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,
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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