CardioSource WorldNews - Page 26

CLINICAL INNOVATORS Interview by KATLYN NEMANI, MD A Renaissance Man in the Golden Age of Cardiology An Interview with Douglas Zipes, MD D ouglas Zipes, MD, is a renowned cardiologist and expert in arrhythmias. He invented the implantable transvenous cardioverter, the first device of its kind that could be introduced through a catheter into the heart. Dr. Zipes completed his medical school training at Harvard Medical School in 1964 and went on to complete his medicine residency and cardiology fellowship at Duke University Medical Center. Dr. Zipes has spent most of his career as a cardiologist at Indiana University School of Medicine, most recently as Distinguished Professor of Medicine, Pharmacology, and Toxicology. He has published over 800 articles and 21 textbooks. Recently, he started a new chapter in his life as a novelist. When did you decide to become a cardiologist? Who were some of your mentors along the way? After graduating Harvard Medical School, I interned at Duke University Medical Center. Initially I wanted to become a nephrologist. Explaining clinical conditions by their pathophysiology appealed to me. Then, Duke opened the first CCU in the south and I when I rotated through, I fell in love with the same phenomenon for which nephrology appealed, but cardiology added fascinating squiggly ECG lines to interpret and that sealed my decision to switch. Eugene Stead, MD, Duke chair of medicine, had an early influence. His philosophy was that the patient’s interests lay at the heart of all we did, and that the best way to learn to take care of patients was to immerse yourself in their care. To accomplish this, Dr. Stead made sure we practically lived with the patient and his/her illness to absorb all there was to know. Interns worked in the hospital 6 and a half days a week, and were on call 5 nights out of 7. The second major influence was Gordon Moe, 24 CardioSource WorldNews MD, with whom I trained in basic electrophysiology. Gordon directed the Masonic Medical Research Laboratory in Utica, NY. I benefited not only from Gordon’s scientific genius but also from his kind heart, generous spirit, and sense of humor (he left his replacement at Syracuse a giant horse condom to which was pinned the note, “Dear Jim: I know you can fill my shoes, but…”). The third person is Eugene Braunwald, MD. Gene invited me to write the EP section for the 2nd edition of Braunwald’s Heart Disease, and I have written it for every edition since. Then, he invited me, with Peter Libby, to co-edit the entire book with him beginning with the sixth edition, later joined by Bob Bonow, MD, Doug Mann, MD, and Gordon Tomaselli, MD. I will be the editor-in-chief for the 11th edition,which is in preparation. Gene is THE most outstanding cardiologist in the world today and his integrity, intellect, and insights have provided a role model that has profoundly impacted me over the last 35 years. once has my integrity been challenged because of that relationship, nor has my industry association prevented me from becoming president or chair of a number of very important organizations, such as the Heart Rhythm Society, the ACC, and the American Board of Internal Medicine, and editor-in-chief of seven cardiology journals, five of which I was the founding editor. The second has been medical legal work. Often shunned by doctors, I have been challenged: why do it? I have often thought that issue through. I’ve concluded—not to get too high and mighty—that it’s like paying dues to live in the society we have, with all its warts. Certainly I am well paid for what I do, but it’s more than that. Someone with an important reputation needs to stand up and do what’s right: defend the innocently accused or confront the wrongdoers. It’s that simple. Many physicians want no part of it, but I think expert testifying is a necessary duty. Without it, our legal system could not function. You have had an enriching career spanning over 50 years of patient care and clinical research. What have been some of the most satisfying milestones for you? Patient care has been the most satisfying. That, and the ability to go from the lab to the bedside and vice versa have been the highlights of my career. I could take a clinical observation and study it in the lab, or make a laboratory discovery and apply it clinically. My career has been filled with these very gratifying experiences. I have had two other interests, important to my career, both of which have been questioned by others. The first has been an association with industry beginning at a time (1975) when it was not very acceptable. I am very proud that I consulted for Medtronic for 35 years until 2010, and not Decades ago, you developed the implantable transvenous cardioverter. How did you come up with the idea of delivering a shock via catheter and bring it to fruition? In 1983 I invented the synchronous intravenous cardioverter based on a new (now well-established) concept of delivering an electric shock over a catheter in the heart to terminate VT. I invented it while consulting for Medtronic. Per my contract, all the proceeds went to them and I’ve never received a penny (my wife has reminded me many times that, while I might be a smart doctor, I’m a lousy businessman). Medtronic made the device for me to test and implant in patients. Medtronic then created the PCD, a pacemaker, cardioverter, and defibrillator combined into one device, that incorporated my invention. December 2016