<HTML><BODY style="word-wrap: break-word; -khtml-nbsp-mode: space; -khtml-line-break: after-white-space; ">Dr. Jose Luis Merino from Spain asks<DIV><BR class="khtml-block-placeholder"></DIV><DIV>- <SPAN lang="EN-US" style=""><FONT class="Apple-style-span" face="Arial" size="4"><SPAN class="Apple-style-span" style="border-collapse: collapse; font-size: 13.3333px;">How do you envision the future treatment/prevention of sudden death: drugs, catheter ablation or devices? If you see a major role for the devices, </SPAN></FONT></SPAN><TABLE border="1" cellspacing="0" cellpadding="0" width="1584" style="width: 1584pt; border-top-style: none; border-right-style: none; border-bottom-style: none; border-left-style: none; border-width: initial; border-color: initial; "><TBODY><TR><TD width="109" valign="top" style="width:109.25pt;border:solid windowtext .5pt; padding:0cm 5.4pt 0cm 5.4pt"><DIV class="MsoNormal"><SPAN lang="EN-US" style="font-size:10.0pt;font-family:Arial; mso-ansi-language:EN-US"><FONT class="Apple-style-span" face="Arial" size="4"><SPAN class="Apple-style-span" style="border-collapse: collapse; font-size: 13.3333px;">what kind of device do you think will be used for sudden death primary prevention i.e.: simple device only able to deliver few electrical high energy </SPAN></FONT></SPAN></DIV><DIV class="MsoNormal"><SPAN lang="EN-US" style="font-size:10.0pt;font-family:Arial; mso-ansi-language:EN-US"><FONT class="Apple-style-span" face="Arial" size="4"><SPAN class="Apple-style-span" style="border-collapse: collapse; font-size: 13.3333px;">shocks, subcutaneous device without endocardial-epicardial leads, single-dual-triple chamber device, etc).</SPAN></FONT></SPAN><SPAN style=""><SPAN class="Apple-style-span" style="border-collapse: collapse;"><O:P></O:P></SPAN></SPAN></DIV></TD></TR></TBODY></TABLE><SPAN class="Apple-style-span" style="border-collapse: collapse;"><DIV><SPAN class="Apple-style-span" style="border-collapse: separate;"><BR class="khtml-block-placeholder"></SPAN></DIV><DIV><BR class="khtml-block-placeholder"></DIV>Dr. Andrew Epstein from U.S.A. answers</SPAN></DIV><DIV><SPAN class="Apple-style-span" style="border-collapse: collapse;"><BR class="khtml-block-placeholder"></SPAN></DIV><DIV><SPAN class="Apple-style-span" style="border-collapse: collapse;">- <SPAN lang="EN-US" style=""><FONT class="Apple-style-span" face="Arial"><SPAN class="Apple-style-span" style="border-collapse: separate;">Unfortunately, the future cannot be predicted.</SPAN></FONT><SPAN style="mso-spacerun: yes"><FONT class="Apple-style-span" face="Arial"><SPAN class="Apple-style-span" style="border-collapse: separate;"> </SPAN></FONT></SPAN><FONT class="Apple-style-span" face="Arial"><SPAN class="Apple-style-span" style="border-collapse: separate;">We are in need for new drugs, but the market is focused on devices.</SPAN></FONT><SPAN style="mso-spacerun: yes"><FONT class="Apple-style-span" face="Arial"><SPAN class="Apple-style-span" style="border-collapse: separate;"> </SPAN></FONT></SPAN><FONT class="Apple-style-span" face="Arial"><SPAN class="Apple-style-span" style="border-collapse: separate;">The new drugs coming out will be for atrial fibrillation--the ventricles are not of interest to the pharmaceutical industry.</SPAN></FONT><SPAN style="mso-spacerun: yes"><FONT class="Apple-style-span" face="Arial"><SPAN class="Apple-style-span" style="border-collapse: separate;"> </SPAN></FONT></SPAN><FONT class="Apple-style-span" face="Arial"><SPAN class="Apple-style-span" style="border-collapse: separate;">Ablation will play a minor role in SD prevention, likely for idiopathic VF and to decrease frequent ICD therapy.