Podcasts about Cardiac electrophysiology

This week on Health Matters, as we continue to observe Heart Month, we will explore the role that genetics play in heart health.Understanding your family history of cardiovascular health is essential. In fact, about 30% of heart disease can be linked to family history. We speak with Dr. Jessica Hennessy, a clinical cardiac electrophysiologist and cardiogenetics expert at NewYork-Presbyterian and Columbia to help break down which heart conditions and risk factors may be inherited. She provides valuable insight on effectively managing heart health, including the importance of lifestyle modifications in preventing heart disease, including for individuals with a genetic predisposition. She also explains who should get genetic testing and what that process looks like.___ Dr. Jessica Hennessey specializes in Cardiac Electrophysiology, with a special focus on Sports & Exercise Cardiology. She practices primarily in New York, NY, and is affiliated with NewYork-Presbyterian/Columbia University Irving Medical Center. Dr. Hennessey graduated from Duke University School of Medicine in 2014, and completed her training at Massachusetts General Hospital, NewYork-Presbyterian/Columbia University Irving Medical Center and NewYork-Presbyterian/Columbia University Irving Medical Center. She is board certified in Internal Medicine, Cardiovascular Disease and Cardiac Electrophysiology. ___ Health Matters is your weekly dose of health and wellness information, from the leading experts. Join host Courtney Allison to get news you can use in your own life. New episodes drop each Wednesday. If you are looking for practical health tips and trustworthy information from world-class doctors and medical experts you will enjoy listening to Health Matters. Health Matters was created to share stories of science, care, and wellness that are happening every day at NewYork-Presbyterian, one of the nation's most comprehensive, integrated academic healthcare systems. In keeping with NewYork-Presbyterian's long legacy of medical breakthroughs and innovation, Health Matters features the latest news, insights, and health tips from our trusted experts; inspiring first-hand accounts from patients and caregivers; and updates on the latest research and innovations in patient care, all in collaboration with our renowned medical schools, Columbia and Weill Cornell Medicine. To learn more visit: https://healthmatters.nyp.org

Send us a textA groundbreaking innovation is making waves for the approximate six million Americans who suffer with atrial fibrillation (AFib). It's called pulsed field ablation. In our latest podcast episode, host Debra Schindler talks with Dr. Sunjeet Sidhu, a renowned cardiac electrophysiologist at MedStar Health, to explore the intricacies and benefits of this safer, faster, cutting-edge treatment. The number of those suffering with AFib, may even be an underestimate, but statistics show they are steadily increasing due to factors such as an aging population and the obesity epidemic. Traditionally, AFIB treatment involved thermal ablation methods, which, although effective, posed risks of collateral damage to surrounding tissues. Enter pulsed field ablation, a technique that uses ultra-short electrical pulses to target and destroy abnormal heart tissue without harming nearby structures. This method is not only safer but also more efficient, reducing procedure times significantly. Dr. Sidhu explains how pulsed field ablation works by creating a scar tissue barrier, effectively isolating the problematic areas of the heart that trigger AFIB. Unlike thermal ablation, which relies on heating or freezing tissues, pulsed field ablation uses electroporation to disrupt cell membranes, leading to cell death and scar formation. The heart cells are particularly sensitive to this type of injury, allowing for precise targeting without affecting surrounding tissues. The benefits of pulsed field ablation are manifold. Patients experience shorter procedure times, reduced anesthesia exposure, and fewer complications. Dr. Sidhu shares his firsthand experiences, noting a significant improvement in patient outcomes and satisfaction. He recounts a heartwarming story of a young mother who, after undergoing the procedure, was able to regain her quality of life and engage in activities with her children without the debilitating effects of AFIB.For more episodes of MedStar Health DocTalk, go to medstarhealth.org/doctalk.

The Gabelli Team co-hosted the 6th Annual Healthcare Symposium with Columbia Business School at the Paley Center in New York City on November 15th: https://business.columbia.edu/healthcare/events/gabelli-funds-columbia-business-school-healthcare-symposium AGENDA 8:45 AM Introduction - Jeff Jonas, CFA, & Carri Chan, PhD PANEL 1 9:00AM Panel 1 - led by Jeff Jonas, CFA *"Unlocking the Potential of Surgical Robotics and Artificial Intelligence"* Panel Participants: • Gretchen Jackson, MD, PhD, Vice President, Scientific Medical Officer at Intuitive • Joshua Stopek, PhD, Vice President Research and Development at HistoSonics • Martin Martino, MD, MBA, Medical Director of Gynecology and Robotic Surgery at Ascension Watch here: https://youtu.be/MWIx_kxcnug PANEL 2 10:10AM Panel 2 - led by Daniel Barasa, MBA "Interoperability, Digital Transformation and Enhancing Patient Care" Panel Participants: • Michael Bouton, MD, MBA, Chief Medical Information Officer of NYC Health + Hospitals • Sara Dillon, Chief Data Officer of Henry Schein • Nick Frenzer, VP of Implementation at Epic • Josh Weiner, Senior Vice President, Enterprise Consumer Analytics at CVS Health Watch here: https://youtu.be/Zx2E1XFwN-0 PANEL 3 "Advances in Atrial Fibrillation Technology and Treatment" 11:20AM Panel 3 - led by Carri Chan, PhD Panel Participants: • Joe Fitzgerald, MBA, EVP & Group President, Cardiology at Boston Scientific • Larry Biegelson, Senior Medical Device Analyst at Wells Fargo • Elaine Wan, MD, Esther Adboodi Associate Professor of Medicine in Cardiology and Cardiac Electrophysiology at Columbia University Irving Medical Center Watch here: https://youtu.be/VAetvqKkRjg To learn more about Gabelli Funds' fundamental, research-driven approach to investing, visit https://m.gabelli.com/gtv_cu or email invest@gabelli.com. Connect with Gabelli Funds: • Twitter - https://twitter.com/InvestGabelli • Instagram - https://www.instagram.com/investgabelli/ • Facebook - https://www.facebook.com/InvestGabelli • LinkedIn - https://www.linkedin.com/company/investgabelli/ http://www.Gabelli.com Invest with Us 1-800-GABELLI (800-422-3554) 0:00 Welcome 2:55 Introduction 11:37 Panel 1: Unlocking the Potential of Surgical Robotics and Artificial Intelligence

The Gabelli Team co-hosted the 6th Annual Healthcare Symposium with Columbia Business School at the Paley Center in New York City on November 15th: https://business.columbia.edu/healthcare/events/gabelli-funds-columbia-business-school-healthcare-symposium AGENDA 8:45 AM Introduction - Jeff Jonas, CFA, & Carri Chan, PhD PANEL 1 9:00AM Panel 1 - led by Jeff Jonas, CFA "Unlocking the Potential of Surgical Robotics and Artificial Intelligence" Panel Participants: • Gretchen Jackson, MD, PhD, Vice President, Scientific Medical Officer at Intuitive • Joshua Stopek, PhD, Vice President Research and Development at HistoSonics • Martin Martino, MD, MBA, Medical Director of Gynecology and Robotic Surgery at Ascension Watch here: https://youtu.be/MWIx_kxcnug PANEL 2 10:10AM Panel 2 - led by Daniel Barasa, MBA *"Interoperability, Digital Transformation and Enhancing Patient Care"* Panel Participants: • Michael Bouton, MD, MBA, Chief Medical Information Officer of NYC Health + Hospitals • Sara Dillon, Chief Data Officer of Henry Schein • Nick Frenzer, VP of Implementation at Epic • Josh Weiner, Senior Vice President, Enterprise Consumer Analytics at CVS Health Watch here: https://youtu.be/Zx2E1XFwN-0 PANEL 3 "Advances in Atrial Fibrillation Technology and Treatment" 11:20AM Panel 3 - led by Carri Chan, PhD Panel Participants: • Joe Fitzgerald, MBA, EVP & Group President, Cardiology at Boston Scientific • Larry Biegelson, Senior Medical Device Analyst at Wells Fargo • Elaine Wan, MD, Esther Adboodi Associate Professor of Medicine in Cardiology and Cardiac Electrophysiology at Columbia University Irving Medical Center Watch here: https://youtu.be/VAetvqKkRjg To learn more about Gabelli Funds' fundamental, research-driven approach to investing, visit https://m.gabelli.com/gtv_cu or email invest@gabelli.com. Connect with Gabelli Funds: • Twitter - https://twitter.com/InvestGabelli • Instagram - https://www.instagram.com/investgabelli/ • Facebook - https://www.facebook.com/InvestGabelli • LinkedIn - https://www.linkedin.com/company/investgabelli/ http://www.Gabelli.com Invest with Us 1-800-GABELLI (800-422-3554)

