly restricted so that we couldn’t have faceto-face meetings, which is so important because for so many people who had links with our Society – nurses, physiologists and the pharmaceutical industry, for example – these meetings were always a great melting pot to exchange ideas. It has been sad to miss that kind of interaction.”

However, there are positive aspects to the situation, he stressed. “We have managed throughout the year to engage with all our members through a lot of programmes,” said Prof Maher. “We had a fantastic spring-summer series of three meetings and at times there were over 150 people logging in to some of those sessions, which far exceeds the audience we might have had were it a live event. So in fact, we are probably reaching more people in this way.”

In addition, these sessions are recorded, giving people a chance to visit the ICS website and watch them at their
convenience. “We also have a really good ‘Cardiologists of Tomorrow’ series, where trainees take 10 key topics
in terms of their training and we invite two consultants to present the latest information on those topics. That happens every month, and there have been huge attendances for those sessions.”

He explained that communication has been working well within the Society and beyond, and the ICS has had joint meetings with the British Cardiovascular Association, the European Society of Cardiology and the American College of Cardiology. For the future, Prof Maher said he believes the hybrid option will be popular for meetings when the pandemic has passed.

Trainees

Irish cardiologists and trainees have an excellent reputation worldwide and there has always been a steady flow
of trainees going to work in centres of excellence around the world, with a view to bringing their expertise and knowledge home for the benefit of Irish patients. Prof Maher was asked if the pandemic has curtailed that flow in
the past 18 months. “There have been a couple of individual cases where that has happened but overall, it hasn’t had
a massive impact,” he explained.

“This hasn’t come to my attention as a significant issue because a lot of people were already in situ when Covid happened,” he added.

Prof Vincent Maher

A little over two years ago, the ICS hosted the hugely successful ‘Cardiology on the Green’ conference, a first-time collaboration with the Mayo Clinic in the US. The hope is that this meeting will happen again next year, said Prof Maher. “In fact, in preparation for that, one of our spring-summer series was with a Mayo Clinic faculty and they are always really enthusiastic to get over to Ireland, so we have high hopes of having another Cardiology on the Green next April or May.”

Prof Maher also touched on the difficulties in providing cardiac care to Irish patients during the Covid crisis. “We had to make major changes in the management of our patients,” he told MI. “Telephone consultations are still the predominant way in which we have to practise. It’s not ideal, but we still see all new patients face-to-face, as well as patients who have problems that are more difficult to manage.

In the beginning [of the pandemic], the heart failure patients were an extremely high-risk group to manage. We had to manage these patients remotely and did an amazing job using remote blood pressure, heart rate and weight monitoring to help titrate drugs sufficiently well to avoid admissions during this critical time.

“However, some patients do need to see us in person,” Prof Maher continued. “Once the restrictions were removed or eased, those patients started to come back to the clinic, but of course there is a backlog because the patients who couldn’t see us face-to-face now want to come and see us.”

Waiting lists

Even before Covid, the waiting lists for testing procedures and cardiology care were “unacceptable”, said Prof Maher. “Some years ago, in our catchment area we piloted direct-access GP stress testing, and that has really helped. But to get access to, for example, a carotid ultrasound, which detects early atherosclerosis, can take perhaps a year to 18 months,” he said. “So patients are going over to the private sector to get those procedures because it’s so hard to get them in the public sector, unless you have had a stroke or TIA, for example. On top of that, Covid has added more people to these waiting lists.”

In terms of the Society, Prof Maher explained that there are a number of notable highlights he is looking forward to. “It is impossible to fit all aspects of cardiology into one programme, but we are emphasising genetics in cardiology as a new entity, and Prof Perry Elliot from University College London will be speaking on dilated cardiomyopathy and who is susceptible to that,” he said. “If you have aortic stenosis, it can be a big problem for people who have congenital bicuspid aortic valve, and these patients go on to need an intervention. There will be a very interesting talk about whether that can be done with a device (‘TAVI’) versus a surgical replacement, so that will be a fascinating topic for discussion.”

ICS would be an ideal

body to look at the

prospect of all-island

registries around

cardiovascular

diseases, which we

don’t currently have

in Ireland. It’s a

shame we don’t have

that, compared to

some other countries

As always, heart disease prevention and new methods of improving patients’ lipid profiles will feature on the
programme and Prof Kosh Ray from Imperial College London will speak on that topic.

“I am delighted that Prof Ken McDonald, who has been a stalwart in Irish cardiology, is going to deliver the Stokes Lecture this year,” said Prof Maher. “It’s a great honour to have him deliver that talk. Prof McDonald has devoted his career to highlighting heart failure in Ireland and it’s a testament to him that those services have expanded, and continue to expand, in Ireland. It will be great to get his perspective on where we need to evolve next.”

‘Diaspora Map’

The ICS has also built a website for members and others that is highly interactive and features a creative and useful initiative. “We have developed a ‘Diaspora Map’ that can identify all cardiologists with Irish links around the world, including details such as whether they can offer training, for example,” said Prof Maher. “It’s a great opportunity for trainees and consultants to access the map and identify places around the world where they would like to work. There are also huge educational resources built-in to our website that are very useful for our members.”

Regarding the future for his time at the helm of the Society, Prof Maher said: “I’m hoping to look at a strategic plan for the Society that will outline how we are going to take the Society forward.” In his opinion, “ICS would be an ideal body to look at the prospect of all-island registries around cardiovascular diseases, which we don’t currently have in Ireland,” he said. “It’s a shame we don’t have that, compared to some other countries. We also need to consider our role in research, so there are many exciting things in planning at the moment.”

Prof Maher concluded: “I’d like to thank all those who have contributed hugely to our services, including lecturers and those who participated,” he said. “There has been a great will and appetite for us to maintain and build good links. None of this would have been possible without ongoing support from the pharmaceutical industry, who have missed links with us on a day-today basis but have continued to support us, so I would like to thank them,” he told MI.

We are also very grateful for the technical support and guidance from ‘CrowdComms’ to enable us to navigate
the virtual space easily. “A lot of organisations have had no meetings at all over the past year and a half, and that has been difficult for them. We have been fortunate to have been able to continue to put ourselves out there.”

Delegates can register for the ICS 72nd
Annual Scientific Meeting using the
following details:
Registration: www.conferencediary.ie
ICS Meeting PIN: ICSAGM2021
INCA Meeting PIN: INCA2021
IIMCS Meeting PIN: IICMS2021