How did you get into the field of cardiac electrophysiology (EP)?

I always enjoyed reading electrocardiograms as a medical student. Then, while a resident at Georgetown University Medical Center, I had the opportunity to work with Drs. Al Solomon and Cyndi Tracy, who intensified my interest in electrophysiology. This made my decision to pursue EP as a career much clearer.

Once I became a cardiology fellow, the decision was fairly easy to subspecialize in EP. My EP training at Duke was outstanding. We were very fortunate to routinely gain exposure to complex ablation and device work. I also had the privilege to work with a number of superb electrophysiologists. Ultimately, the research experience there was a great foundation for my decision to continue in academic medicine.

The opportunity at MCG was a good fit for me: it is a program that really wanted to build an ablation program from the ground up, which has certainly proved very challenging.

Tell us about your role as Director of Cardiac Arrhythmia Ablation Services at the Medical College of Georgia. What is a typical work day like for you?

Two and a half days a week are spent in the EP lab. I have three half-day clinics a week as well: one is dedicated to device follow ups, and the others are for new and follow up EP patients. Lab days are typically very busy. I also round on the consultative EP service every other week.

We have striven to build a robust ablation program, as our region is tremendously underserved, so I have been heavily focusing on educating our EP lab staff. We ve done this by doing didactic sessions, as well as simply taking the extra time during EP studies and ablations to explain to our nurses and techs what I am doing and what it means. I joke with them that they are my EP fellows! The investment has paid off, too in a year they have accomplished a tremendous amount. We now routinely perform complex ablations, including ischemic ventricular tachycardia (VT) and atrial fibrillation (AF). In addition, I recently started a Web site (www.epmcg.net) designed to help educate our patients, their families and referring doctors about what we have to offer. Web programming can be very challenging!

What are some of the daily challenges you encounter in the lab?

We are primarily limited by space. We have only 1 EP lab, and are in the preliminary stages of planning a second. So, when it is busy, turnover times are an issue.

What do you consider unique about your ablation program?

Our region is the Central Savannah River Area, of which Augusta serves as the hub. We are the only biplane EP lab and the only regional lab with both ESI and Carto as well as Siemens ICE. In addition, we are the only lab with cryoablation, of which we perform 3-4 procedures a week. Thus, we are very unique in our region. We are also equipped to perform any type of ablation, as well as perform ablation in the adolescent population.

Recently, in collaboration with our cardiac surgeons, we began successfully performing hybridized EP surgeries, such as complex epicardial left ventricular (LV) mapping and ablation via a mini-thoracotomy approach, in our lab. This allows unprecedented catheter mobility in the epicardial space in patients with prior sternotomies who are not ideal candidates for a sub-xyphoid approach. We are the only center in the region performing procedures such as this.