The Gabelli Team co-hosted the 6th Annual Healthcare Symposium with Columbia Business School at the Paley Center in New York City on November 15th: https://business.columbia.edu/healthcare/events/gabelli-funds-columbia-business-school-healthcare-symposium AGENDA 8:45 AM Introduction - Jeff Jonas, CFA, & Carri Chan, PhD PANEL 1 9:00AM Panel 1 - led by Jeff Jonas, CFA "Unlocking the Potential of Surgical Robotics and Artificial Intelligence" Panel Participants: • Gretchen Jackson, MD, PhD, Vice President, Scientific Medical Officer at Intuitive • Joshua Stopek, PhD, Vice President Research and Development at HistoSonics • Martin Martino, MD, MBA, Medical Director of Gynecology and Robotic Surgery at Ascension https://youtu.be/MWIx_kxcnug PANEL 2 10:10AM Panel 2 - led by Daniel Barasa, MBA "Interoperability, Digital Transformation and Enhancing Patient Care" Panel Participants: • Michael Bouton, MD, MBA, Chief Medical Information Officer of NYC Health + Hospitals • Sara Dillon, Chief Data Officer of Henry Schein • Nick Frenzer, VP of Implementation at Epic • Josh Weiner, Senior Vice President, Enterprise Consumer Analytics at CVS Health https://youtu.be/Zx2E1XFwN-0 PANEL 3 *"Advances in Atrial Fibrillation Technology and Treatment"* 11:20AM Panel 3 - led by Carri Chan, PhD Panel Participants: • Joe Fitzgerald, MBA, EVP & Group President, Cardiology at Boston Scientific • Larry Biegelson, Senior Medical Device Analyst at Wells Fargo • Elaine Wan, MD, Esther Adboodi Associate Professor of Medicine in Cardiology and Cardiac Electrophysiology at Columbia University Irving Medical Center https://youtu.be/VAetvqKkRjg To learn more about Gabelli Funds' fundamental, research-driven approach to investing, visit https://m.gabelli.com/gtv_cu or email invest@gabelli.com. Connect with Gabelli Funds: • Twitter - https://twitter.com/InvestGabelli • Instagram - https://www.instagram.com/investgabelli/ • Facebook - https://www.facebook.com/InvestGabelli • LinkedIn - https://www.linkedin.com/company/investgabelli/ http://www.Gabelli.com Invest with Us 1-800-GABELLI (800-422-3554)

Dr. Michael Co with Sanford - specializing in Cardiac Electrophysiology - discusses the topic of Atrial fibrillation (AFib),  a heart condition that causes the upper chambers of the heart to beat irregularly and the signs that younger people may be suffering from increased risk due to multiple factors - including lifestyle choices.See omnystudio.com/listener for privacy information.

Bon Secours St. Mary's Hospital is now offering a new, innovative FDA-approved procedure for atrial fibrillation (AFib). AFib is among the most common abnormal heart rhythm disorders. Now, mere months after its Food and Drug Administration approval, Bon Secours successfully performed four procedures with a Pulsed Field Ablation (PFA) System. Bon Secours St. Mary's Hospital is the first hospital in the state to do so. Dr. An Bui, the Director of Cardiac Electrophysiology for Bon Secours Richmond, called the new Pulsed Field Ablation technology the future of his field. Click here to continue reading on WTVR.com, a Henrico Citizen partner...Article LinkSupport the show

In this episode, we feature a discussion with Jose Osorio, MD, from HCA Florida Mercy Hospital in Miami, Florida, and Paul Zei, MD, from Brigham and Women's Hospital in Boston, Massachusetts. Drs Osorio and Zei discuss quality improvement in electrophysiology, with the focus on building a high-quality, comprehensive atrial fibrillation program.

Heart health champion, Dr. Royce Bargas, shares insight into her world of Integrative Cardiology, where the focus is on prevention and total body vitality rather than just managing disease. Dr. Bargas is board-certified in Internal Medicine, Cardiovascular disease, and Cardiac Electrophysiology, and is certified by the Institute of Functional Medicine.  She utilizes the roots of Osteopath and the fundamentals of Functional Medicine to get to the root causes of chronic disease.  Curious, brave, and energetic, Dr. Bargas is a certified RECODE provider for the Dale Bredesen, MD, protocol- designed to reverse Alzheimer's Disease.  Here's the link to Dr. Bredesen's 2021 study that we discussed in today's podcast - “ReCODE:  A Personalized, Targeted, Multi-Factorial Therapeutic Program for Reversal of Cognitive Decline https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8533598/  Dr. Bargas is founder of Bargas Wellness in Edmond, Oklahoma. 

In this episode of the Better Edge podcast, Bradley P. Knight, MD, director, Cardiac Electrophysiology, director, Center for Heart Rhythm Disorders and the Chester C. and Deborah M. Cooley Distinguished Professor of Cardiology at Northwestern Medicine, discusses the intricacies of safely and effectively implanting LAAO devices for stroke prevention in patients with atrial fibrillation. He talks about the criteria for determining whether a LAAO device is optimal for a patient and his greatest clinical challenge as a cardiac electrophysiologist when placing this closure device.

In this episode of The EP Edit, we are highlighting a discussion on simulation training in cardiac electrophysiology (EP). Stephan P. Seslar, MD, PhD, is an attending pediatric cardiologist and electrophysiologist at Seattle Children's Hospital and assistant professor at the University of Washington School of Medicine. Ashkan Ehdaie, MD, is an assistant professor of cardiology and associate director of the Clinical Cardiac EP Fellowship Training Program at Cedars-Sinai. You can view the transcript for this episode here.

In this episode of The EP Edit, we are highlighting a discussion on artificial intelligence (AI) in medicine, cardiology, and cardiac electrophysiology (EP). Lior Jankelson, MD, PhD, is the director of the Inherited Arrhythmia Program, principal investigator (PI) of the Computational Cardiology Research Lab, and associate professor of medicine at NYU Langone Health. Sumit Chopra is an associate professor in the Department of Radiology at the NYU Grossman School of Medicine, and director of machine learning research in the Department of Radiology at NYU Langone Health.

The world of cardiac electrophysiology can be daunting, so we suggest that you listen to this insightful conversation with the experts. Deputy Editor Dr. Zamaneh Kassiri (University of Alberta) interviews authors Dr. Crystal Ripplinger (University of California Davis), Dr. Nikki Posnack (The George Washington University and Children's National Hospital), Dr. Alexey Glukhov (University of Wisconsin-Madison), Dr. Matthew Kay (The George Washington University), Dr. Carol Ann Remme (Amsterdam University Medical Centers), and Dr. Alex Quinn (Dalhousie University) about their comprehensive new guidelines for assessment of cardiac electrophysiology and arrhythmias in small animals. This thorough guidelines article by Ripplinger et al. covers many common electrophysiology approaches used in the field at the tissue level, whole heart level, and in vivo measurements. In addition, the authors dive into what parameters investigators may want to measure, providing helpful and clear guidance on how to calculate such parameters and what those parameters might mean in terms of electrophysiology remodeling and arrhythmia propensity. Both senior investigators and trainees will find these guidelines approachable and useful. Listen and learn from the experts.   Crystal M. Ripplinger, Alexey V. Glukhov, Matthew W. Kay, Bastiaan J. Boukens, Nipavan Chiamvimonvat, Brian P. Delisle, Larissa Fabritz, Thomas J. Hund, Bjorn C. Knollmann, Na Li, Katherine T. Murray, Steven Poelzing, T. Alexander Quinn, Carol Ann Remme, Stacey L. Rentschler, Robert A. Rose, and Nikki G. Posnack Guidelines for assessment of cardiac electrophysiology and arrhythmias in small animals Am J Physiol Heart Circ Physiol, published November 21, 2022. DOI: 10.1152/ajpheart.00369.2022.