</SPAN></FONT><SPAN style="mso-spacerun: yes"><FONT class="Apple-style-span" face="Arial"><SPAN class="Apple-style-span" style="border-collapse: separate;"> </SPAN></FONT></SPAN><FONT class="Apple-style-span" face="Arial"><SPAN class="Apple-style-span" style="border-collapse: separate;">Finally, a "simple" device woud be nice, but that has not been the way the market has been driven, and I don't see it happening. </SPAN></FONT><P class="MsoNormal" style="mso-pagination:none;tab-stops:28.0pt 56.0pt 84.0pt 112.0pt 140.0pt 168.0pt 196.0pt 224.0pt 252.0pt 280.0pt 308.0pt 336.0pt; mso-layout-grid-align:none;text-autospace:none"><SPAN lang="EN-US" style=""><FONT class="Apple-style-span" face="Arial"><SPAN class="Apple-style-span" style="border-collapse: separate;">Recall the failure of Intermedics and the Biotronik Airbag in this regard.</SPAN></FONT><SPAN style="mso-spacerun: yes"><FONT class="Apple-style-span" face="Arial"><SPAN class="Apple-style-span" style="border-collapse: separate;"> </SPAN></FONT></SPAN><FONT class="Apple-style-span" face="Arial"><SPAN class="Apple-style-span" style="border-collapse: separate;">A subcutaneous ICD will be of interest, but clinical trial results are awaited, and we'll have to see how physicians react</SPAN></FONT></SPAN><SPAN lang="EN-US" style=""><FONT class="Apple-style-span" face="Arial" size="4"><SPAN class="Apple-style-span" style="border-collapse: separate; font-size: 13.3333px;">.</SPAN></FONT></SPAN></P><FONT class="Apple-style-span" face="Arial"><SPAN class="Apple-style-span" style="border-collapse: separate;"><O:P></O:P></SPAN></FONT></SPAN><BR></SPAN><DIV> <SPAN class="Apple-style-span" style="border-collapse: separate; border-spacing: 0px 0px; color: rgb(0, 0, 0); font-family: Helvetica; font-size: 12px; font-style: normal; font-variant: normal; font-weight: normal; letter-spacing: normal; line-height: normal; text-align: auto; -khtml-text-decorations-in-effect: none; text-indent: 0px; -apple-text-size-adjust: auto; text-transform: none; orphans: 2; white-space: normal; widows: 2; word-spacing: 0px; "><DIV style="margin-top: 0px; margin-right: 0px; margin-bottom: 0px; margin-left: 0px; ">--</DIV><DIV style="margin-top: 0px; margin-right: 0px; margin-bottom: 0px; margin-left: 0px; ">Dr.<SPAN class="Apple-converted-space"> </SPAN>Sergio<SPAN class="Apple-converted-space"> </SPAN>Dubner</DIV><DIV style="margin-top: 0px; margin-right: 0px; margin-bottom: 0px; margin-left: 0px; ">President<SPAN class="Apple-converted-space"> </SPAN>of<SPAN class="Apple-converted-space"> </SPAN>Scientific<SPAN class="Apple-converted-space"> </SPAN>Committee</DIV><DIV style="margin-top: 0px; margin-right: 0px; margin-bottom: 0px; margin-left: 0px; font: normal normal normal 13px/normal Lucida Grande; min-height: 16px; ; font-family: Lucida Grande; font-size: 13px; "><BR style="font-family: Lucida Grande; font-size: 13px; "></DIV><DIV style="margin-top: 0px; margin-right: 0px; margin-bottom: 0px; margin-left: 0px; ">Dr.<SPAN class="Apple-converted-space"> </SPAN>Edgardo<SPAN class="Apple-converted-space"> </SPAN>Schapachnik</DIV><DIV style="margin-top: 0px; margin-right: 0px; margin-bottom: 0px; margin-left: 0px; ">President<SPAN class="Apple-converted-space"> </SPAN>of<SPAN class="Apple-converted-space"> </SPAN>Steering<SPAN class="Apple-converted-space"> </SPAN>Committee</DIV><DIV><BR class="khtml-block-placeholder"></DIV><DIV><BR class="khtml-block-placeholder"></DIV><BR class="Apple-interchange-newline"></SPAN> </DIV><BR></DIV></BODY></HTML>