This year’s edition of the Heart Rhythm Society annual scientific sessions is in the can, and there were a number of interesting related developments inside and outside the confines of the Boston Convention and Exhibition Center. While the content was fascinating, there was also a lot about social media that was quite interesting as well.

Lead Twitterators have stethoscopes

Gatherings like HRS draw an interesting and varied crowd, but when you look at the event’s hashtag (#HRS2015), you have to wonder about the ratio of media tweets to those from other sources. It struck me that the event lacked the volume of media coverage that I seem to recall was there in the past. When I dial up the hashtag on my own feed (@MedDeviceMark), it seems that physicians were far and away the heaviest users of the hashtag. Even if you remove the pound sign, media sources account for very few tweets.

The problem – assuming you think this is a problem – is that the media were really not there for the event if the Twitter feed is any indication. There was, however, at least one potentially mitigating circumstance, which I’ll explain later.

Prior engagement over a tech assessment

Conspiracy theory is about as much fun as one can have without breaking the law, and the Centers for Medicare & Medicaid Services released a couple of technology evaluations dealing with cardiac electrophysiology just prior to the HRS festivities in Boston. Coincidence? Maybe, but it’s a lot more fun to think it was timed that way.

The technology evaluation for catheter ablation for treatment of atrial fibrillation is dated April 20, and it shows up at the CMS website 10 days later, so no big deal. However, the tech evaluation for cardiac resynchronization in the Medicare population is dated March 24, and it does not appear on the Medicare coverage center webpage until May 1.

I had tweeted about the ablation/afib document in the first week of May, and a lot of the same electrophysiologists who were active at HRS 2015 were also very active in discussing this document on Twitter. Many of those discussions revolved around patient selection, durability of effect, and which tissues to ablate, all relevant topics.

However, I advised the physicians that CMS has sent a pretty clear signal that it wants to know what it’s paying for, and that the agency will get those data by hook or by crook. David Wilber, the editor in chief of JACC Clinical Electrophysiology seemed to agree, remarking in the May 6 edition of Medical Device Daily that the agency may be trying to tell everyone it’s time for an ablation/afib registry.

As we all know, though, registries ain’t cheap. Medtronic, Boston Scientific and St. Jude Medical should be prepared to bring out the checkbook because hospitals are not going to foot the bill for this one alone, and the National Heart, Lung and Blood Institute doesn’t exactly have access to Fort Knox, either.

The critical question here as best as I can tell is whether CMS will be happy with just a registry, or whether it will start looking at coverage with evidence development for afib ablation in addition to a registry. After all, CMS did announce last year it intends to make more extensive use of CED.

Wireless limbo at BCEC

Anyone in the media who did attend HRS 2015 probably wanted to chew glass over the wireless service at the Boston Convention and Exhibition Center, but calling it “service” is something of a misnomer. It was a nightmare, and it’s difficult to do a lot of tweeting when you’re scrambling to get more basic things done, such as accessing the medical journal articles needed to provide context for our coverage. It wasn't much fun for anyone providing media relations service at HRS, either, and my hat is off to them for working around it.

A note to the head honchos at BCEC. Might wanna get that fixed if you like booking these big, media-friendly conventions.