Cardiac device techs are in hot demand, but gaps in staffing and education are causing difficulties for this role. On MedAxiom HeartTalk, host Melanie Lawson talks with Kelli Shifflett, MHA, FACMPE, AVP of Revenue Growth and Business Development, HCA Physician Services, Sirena Bridges, MSPH, MSN, FNP-BC, CCDS, Clinical Director, Melissa Hauck Center for Device Therapy at Centennial Heart, and Nicole Knight, LPN, CPC, CCS-P, SVP of Revenue Cycle Solutions and Care Transformation, Medaxiom. Together, they discuss innovative strategies that your organization can use to help address this growing issue. Guest BiosKelli Shifflett, MHA, FACMPE, AVP of Revenue Growth and Business Development, HCA Physician Services – Kelli has been with HCA Physician Services for 20 years in a variety of practice operation roles from Practice Manager to Division Vice President. She resides in Austin with her family and is passionate about process improvement and finding practice efficiencies in a constantly changing healthcare environment. She enjoys her current role of partnering with companies whose products improve the daily workflows and needs patients, providers and healthcare teams. Sirena Bridges, MSPH, MSN, FNP-BC, CCDS, Clinical Director, Melissa Hauck Center for Device Therapy at Centennial Heart – Sirena has worked in the healthcare field for over 20 years; with the last 10 years working as a Nurse Practitioner in Cardiac Electrophysiology with a focus on device management of Cardiac implantable electronic devices at Centennial Heart. She became the inaugural Clinical Director of the Melissa Hauck Center for Device Therapy at Centennial Heart in Nashville in November 2021. In her role as the Clinical Director, she brings a wealth of clinical and technical expertise on interpretations, programming and troubleshooting of cardiac implantable electronic devices and remote transmissions. She also serves as a clinical resource for patients, peers and colleagues. Sirena has a Bachelor's Degree in Cardio-respiratory Care Sciences from Tennessee State University and a Master's Degree in Public Health from Meharry Medical College in addition to a Master's Degree in Nursing from Vanderbilt University. She is also a Certified Cardiac Device Specialist (CCDS) through the IBHRE (International Board of Heart Rhythm Examiners). Nicole Knight, LPN, CPC, CCS-P, EVP of Revenue Cycle Solutions and Care Transformation, Medaxiom - Nicole's decades of healthcare experience include cardiovascular and neurology practice operations, clinical management, business office management and consulting. The most recent years have been devoted to cardiovascular consulting in operations, LEAN process improvement and the revenue cycle. Prior to joining MedAxiom, Nicole served as Practice Administrator for Baptist Neurology and Northeast Florida Cardiology and Director of Operations for Jacksonville Heart Center and Louisiana Cardiology Associates. She has extensive expertise in coding, compliance and education for various specialties including cardiology, neurology, radiology, hematology/oncology, orthopedic, ENT, gastroenterology and internal medicine. Nicole has provided physician and staff coding and compliance education sessions nationally. Nicole has completed numerous education hours towards a B.S. in Health Care Administration. In addition, she maintains her LPN licensure in Louisiana and Florida. She is a member of the American Academy of Professional Coders and the American Health Information Management Association. She received her Advanced Cardiovascular Coding Certification with the Board of Medical Specialty Coding and completed the AAPC inpatient coding and reimbursement course. Nicole is a certified AHIMA ICD-10-CM Trainer and completed a LEAN Healthcare training course at Johns Hopkins University. She also serves on the Physician Practice Council for AHIMA. This episode is supported by an independent educational grant from Medtronic.

In this episode of The EP Edit podcast, we are highlighting the November 10th session of the Great Debates & Updates in Electrophysiology (GDUEP) conference, which will focus on management strategies for ventricular arrhythmias and heart failure. Brad Knight, MD, and Raul Weiss, MD, are Course Co-Directors of the GDUEP and will be presenting during the November 10th session. Dr Knight is the Clinical Editor of EP Lab Digest and Medical Director of Cardiac Electrophysiology at Northwestern Medicine in Chicago, Illinois. Dr Weiss is the Director of the Cardiac Electrophysiology Program at Ohio State University Wexner Medical Center in Columbus, Ohio. For more information about the GDUEP conference, please visit https://www.ep.greatdebatesandupdates.com/register. This unique, debate-style conference is offered complimentary for clinicians, and all live sessions are also available on-demand through the end of 2022.

This episode features Dr. David Wang, Co-Director of the Neurovascular Division & Petznick Stroke Center at Barrow Neurological Institute; Dr. Robert Lemery, Cardiac Electrophysiologist at Arizona Heart Rhythm Center; & Dr. Vijay Swarup, Director of Cardiac Electrophysiology at Arizona Heart Rhythm Center & Director of Electrophysiology at St. Joseph's Hospital. Here, they discuss details surrounding their collaborative work with The Arizona Brain and Heart Symposium taking place October 21st & 22nd, 2022. Learn more at https://www.barrowneuro.org/patient-care/support-resources/education-seminars/the-arizona-brain-and-heart-symposium/

We hear about the importance of knowing your heart, checking your pulse, and what is Atrial Fibrillation with Prof. Gábor Széplaki Head of Cardiac Electrophysiology at Mater Private.

Show Notes - All Things Afib - CAST-AF 2022 with Dr. Bradley KnightSo many legends in the AFib world are excited about the upcoming Catheter and Surgical Therapies for Atrial Fibrillation (CAST AF) Conference happening at the end of August in Chicago. Here to speak with me about some of the sessions is my esteemed guest Dr. Bradley Knight, Director of Cardiac Electrophysiology, Bluhm Cardiovascular Institute of Northwestern at Northwestern Medicine.We'll discuss some of what you'll see and hear at this world-class conference, happening Friday and Saturday, August 26-27 at the Radisson Blu Aqua in Chicago, IL. The talks scheduled are only 10-15 minutes each, with plenty of time built in for questions and discussion after each section. From AI to PFA, wearables, and other forward-looking AFib topics, presenters and technology, register now to attend and get intense, high-yield information, theories, and technology that you can put into practice the very next day you return to work!Dr. Knight is the Chester C. and Deborah M. Cooley Distinguished Professor of Cardiology at Northwestern University, and has been the Director of the Heart Rhythm Program at the BCVI, since November 1, 2009. He earned his BS in Public Health/Biostatistics at the University of North Carolina in Chapel Hill, and his MD at the Ohio State University. After completing his training in Medicine, Cardiology, and Cardiac Electrophysiology at the University of Michigan, he joined the Michigan faculty in 1997. He later served as the Director of Cardiac Electrophysiology at the University of Chicago from 2002 to 2009.As the Medical Director of Cardiac Electrophysiology at Northwestern Medicine, Dr. Knight remains clinically active with a broad range of clinical and research interests in the field of Heart Rhythm Disorders. These interests range from catheter ablation for complex arrhythmias, such as atrial fibrillation, to fundamental issues related to the basic mechanisms of various types of arrhythmias, and the use of imaging in the electrophysiology laboratory to guide ablation procedures and device implantation. He is involved in several multi-center clinical trials that are evaluating novel ablation tools and implantable devices, including the cryoballoon for pulmonary vein isolation, the totally subcutaneous implantable defibrillator, and left atrial appendage occlusion devices. He has coauthored over 300 scientific papers and is on the editorial board of several high-impact medical journals. He has served on the ABIM CCEP Exam Writing Committee for ten years, and is the Editor-in-Chief of the Journal of Cardiovascular Electrophysiology (JCE) and EPLab Digest.All Things Afib is hosted by me, Dr. Armin Kiankhooy. As a board-certified cardiothoracic surgeon, my focus is on advanced treatments for heart and lung failure and minimally-invasive surgical treatments for atrial fibrillation such as the Hybrid Maze procedure. You can find me on staff at Adventist Health Heart and Vascular Institute in St. Helena California. Discussion points:This may be the best conference happening in the world todayFocus on interventional therapiesStructure of the conference, short and intense for high-yield informationThe collaborative methods in practice at NorthwesternHot Topic: Pulse Field Ablation and it's many advantagesTalking tech: Devices and wearablesThe new approaches - using anticoags, closing the left atriral appendage, LAOS III and reducing stroke risksTraining programs at Northwestern – new opportunitiesThe differences in training from only ten years ago are staggeringRegister to attend today!Resources:Dr. Bradley Knight LinkedInDr. Bradley Knight TwitterCATH AF 2022Dr. Kiankhooy LinkedInAll Things AFib WebsiteAll Things AFib TwitterAll Things AFib YouTube Channel

