Tell us about your medical background and how you came to work in the field of electrophysiology. What interested you about this field?
Growing up, medicine always fascinated me. I grew up in a family that had no physicians, but I was always impressed by our family physician who took care of everything, from a common cold to a major sickness. He was a very influential person in our lives. After I experienced a serious bout of malaria, his sense of commitment to patient care became the foundation for me to think about biological sciences and medicine. During medical school years, cardiovascular science always impressed me – the heart is such a very small organ, yet it can impact the human body in so many ways. While I was in internal medicine, I had the good fortune of having several attending physicians who inspired me to pursue cardiology. I was also really impressed by the exciting work being done early on by Drs. Michel Haïssaguerre, Andrea Natale, and Carlo Pappone in atrial fibrillation (AF) ablation — I believe it formed the foundation for my interest in EP.
Describe your position as Director of the Center for Excellence in AF and Complex Arrhythmias. What is a typical week like for you?
In a typical week, I am in the lab about 3 days in a week, and spend 2 days in the clinic seeing patients. On average, I do about 2-3 complex arrhythmia ablation cases per day. Our patients come from the surrounding 5-6 states. Most present with AF, VT, or a congenital cardiac arrhythmia.
Tell us also about your involvement as one of founding course directors with the International Symposium on Left Atrial Appendage (ISLAA) conference. How did you get involved?
As interest was growing about the left atrial appendage, there was no concerted effort to bring together scientists and physicians from different parts of the world to discuss advancements. This became a compelling reason to create a common platform to discuss data, training, research, etc. I reached out to leaders in the field – including Drs. David Holmes, Vivek Reddy, Saibal Kar, and Andrea Natale — and they had overwhelming support for this concept. We all came together and formed the ISLAA Foundation, which organizes the ISLAA conference every year.
Tell us about your involvement as course director of the Kansas City Heart Rhythm Symposium (KCHRS), now in its eighth year. What can you tell us about your involvement with this program as well?
When I moved to Kansas City in 2006, I saw a clear need for high-quality education, both for physicians and allied health professionals in the field. Attending international meetings can often be difficult for many, so the idea came about to create a regional meeting that would satisfy the educational needs of the surrounding 6-7 states. We envisioned a high-quality symposium where people would have access to hearing from international speakers on current topics that are relevant to clinical practice. At our first annual conference in 2009, there was a lot of interest and we were very much encouraged by the attendance. Momentum picked up year after year, and we are now able to attract some of the biggest names in the world to speak at this meeting. The KCHRS fulfilled an unmet need, because there were not that many educational opportunities in the Midwest. I think for a large institution such as ours, it’s only natural to take the leadership in education and provide for the educational needs of the people in the field. As a concept, the KCHRS was very well accepted and we’ve been doing really well.
What aspects of your work do you find most rewarding?
Taking care of patients and addresssing unanswered clinical questions in research are the most rewarding aspects of my professional life.
Can you share one of the more unusual AF cases you have treated?
I am always fascinated by the surprises that arise during AF cases. I think we all go into cases with preconceived notions: This will be a straightforward paroxysmal AF case — we’ll get in and get out. It’s never like that! All cases have challenges, and from a learning standpoint, it can be incredibly humbling and rewarding at the same time. For example, you would think that getting into a femoral vein and gaining access into the heart would be the easiest thing you can do if you’ve worked with thousands of patients. However, every patient is different, so be aware of the basic principles and cognizant of the individual variations that each case can present. “Expect the unexpected” is one of the principles I try to teach my fellows. Don’t get too ahead of yourself, approach cases in a very systematic way, and you will get to where you should. I’m also fascinated at the complexity of the persistent AF cases — why is it that some patients with a very short duration of AF have so much more scar tissue and substrate changes than others who have been in AF for 25 years and have a pristine-looking atrium? This field fascinates me, and makes my job exciting and challenging at the same time.