This month we speak with Jagmeet P. Singh, MD, DPhil, Associate Professor of Medicine, Harvard Medical School, Cardiac Arrhythmia Service, Massachusetts General Hospital Heart Center.

Tell us about your medical background and how you came to work in the field of electrophysiology. What interested you about this field?

My journey so far has zigzagged across 3 continents. I started out in India, where I received my basic medical education and initial training in medicine and cardiology. Soon thereafter I went on a scholarship to Oxford University, UK, where I completed my doctorate (D.Phil.) in clinical and translational electrophysiology. Subsequently, I moved to Boston and went on to complete my internal medicine residency, cardiology and cardiac electrophysiology fellowship at Massachusetts General Hospital, Harvard Medical School. Along the way, I also completed a research fellowship at the Framingham Heart Study and a Master of Science degree in clinical investigation from MIT-Harvard.

In regard to my interest in electrophysiology, this was primarily fostered during my early years of training. I had always been intrigued by complexities of the electrical circuitry of the heart, but it was my research years at Oxford and Framingham that solidified my interest in clinical electrophysiology. Over the years (more so by chance), I have managed to get a sound grounding and education in basic, epidemiological and clinical research in the field of electrophysiology. I really do enjoy taking care of patients, thinking about research and new approaches, and also working with my hands. The field of electrophysiology has provided me this “all-encompassing opportunity” to be a clinician, teacher, researcher, and an interventionalist.

Describe your position at Massachusetts General Hospital. Tell us about the Cardiac Resynchronization Therapy Program.

At MGH, I am the Director of the Cardiac Resynchronization Therapy Program. This is a multidisciplinary program caring for heart failure patients with implanted devices. I founded this program in late 2005, based on the contention that we were not doing enough for our patients with heart failure after implanting them with resynchronization therapy devices. These patients are, as you know, a frail group of ambulatory individuals with implanted devices who receive their care from a variety of subspecialists (i.e., electrophysiologists, heart failure and imaging specialists). At least in our institution at that time, there was no structured cross talk amongst the subspecialists involved and patients were presumably not getting what I would label as optimal integrated care. We all knew that a significant minority of patients receiving CRT devices were non-responders and that we could do more to recognize these patients; we were not proactively treating the correctable causes or using the valuable information from their device “diagnostics.” In fact, most of these patients would come to our attention only after they had already had a significant episode of heart failure exacerbation. So in order to provide better care, we brought together the different subspecialties under one roof in the form of a multidisciplinary clinic.