In this episode we sit down with Jeanne E. Poole, MD, FACC.  She led our Cardiac Electrophysiology section from 2000-2021 and currently Editor-in-Chief of HeartRhythm O2 Journal. http://heartrhythmopen.com.We get into all where implantable defibrillation has come and where it's headed.  In addition we talk about what characteristics make an exceptional electrophysiologist and how journals can better include allied professionals.0:38 - A child of Boeing 1:57 - Impact of Dr. Leon Green4:15 - Development of Implantable Cardiac Monitoring8:11 - Collaboration with Harborview11:40 - Patients and Uncertainty12:35 - How implantable defibrillators work14:25 - Discussion with patients and use of defibrillators18:35 - End stage terminal disease and implantable conversations20:50 - Cardiac Resynchronization Therapy (CRT)25:30 - Non-response reasons29:00 - Avoiding long leads33:18 - Indications for advanced technologies36:45 - Building and leading the Electrophysiology team43:00 - Identifying a good candidate for Electrophysiology career track46:00 - Founder and Editor in Chief of Heart Rhythm Society O2 Journal 50:00 - Allied Professionals access to journal - APP Publishing ResourcesYou can reach Dr. Poole here:@jepoolemdJPoole@uw.edu

In this episode of The EP Edit, we're featuring a discussion on an innovative new model of care for cardiology and cardiac electrophysiology (EP). Dr Moeen Saleem and Dr Kanwar Singh discuss the independent private practice care model at the Midwest Cardiovascular Institute in Naperville, Illinois, and Cardiovascular Institute of the South in Houma, Louisiana. Read the full episode transcript here.

There have been many advancements in the field of electrophysiology. Dr. Oussama Wazni, Section Head, Cardiac Electrophysiology & Pacing Section, and Dr. Hiroshi Nakagawa discuss some of these evolutions and progress including new methods utilizing ablation index, ablation techniques, and developments in advanced high-definition mapping.

In this episode of The EP Edit, we're featuring a discussion on the role of artificial intelligence, machine learning, and deep learning in cardiac electrophysiology. Dr. Arun Sridhar and Dr. Patrick Boyle from the University of Washington will be discussing current applications, future directions, as well as their recent article in EP Lab Digest. Dr. Boyle is an assistant professor in the Department of Bioengineering at the University of Washington, and Dr. Sridhar is a cardiac electrophysiologist and assistant professor at the University of Washington School of Medicine. This episode was recorded in April 2022.

In this episode from July 2020, we're joined by Dr. Khaldoun Tarakji to discuss the opportunities and challenges associated with the use of wearable technologies in the EP practice. Dr. Tarakji is an electrophysiologist and the Associate Section Head of Cardiac Electrophysiology at the Cleveland Clinic. He is also the founder and director of the Center for Digital Health and Telemedicine for the Heart and Vascular Institute at the Cleveland Clinic. This interview was done by Jodie Elrod, Managing Editor of EP Lab Digest. For more information, please see Dr. Tarakji's article in EP Lab Digest's August 2020 issue.

In this episode from May 2019, we're joined by Dr. Edward J. Schloss, a cardiac electrophysiologist and the Division Chief of Cardiac Electrophysiology at The Christ Hospital in Cincinnati, Ohio. With over 10,500 followers, Dr. Schloss has an active and longstanding account (@EJSMD) on Twitter. In this podcast, we asked for his perspectives on how to best navigate the platform, which is very popular with EP professionals. Of note, this interview took place ahead of Heart Rhythm 2019. This interview was done by Jodie Elrod, Managing Editor of EP Lab Digest. For more information about this episode, click here.

Professor Peter Kistler, Head of Cardiac Electrophysiology at Alfred Health, discusses the risk factors associated with cardiovascular disease and the effect of coffee on heart health; Anna Bernasochi, the Suicide Prevention Manager at Switchboard Victoria, canvasses Switchboard's LGBTIQA+ suicide bereavement groups and the support and connection they provide for people experiencing a loss through suicide; and the team unpack recent research on how to live a healthy life. With presenters Dr Nick, Prudence Dear, and Panel Beater.Website: https://www.rrr.org.au/explore/programs/radiotherapyFacebook: https://www.facebook.com/RadiotherapyOnTripleR/Twitter: https://twitter.com/_radiotherapy_Instagram: https://instagram.com/radiotherapy_tripler

Kishlay Anand, MD, MS, FHRS, speak with host Edward Araujo about cardiac electrophysiology and his views on value-based care. Dr. Anand is a board-certified cardiologist and cardiac electrophysiologist. He Dr. Anand graduated from the All India Institute of Medical Sciences (AIIMS) in New Delhi, India. He earned a masters degree in epidemiology at Columbia University, New York, and went on to complete an internal medicine residency and cardiology fellowship at Creighton University in Nebraska, followed by a cardiac electrophysiology fellowship at the University of California in San Diego. Dr. Anand is also President of Apricus Health, a network that aligns primary care physicians and specialists. Sponsored by Bahbah Sobers Wealth Management, Arizona Department of Health Services, and MICA, the exclusive provider of medical professional liability insurance for MCMS members. The Arizona Physician Podcast is a production of Maricopa County Medical Society.

Commentary by Drs. Bruce Stambler and Kenneth Ellenbogen

Commentary by Drs. Bruce Stambler and Kenneth Ellenbogen

Dr. Nayak is an academic cardiac electrophysiologist. He talks about his experiences and gives advice to students interested in cardiac electrophysiology.

Physiologic pacing is an approach to treat patients with complete heart block that minimizes pacing induced cardiomyopathy and heart failure. Dr. Oussama Wazni, Section Head, Cardiac Electrophysiology and Pacing, and Dr. Roy Chung, Director of Physiologic Pacing Center, discuss physiologic pacing at Cleveland Clinic: outcomes, indications, benefits, patient selection and contraindications of this type of pacing.

Commentary by Dr. Valentin Fuster

Joining us for a second time on the Healthcare Corner is Dr. Gil Ungab, sharing his knowledge of the hot topic of healthcare inequality. Why does it exist? If you are in a minority group in the U.S., how are you affected? When it comes to drug trials, the industry needs to make an effort to include all ethnicities. How does COVID-19 come into play with inequalities for all communities? Come join us today to learn more about how we can work together to represent all individuals. Dr. Gil UngabDr. Gilanthony Ungab, M.D., is a cardiology specialist in National City, California, and has over 27 years of experience in the medical field.  He graduated from the University of California, San Diego, School of Medicine, in 1994.  He is a private practice cardiac electrophysiologist and former Medical Director of Cardiac Electrophysiology at Sharp Chula Vista Medical Center in San Diego, California. He served as a member on research and development committees at Boston Scientific, St. Jude, and Biotronik.

Devi Nair, M.D., Director of Cardiac Electrophysiology at St. Bernards Heart Care in Jonesboro, Ark., discusses one of the most rapidly-advancing fields in healthcare, what sets her team apart and what drives her to pursue cutting-edge care options for her rural patients.

Well Said has invited Dr. Jason Chinitz, Director of Cardiac Electrophysiology at South Shore University Hospital and an associate professor at the Donald and Barbara Zucker School of Medicine to talk about pacemakers, the sophisticated electronic devices widely used to treat a variety of heart conditions.

Commentary by Drs. Maully Shah & Edward Walsh

In this episode of Expert Answers, Dr. Nguyen debunks some common myths, and shares best-practices for data acquisition, analysis, and interpretation.

In this episode of Expert Answers, Dr. Nguyen debunks some common myths, and shares best-practices for data acquisition, analysis, and interpretation.

Well Said has invited Dr. Nicholas Skipitaris, Director of Cardiac Electrophysiology for Lenox Hill Hospital and the Western Region, Northwell Health and Assistant Professor of Cardiology, Zucker SOM as we explore exactly what Atrial Fibrillation is and dive into the symptoms, medications and strategies for combating this condition.

Commentary by Drs. Usha Tedrow and William Stevenson

Commentary by Drs. Usha Tedrow and William Stevenson

Join us for our conversation on Atrial Fibrillation (AFib or AF) featuring our special guest Dr. Gil Ungab. AFib is a serious diagnosis. While this condition isn't fatal in itself, it can lead to potentially life-threatening complications. Two of the most common complications of AFib are stroke and heart failure, both of which can be fatal if not managed quickly and effectively. Dr. Gil UngabDr. Gilanthony Ungab, M.D., is a cardiology specialist in National City, California, and has over 27 years of experience in the medical field.  He graduated from the University of California, San Diego, School of Medicine, in 1994.  He is a private practice Cardiac Electrophysiologist and former Medical Director of Cardiac Electrophysiology at Sharp Chula Vista Medical Center in San Diego, California. He served as a member on research and development committees at Boston Scientific, St. Jude, and Biotronik.

Back in December 2020, Jennifer moderated a panel for Child-Bright titled "Roles and Relationships: Ethical Considerations Related to Involving Children and Parents in Patient-Oriented Research". Child-Bright and the panelists generously agreed to let us use 'tape' from that session to explore some of the themes we thought our listeners would find especially interesting. (The panelists are: Elizabeth Stephenson, Franco Carnevale, Gillian Backlin, Antonia Palmer, Thierry Lacaze-Masmonteil. Profiles below.) In this episode, Jennifer and Emily pick up one of the discussion threads to consider whether there might be a role for Research Ethics Boards (REBs) in supporting meaningful patient partnership. (The video recording of the original Zoom event is openly available. You can watch it here. In the session we covered so much more than we were able to address!  It's not required in order to enjoy this episode, but we do encourage everyone to watch.) [download transcript] Mentioned in this episode: Roles and Relationships: Ethical Considerations Related to Involving Children and Parents in Patient-Oriented Research Child-Bright Network Ethics Guidance for Developing Partnerships with Patients and Researchers The Canadian Collaboration for Child Health: Efficiency and Excellence in the Ethics Review of Research (CHEER) Tri-Council Policy Statement: Ethical Conduct for Research Involving Humans – TCPS 2 (2018) Reading that challenges common understandings about the role of REBs: The Ethics Rupture: Exploring Alternatives to Formal Research-Ethics Review How did we ever get into this Mess? The Rise of Ethical Regulation in the Social Sciences Regulating Creativity: Research and Survival in the IRB Iron Cage Against Research Ethics Committees "We need more critical thinking in clinical bioethics if patient autonomy is what we seek" Panelist Profiles: Elizabeth Stephenson is a Professor of Pediatrics at the University of Toronto and the Section Head of Cardiac Electrophysiology at The Hospital for Sick Children. Her research focus on electrophysiology has led to clinical investigations in cardiac resynchronization- and implantable defibrillator therapies. Additionally, she serves as the Chair of the SickKids' Research Ethics Board. Franco Carnevale is a nurse, psychologist and clinical ethicist with research interests in pediatric ethics. In addition to a number of academic appointments at McGill, he is the founder and principal investigator for VOICE (Views On Interdisciplinary Childhood Ethics) to advance knowledge and practices relating to ethical concerns in childhood. Gillian Backlin is a technical writer, an active member of CHILD-BRIGHT's National Youth Advisory Panel, and a Patient and Family Ambassador Liaison  at the  BC Children's Hospital's Sunny Hill Health Centre. Antonia Palmer is actively involved in the realm of pediatric oncology. In addition to being the co-founder of the Advocacy for Canadian Childhood Oncology Research Network, she founded Neuroblastoma Canada, and is a board member for Childhood Cancer Canada. She also chairs the Patient and Family Advisory Committee of the CHEER (Canadian Collaboration for Child Health: Efficiency and Excellence in the Ethics Review of Research) initiative which aims to streamline and improve the research ethics review process to enhance and expedite child health research across Canada. Thierry Lacaze-Masmonteil is child health and wellness researcher. He is a Professor of Pediatrics at the university of Calgary and is the section head of Neonatology at the Cumming School of Medicine. Additionally, he serves as the scientific director of MICYRN - the Maternal Infant Child Youth Research Network and is a co-principal investigator on the aforementioned CHEER initiative.

Commentary by Drs. Edward Gerstenfeld and Francis Marchlinski

In this week's Hard Shoulder Health Check Dr Jonathan Lyne, Director of Cardiac Electrophysiology at the Beacon Hospital joined Kieran to discuss irregular heartbeats.

Link to bioRxiv paper: http://biorxiv.org/cgi/content/short/2020.09.28.317461v1?rss=1 Authors: Aghasafari, P., Yang, P.-C., Kernik, D. C., Sakamoto, K., Kanda, Y., Kurokawa, J., Vorobyov, I., Clancy, C. E. Abstract: Exciting developments in both in vitro and in silico technologies have led to new ways to identify patient specific cardiac mechanisms. The development of induced pluripotent stem cell-derived cardiomyocytes (iPSC-CMs) has been a critical in vitro advance in the study of patient-specific physiology, pathophysiology and response to drugs. However, the iPSC-CM methodology is limited by the low throughput and high variability of resulting electrophysiological measurements. Moreover, the iPSC-CMs generate immature action potentials, and it is not clear if observations in the iPSC-CM model system can be confidently interpreted to reflect impact in human adults. There has been no demonstrated method to allow reliable translation of results from the iPSC-CM to a mature adult cardiac response. Here, we demonstrate a new computational approach intended to address the current shortcomings of the iPSC-CM platform by developing and deploying a multitask network that was trained and tested using simulated data and then applied to experimental data. We showed that a deep learning network can be applied to classify cells into the drugged and drug free categories and can be used to predict the impact of electrophysiological perturbation across the continuum of aging from the immature iPSC-CM action potential to the adult ventricular myocyte action potential. We validated the output of the model with experimental data. The method can be applied broadly across a spectrum of aging, but also to translate data between species. Copy rights belong to original authors. Visit the link for more info

Happy Women in Medicine Month! We’re celebrating by talking with super doc Dr. Kamala Tamirisa, a cardiologist super specialist in Cardiac Electrophysiology & Advanced Cardiac Imaging at Texas Cardiac Arrhythmia. She completed her training in Internal Medicine and served as Chief Resident at St. Louis University in Missouri. After she completed General Cardiology, Cardiac Electrophysiology, and Cardiac MRI fellowships at the University of Michigan. She then joined a large cardiology group (ProMedica Physicians Cardiology) in Ohio where she serves as the Director of The University of Toledo.   She talks about her journey into medicine, which started with her father walking into her classroom trying to get her to stop studying medicine. Kamala and Donnica discuss how even though everyone is tired of talking about politics, politics plays a crucial role in our healthcare system. Kamala talks about her personal experience of working with patients who refuse to wear a mask during the pandemic. If Kamala could make one big change in the health care system, she would take away the insurance companies she has to fight with to get her patients the care they need. They discuss RBG’s legacy and the best way for the Supreme Court to move forward to give women the best fighting chance for fair healthcare.

Commentary by Emile Daoud, MD and Fred Morady, MD

Dr. Kamala Tamirisa is a clinical cardiac electrophysiologist at Texas Cardiac Arrhythmia, In Dallas Texas. Dr. Tamirisa completed her training in Internal Medicine and served as Chief Resident at St. Louis University. She then went on to complete her General Cardiology, Cardiac Electrophysiology, and Cardiac MRI fellowships at the University of Michigan, Ann Arbor, Michigan. In this podcast you’ll hear about Dr. Tamirisa’s unique take on how to become a leader in the field of medicine, her fascinating hobbies and how she uses them to decompress after a long day at work, you’ll hear her explain how the heart works in very simple terms, and the direction in which her field is moving. Her twitter handle is @KTamirisaMD. You can see her full bio at: https://tcaheart.com/dr-kamala-tamirisa/ White Coat Story is a podcast series for school students to gain first-person insights into the practice of medicine, and what it takes to get there.

Commentary by Drs. Olujimi A. Ajijola and Douglas Zipes

As the country begins the reopening process, many remain concerned about hospital visits and postponing surgery. As the Chief of Staff at a major urban hospital, Dr. Jones brings a strong understanding of the challenges facing medical staff, patients, and caregivers. In our discussion, he describes the measures he and his colleagues continue to take to keep patients, families, and staff safe in this "new normal' facing our country. Dr. Christopher Jones specializes in Cardiac Electrophysiology at Centennial Heart in Nashville, TN. For more information, please visit www.centennialheart.com.     What is elective surgery?  Is it optional?   Will my loved be safe at the hospital? Can I visit? What is "Caregiver authority? How do we deal with the fear? About Peter Rosenberger and HOPE FOR THE CAREGIVER? “How can you laugh given what you all live through!?” Peter Rosenberger often hears that question when people learn of his 34+ year journey as a caregiver for his wife, Gracie, who lives with severe disabilities(80 operations & the amputation of both legs).Yet, Peter and Gracie draw hope from their deep faith which strengthens their hearts—and the couple brings a contagious inspiration that lightens weary hearts struggling with challenges.  Sponsored by: Standing With Hope

Duke cardiology fellow, Rahul Loungani, interviews Dr. Jonathan Piccini, director of the Electrophysiology Clinical Trials Program and Arrhythmia Core Laboratory at Duke University, about atrial fibrillation management in patients with heart failure. They discuss rate vs rhythm control and strategies for both, new onset AF in the context of critical illness, wearable devices in AF, escalation of therapy in AF, ideal patient for catheter ablation, and AF patients with cardiac resynchronization therapy. On the CardioNerds Heart Failure topic page you’ll podcast episodes, references, guest experts and contributors, and so much more. Take me to the Heart Failure Topic Page Take me to episode topics page Acute Decompensated Heart Failure Primer – Youtube Jonathan P. Piccini, MD, MHS is a clinical cardiac electrophysiologist and Associate Professor of Medicine at Duke University Medical Center and the Duke Clinical Research Institute. His research interests include the conduct of clinical trials and the assessment of cardiovascular therapeutics for the care of patients with heart rhythm disorders. At present, he is the Director of the EP Clinical Trials Program and Arrhythmia Core Laboratory at Duke University. He also serves on the Clinical Working Group of the American Heart Association’s Get With The Guidelines – Atrial fibrillation (GWTG-Afib) registry program. He is an associate editor for the American Heart Journal and serves on the editorial board of Heart Rhythm, the European Heart Journal, and the Journal of Cardiac Electrophysiology. He is the Principal Investigator of the data and coordinating center for ORBIT AF, a 25,000 patient registry focused on quality of care and improving outcomes in patients with atrial fibrillation. He is also the PI of the GENETIC AF clinical trial, the first clinical trial to study genotype-directed rhythm control therapy for atrial fibrillation. He also serves on the steering committees of multiple international randomized trials focused on the treatment of atrial fibrillation.  Dr. Piccini has more than 175 publications in the field of heart rhythm medicine. Clinically, his focus is on the care of patients with atrial fibrillation and complex arrhythmias, with particular emphasis on catheter ablation and lead extraction. Dr. Rahul Loungani completed medical school at the medical university of SC and then traveled to Baltimore for internal medicine training in the Osler Residency Program at the Johns Hopkins Hospital.  Here he fell in love with the management and hemodynamics of critically ill patients. He is currently a third-year cardiology fellow at Duke University Medical Center where he will also be pursuing fellowship in advanced heart failure and transplant cardiology next year. His current interests are in Cardiac amyloid, In particular its arrhythmic manifestations, early diagnosis, and novel therapeutics. He also loves teaching the housestaff and was awarded the Cassell-Saperstein award at Duke,  recognizing the fellow who most demonstrates a commitment to teaching and passion for clinical education. Outside of the hospital loves being a new dad to baby Arya

Dr. Efrain Gonzalez has been in practice in the Miami area since 1995, and is board certified in Cardiology and Cardiac Electrophysiology.  Dr. Gonzalez is the former Medical Director of Cardiac Electrophysiology at Baptist Cardiac and Vascular Institute and Chief of Electrophysiology at Mercy Hospital. Dr. Joe and Dr. Gonzalez discuss the role of your hormone levels when it comes to your cardiovascular health . They explain how supplementing specific hormones that have become depleted with age, help lower your risk of a heart attack and/or stroke. For more information regarding the treatments discussed on this episode, please visit our website at www.apmrmiami.com.

Oussama Wazni, MD, Section Head, Cardiac Electrophysiology and Pacing, and electrophysiologist Walid Saliba, MD, discuss atrial fibrillation stroke prevention, and the role of left atrial appendage occlusion. Drs. Wazni and Saliba also discuss outcomes noted at Cleveland Clinic, what to do in patients that are unable to take Coumadin due to the risk of bleeding, FDA indications, new technology available and the role of LAA occlusion in light of the newer anticoagulants.

Session 84 Dr. Edward Schloss joined me to talk about his journey to Cardiac Electrophysiology, what 17 years in the field looks like, and his likes and dislikes of his specialty. If you're a premed student, go check out all our other resources on MedEd Media Network. If you're a medical student, go check out our newest Board Rounds Podcast. [01:17] Interest in Cardiac Electrophysiology Coming out of undergrad as an engineer, Edward wasn't sure he wanted to be a doctor and only found out as he got further along. It was during second year of med school that he had an ECG class and they were already problem-solving instead of just plain memorization. He also got through different phases such as rheumatology, nephrology, and primary care. In fact, he recalls telling himself one evening that he wasn't going to be a cardiologist. He actually got interested in serial drug testing back in the old days, where they would take people who had cardiac arrest into a lab and they would pace their hearts in order to induce the arrhythmia. They would start the medication and bring them back and do it again. Until he got to the people that did electrophysiology and got mentorship. [04:05] Traits that Lead to Becoming a Good Electrophysiologist Edward says you have to be analytic. You have to be able to look at data objectively and there are going to be mountains of data and you have to sort through the good and the bad. In the lab, you have to be highly meticulous. You have to be focused and meticulous for hours on your feet to be able to get through that. Moreover, establishing relationships with patients is also super important. They don't meet patients on the table, but they meet them ahead of time. They deal with people that are very vulnerable and intimidated. Many of them have been through something life-changing. They're facing the risk of cardiac arrest or they've been through it. Or they're scared to death about their arrhythmias. So you need to humanize it and gather their trust before they hit the lab. And for many of these patients, you follow them for many years. Having a lot of device patients, they have metal in their body that he's responsible for, for the rest of their life. "These people have a hunk of metal in their body that I'm responsible for for the rest of their life so they're kind of married to me professionally." [06:10] Types of Patients and Diseases Edward illustrates a mix of patients coming in. There are young people with palpitations, fainting episodes, which are common. As they get older, you start to see patients who may be healthy but have developed atrial fibrillation from a variety of causes. As you go further to the older population, you'd see patients with myocardial infarction and then you get to the heart failure population as they get older. Edwards favorite is the 90-year-olds who may have a heart block and fainting episode and you put a pacer in them and they're good to go. Edward has a good number of referring physicians, mostly his own partners. When patients hit the door, it's not unusual for them to be ready to go. So they've probably had their echo or their medications, etc. A lot of times, they don't know what they need which is pretty common. So it's common for Edward that he'd have to craft the patients' expectations a little differently. "If they think they know what they need, much of the time they're wrong. That's not because they're not good doctors. It's just our field is so highly specialized." [08:55] Typical Day Edward arrives before 7 am, depending on how much is going on in the hospital. He runs around and sees his post ops. It's very important to see people the day after their procedure personally to cement the relationship. Then he makes it to the lab or the office by 8 am. His days are generally either all day lab or all day office. On an office day, he'll see patients from 8-8:30 and from 8:39 to 5 or so, he sees his patients. Some days can be light, others can be busy. On a lab day, they do procedures that can sometimes take a short amount of time. Sometimes, it takes several hours. It's hard to predict which number of hours. Typically, his day is done by around 6 pm. [10:29] Community vs Academic Edward chose the community setting over academic. He was one of the aggressive fellows who felt ownership over his patients. He jokes around that by the time he got done he was a "PGY-8" which just means that it takes a long time to become an electrophysiologist. So feel kind of ready for it and want to do things yourself. So he hated it when his attendings would lean over his shoulder and take control of the catheters or do access. He realized once he got out of practice that he wasn't going to change. So if he had to do an academic practice and had to teach fellows and give them control, then he would have a tough time with that. Then he found research later in his career but he tried to skirt away from it as much as he could. He did enjoy teaching but he wasn't sure if he was going to be patient about it. [12:33] Percentage of Procedures and Taking Calls If somebody hits his door as new patient evaluation, he does a procedure on them of about 75%. For the 25%, he sees a lot of people come to him for benign palpitations and sometimes all they need to do is put on a monitor and determine they're benign and reassure. This doesn't lead to a procedure. Basically, taking calls has evolved over the course of his career. Most electrophysiologists he's talked with would like to be purely electrophysiology on call. But it took a long time to get to that point. He'd take calls every fifth night and every fifth weekend. He used to do general cardiology call. Then as they got bigger and built an electrophysiology-specific call, the calls got less frequent. But as it got less intense, it became high acuity calls and in many cases, they're very knowledge-based, difficult, complex calls. [15:25] Work-Life Balance Edwards admits going through periodic retirement fantasies, not because he doesn't love his job, but because he just loves his home life. He's got a phenomenal family and a great place to live. So he enjoys being away from the hospital. Weekends he just shuts everything down so he can stay at home and have a nice time. "When you're here, you've got to be here. So you've got to actually devote yourself to that." [16:30] Training Path to Become a Cardiac Electrophysiologist You start out as an internal medicine resident after medical school which is three years. And then you decide whether you go to cardiology and get a cardiology fellowship which is another three years of general cardiology. Then you subspecialize and choose electrophysiology. Depending on what program you're in, that might be combined into the general cardiology program, or it might be a separate fellowship. For him, it was a separate fellowship that added two additional years. In total, it's eight years of postgraduate training before you finally get a real job. In terms of competitiveness, Edward thinks it's still the interventional folks are the most popular. But there are also attending EP (electrophysiology) spots. He thinks it depends on when you get out and what the path is. But just the cardiology itself is tough to get into. [18:16] Other Opportunities to Further Subspecialize "EP is a very narrow field but within that narrow field, there's a fairly significant breadth of knowledge." Edwards describes the specialty as cutting down in the middle between two basic worlds at least within procedural, namely: device implantation and ablations. The amount of research, attempts, and trials before ablation became actually refined to what it is right now, Edward would describe as the longest procedural research type of learning curve he has seen within his field. [20:23] Bias Against DOs and Working with Primary Care Physicians and Other Specialties The DOs Edward has met he'd consider as some of the best docs he had in practice during his fellowship. He personally didn't feel any bias at all. He hopes it's still as open as it was when he was there. They were just rocking and rolling it just like everybody else. Edward feels blessed to have a healthy referral environment. But what he could tell primary care physicians to help cardio electrophysiologists with patient care is first knowing when to refer. And this is true to a lot of other specialties. There are people who are out there but they haven't been referred. And some of their patients have been held onto too long before they could have done something food for them. So if you've got somebody who had heart failure and they haven't seen an electrophysiologist, please refer those folks out. Atrial fibrillation is a classic example where the evolution of how it's being treated has changed quite a bit and not every primary care physician may be aware that they've got great treatments for atrial fibrillation now but they need to get the people earlier rather than later. Additionally, basic testing is important and this applies more to his general cardiology colleagues rather than the primary care physicians. But simple things like just getting EKGs and people that are symptomatic. It's not unusual for him to see somebody who has had an echo, MRI, or cardiac cath, but has been six months since their last EKG and then they will find something that changes the whole game just because the EKG wasn't checked. "We've got great treatments for atrial fibrillation now but we need to get the people earlier rather than later." Edward says EPs are rarely referring out. But they have healthy working relationships with their general cardiologists and heart failure specialists. So it's 90% other cardiologists, although he does work with primary care physicians. But the pathway to a referral from primary care is to put them first into the cardiology system and then from within the cardiology system, they can then be referred to an EP. [24:15] Special Opportunities Outside of Clinical Medicine They work with very complex and technical equipment, very technically complicated. It may not be unusual in medicine but once patients leave the hospital, they still have that equipment inside their body. And that has to be maintained, serviced, and troubleshot. So pacers, defibrillators, biventricular heart devices are super complex. There are lots of things that could go wrong and lots of nuances to how they program the devices. So the industry is critical for them to be able to manage those appropriately. You will have an opportunity to work in the industry. At the MD level, you can consult. Some people work full-time with industry. "Done right, industry-MD partnerships are very healthy. Done wrong, obviously, it is the dark side." [26:23] What He Knows Now That He Wished He Knew Going Into EP What dawned on him as he went out to practice was that the overwhelming amount of information they had to deal with can become absolutely critical that you need to build a team around you and you need to reward and support that team. And they will return to you what you need to be able to take care of your patients. So you'd have to train these people and keep them otherwise you're going to be up the creek if the right people leave you. So take care of your people. "It's literally impossible to do this without this healthy group of supportive people." What he likes the most as a cardiac EP over his years of practice is appreciating the nuance of patient care. Coming out of college as an engineer, he didn't realize how much he liked patient relationships. Another thing he likes is the troubleshooting and complex management of devices. It's a big world that is somewhat impenetrable early on. But once you get in a little bit deeper, these things just open up into so many interesting things. "Barely a day doesn't go by that I don't see something I've never seen before and it just blows me away just how much nuance and difference there is in what we do." Electrophysiologists are very passionate, as Edward describes it. They love what they do and almost nobody knows what the hell it is that they do. And this keeps getting bigger and bigger as they people try to understand this and the world just opens up to you. On the flip side, what he likes the least is pleasing masters that don't have their best interest in mind. He doesn't like checking boxes or doing unnecessary documentation. He doesn't like following the rules of someone who doesn't literally understand why they wrote those rules – the faceless beaureaucrats – for lack of a better term.  Regulatory requirements and fighting for thingsfor your patients from people that are not invested or informed or experts are very challenging. "It's very challenging to do the things that are necessary to do the job that have absolutely nothing to do with the delivery of health care." [31:11] Major Changes in the Field Edward says that if you're a medical student coming in, dive in! This is not going anywhere, and it's just going to get more and more interesting and more exciting. Their patient population is not going anywhere. In the field of devices, we're getting away from the traditional way of delivering energy to the heart which is through leads that pass through the vasculature and down into the heart. We now have very early stages of fully, self-contained pacemakers that go inside the heart entirely, the size of a big pill. This is still in its infancy but the leadless technology of where we're going with devices is getting bigger. It won't completely replace the traditional leads, but that's where we're heading and it's very cool. Plus, Edwards says they're fun to put in! On the ablation side, you'd have to figure out where the arrhythmias are arising in the heart and then how to isolate or eliminate the tissue causing that to arise. Most of those techniques are catheter-based and either freeze or burn. You do a lot of sophisticated mapping to try to figure out where to go. Another amazing thing now is a group partnerring with radiation oncology to external beam-radiate the heart and eliminate arrhythmias that way. Still under thorough investigation, but most of them are excited about how this is going to happen. It could revolutionize how abalation is done. [34:12] Edward’s Thoughts on the Apple Watch with the EKG Feature Edward is pro and informing patients and giving them access to data. But it is a challenge to do that correctly. The problem you can run into with Apple Watch is that you're casting an enormously wide net on a very low risk population. No matter how good the technology is going to be, you're going to see a lot of false positives, which are going to lead down rabbit holes and additional testing – not to mention the fear on the part of the patients and their families and the resources that are going to get used up in the process. Even in the true positives, you're going to see a lot of detected asymptomatic atrial fibrillation. Frankly, we have very limited information about what to do about that. We know a little something about asymptomatic atrial fibrillation because we see it in devices. There are people walking around with pacers in their heart who may not have a diagnosis of atrial fibrillation. But the device will pick it up. And there's still enormous controversy about what to do with that population. "We've got to justle as a discipline to figure out how to manage these folks." [36:28] Final Words of Wisdom If he had to do it again, Edward would still choose the same. There's nothing in medicine that he could imagine he would do more than electrophysiology. It's got all the techy stuff, troubleshooting, engineering, relationships, surgeries -  all these that fascinate him along with the crazy good outcomes, seeing people rise up. It's gratifying how you can turn people around Ultimately, Edwards advice to those considering this field is that if you've got the bug like somebody shows you a crazy EKG or someone comes out with a dev.ice and looks cool,t hen don't be intimdiated. Seek out the right people. You're not going to figure this out on your own. He suspects it's going to be tough to get into fellowship unless you have some contacts. So find somebody like him who would be thrilled that you found this interesting as most people are scared away or just not interested. The stuff is going to look complicated and boring. But just hang in there. After a while and with the proper teaching, it's all going to open up and it's going to be just incredibly fascinating! And then you'll be part of the club. "If you get the proper teaching, it's all going to open up and it's going to just become incredibly fascinating! And then you'll be part of the club." Links: MedEd Media Network Board Rounds Podcast

Oussama Wazni, MD, Section Head, Cardiac Electrophysiology and Pacing and electrophysiologist Walid Saliba MD discuss atrial fibrillation stroke prevention, and the role of left atrial appendage occlusion: outcomes noted at Cleveland Clinic, what to do in patients that are unable to take Coumadin due to risk of bleeding, FDA indications, new technology available and the role of LAA occlusion in light of the newer anticoagulants.

Oussama Wazni, MD, Section Head, Cardiac Electrophysiology and Pacing and Bruce Lindsay MD, past Section Head and past president of Heart Rhythm Society discusses the challenges and findings from the CABANA trial and its implications on future clinical practice, when to offer ablation vs. medical management.

Patients admitted to the intensive care unit (ICU) are at increased risk for cardiac arrhythmias. They may be the reason for admission or resulting from the underlying condition. Treating exacerbating and contributing factors is the first step in management, however in certain cases may not be sufficient. Further the diagnosis of the arrhythmia may difficult from the ECG. An invasive cardiac electrophysiology study (EPS) can be helpful in establishing the diagnosis and can be combined with catheter ablation to eliminate the substrate. The field of cardiac electrophysiology is rapidly developing with technological advances providing insights into the mechanism of certain arrhythmias and expanding the therapeutic potential. This presentation will provide an overview of recent developments and insights into the management of common arrhythmias on the ICU.   

Want to know how deep the rabbit hole goes for corruption in the medical industry?  In this episode we talk to Dr. Wes Fisher MD, who is the Director of Cardiac Electrophysiology at NorthShore University HealthSystem. He is the man, along with the Practicing Physicians of America organization, who is fighting the MOC or maintenance of certification scam we physicians waste time and a lot of money on. His group needs our support to continue the revolution to gain back control of our healthcare system.  Take a listen and hear about collusion, luxury condos, administrators making millions, Cayman Island hideaways and dirty cops.  Some important links: https://www.gofundme.com/practicing-physicians-of-america https://practicingphysician.org https://twitter.com/doctorwes?ref_src=twsrc%5Eappleosx%7Ctwcamp%5Esafari%7Ctwgr%5Esearch http://drwes.blogspot.com    

Dr. Leonard Ganz discusses pharmacologic rate control of atrial fibrillation (AF) and findings of a recent study published in the Journal of the American College of Cardiology regarding the use of digoxin and mortality in patients with AF. Dr. Nancy Sokol hosts. Dr. Ganz is a clinical cardiologist and Director of Cardiac Electrophysiology at the Heritage Valley Health System, in Western Pennsylvania, and Section Editor of the cardiac arrhythmias section in UpToDate. Reference: Lopes RD, Rordorf R, De Ferrari GM, et al. Digoxin and Mortality in Patients With Atrial Fibrillation. J Am Coll Cardiol 2018; 71:1063. Contributor Disclosure: Speaker’s Bureau: Amgen [Heart failure (Ivabradine)]; Pfizer, BMS [Anticoagulation (Apixaban)]; St. Jude Medical, Biotronik [Cardiac rhythm (Pacemaker/ICD)]; Lundbeck [Orthostatic hypotension (Northera)]. Consultant/Advisory Boards: Unequal Technologies [Commotio cordis (Protective equipment)]. Equity Ownership/Stock Options: Unequal Technologies [Commotio cordis (Protective equipment/apparel)].

KYW's Lynne Adkins talks to St. Mary Medical Center Director of Cardiac Electrophysiology Dr. Scott Burke about minimally invasive procedures for cardiac surgery.

Commentary by Dr. Valentin Fuster

Recorded at the 2014 British Cardiovascular Society meeting in Manchester, Heart associate editor Dr James Rudd talks to Dr Arthur Yue, consultant electrophysiologist at the University Hospital of Southampton. In this podcast, they discuss the expanding roles of electrophysiological specialists in managing arrhythmias, accessory pathways and the new upcoming NICE guidelines on atrial fibrillation.

A new medical device may help better treat and prevent strokes for hundreds of thousands of people in the U.S.Atrial fibrillation, or flutter, is a common type of abnormal heartbeat and has been linked to risk of stroke. In this condition, the heart rhythm is fast and irregular. Atrial fibrillation may occur without your knowledge, causing you not to seek medical attention and thus increase your risk of death from stroke.Atrial fibrillation is the most common abnormal rhythm of the heart, and at least five million Americans suffer from the condition.What if there was something that could help prevent strokes from happening in those who suffer from atrial fibrillation, other than medication?A new device about the size of a AAA battery can be injected into your skin. This device then automatically hooks up with a bedside transponder. If you have any abnormal rhythms in your heart, it will find the nearest cell phone tower and transmit that information to your caregiver.Doctors will now be able to tell when you've had an abnormal rhythm, even if you can't.In a Northwestern Medicine study, researchers monitored people with cryptogenic strokes for intermittent atrial fibrillation using the new device. The device detected atrial fibrillation in 30 percent of people with cryptogenic stroke.Using standard techniques, physicians only found atrial fibrillation in about three percent of these patients. Because of these results, those 30 percent of patients were almost all switched to blood thinners. This treatment action should protect them from having another stroke.Medical director for the Program for Atrial Fibrillation at the Bluhm Cardiovascular Institute, associate director of Cardiac Electrophysiology, and a member of the Northwestern Medical Faculty Foundation, Rod S. Passman, MD, shares the alarming risks of atrial fibrillation, new research that helps connect the link between atrial fibrillation and stroke and a new treatment option.

A new medical device may help better treat and prevent strokes for hundreds of thousands of people in the U.S.Atrial fibrillation, or flutter, is a common type of abnormal heartbeat and has been linked to risk of stroke. In this condition, the heart rhythm is fast and irregular. Atrial fibrillation may occur without your knowledge, causing you not to seek medical attention and thus increase your risk of death from stroke.Atrial fibrillation is the most common abnormal rhythm of the heart, and at least five million Americans suffer from the condition.What if there was something that could help prevent strokes from happening in those who suffer from atrial fibrillation, other than medication?A new device about the size of a AAA battery can be injected into your skin. This device then automatically hooks up with a bedside transponder. If you have any abnormal rhythms in your heart, it will find the nearest cell phone tower and transmit that information to your caregiver.Doctors will now be able to tell when you've had an abnormal rhythm, even if you can't.In a Northwestern Medicine study, researchers monitored people with cryptogenic strokes for intermittent atrial fibrillation using the new device. The device detected atrial fibrillation in 30 percent of people with cryptogenic stroke.Using standard techniques, physicians only found atrial fibrillation in about three percent of these patients. Because of these results, those 30 percent of patients were almost all switched to blood thinners. This treatment action should protect them from having another stroke.Medical director for the Program for Atrial Fibrillation at the Bluhm Cardiovascular Institute, associate director of Cardiac Electrophysiology, and a member of the Northwestern Medical Faculty Foundation, Rod S. Passman, MD, shares the alarming risks of atrial fibrillation, new research that helps connect the link between atrial fibrillation and stroke and a new treatment option.

The heart.s function of pumping blood may seem fairly simple but the underlying mechanisms and electrical impulses that maintain a healthy rhythm are extremely complex. Many areas of mathematics, including differential equations, dynamical systems, and topology help model the electrical behavior of cardiac cells, the connections between those cells and the heart.s overall geometry. Researchers aim to gain a better understanding of the normal operation of the heart, as well as learn how to diagnose the onset of abnormalities and correct them. Of the many things that can go wrong with a heart.s rhythm, some measure of unpredictability is (surprisingly) not one of them. A healthy heartbeat is actually quite chaotic not regular at all. Furthermore, beat patterns become less chaotic as people age and heart function diminishes. In fact, one researcher recommends that patients presented with a new medication should ask their doctors, "What is this drug going to do to my fractal dimensionality?" For More Information: Taking Mathematics to Heart: Mathematical Challenges in Cardiac Electrophysiology, John W. Cain, Notices of the AMS, April 2011, pp. 542-549.

The heart.s function of pumping blood may seem fairly simple but the underlying mechanisms and electrical impulses that maintain a healthy rhythm are extremely complex. Many areas of mathematics, including differential equations, dynamical systems, and topology help model the electrical behavior of cardiac cells, the connections between those cells and the heart.s overall geometry. Researchers aim to gain a better understanding of the normal operation of the heart, as well as learn how to diagnose the onset of abnormalities and correct them. Of the many things that can go wrong with a heart.s rhythm, some measure of unpredictability is (surprisingly) not one of them. A healthy heartbeat is actually quite chaotic not regular at all. Furthermore, beat patterns become less chaotic as people age and heart function diminishes. In fact, one researcher recommends that patients presented with a new medication should ask their doctors, "What is this drug going to do to my fractal dimensionality?" For More Information: Taking Mathematics to Heart: Mathematical Challenges in Cardiac Electrophysiology, John W. Cain, Notices of the AMS, April 2011, pp. 542-549.

preDiCT is a major EU-funded project. It's purpose is to make computer models of cardiac electrophysiology, to help predict drug safety.