CardioSource WorldNews - Page 27

Read the news magazines of the “We need additional research and ultimately advances in two arrhythmic areas: atrial fibrillation, a major scourge because of the large numbers of patients affected; and sudden cardiac death, still taking over 300,000 lives annually.” Some of your recent research involves using spinal cord neuromodulation for the treatment of heart failure. Can you tell us a bit abo ut this and where things currently stand? I have been interested in the autonomic nervous system for much of my career and have published many clinical and basic research observations in this area. Spinal cord stimulation (SCS) has been used successfully for a long time in Europe to treat refractory angina in patients with non-revascularizable coronary artery disease. Many years ago, Medtronic asked me to study the mechanism. I remembered a clinical observation by Sam Levine (a Brigham great MD, in the 1950s) that carotid massage relieved angina, and I wondered whether SCS worked via that mechanism. We showed that SCS did indeed induce a cardiac vagomimetic and/or sympatholytic action. We then showed SCS could prevent ischemic VF and ultimately remodel heart failure in dogs. Medtronic funded the clinical study: prospective, randomized, blinded and---it was a bust! No clinical impact in heart failure patients. Sadly, I think the concept has died—at least for the moment. What are some of the major advances you anticipate in the field in the coming decade or two? Genetics, certainly. In a recent article on induced pluripotential stem cells from Brugada patients, authors cured the disease in a dish by reprogrammed the genetic abnormality. A long way from clinical American College of Cardiology application, but it will happen in your lifetime. We need additional research and ultimately advances in two arrhythmic areas: atrial fibrillation, a major scourge because of the large number of patients affected; and sudden cardiac death, still taking over 300,000 lives annually in the US. You recently started a new chapter in your life as a novelist. Can you tell us about some of your latest works? In the twilight of my medical career I have turned to a new challenge: becoming a novelist. My first venture was The Black Widows, a tale about two elderly widows living in the US heading a world-wide terrorist organization. The hero detective has to solve a series of apparent random murders directed by the Black Widows. The second novel, Ripples in Opperman’s Pond is based on a trial and my interactions with the lawyers, in which I was a plaintiff expert testifying against a major drug company accused of hiding cardiovascular side effects of a new drug for arthritis. I combined my experiences in this trial with testifying at one other trial when I defended a colleague from a malpractice charge, and fictionalized them into Ripples in Opperman’s Pond. The third novel, Not Just a Game, takes three generations of a Jewish family and places each in an important Olympics: the father in 1936 Berlin Olympics; the son in the 1972 Munich and the slaughter of 11 Israeli athletes; and the grand daughter in 2016 Rio, where she has to deal with a resurgence of Nazism while winning a gold medal in fencing. How do you spend your time when you’re not providing patient care, conducting research, or writing? I love opera, listen to it a lot and support our local opera company. In fact, I have an opera review! When I was president of Indianapolis Opera (years ago) and we needed money, my board suggested I go on stage in between the first and second acts of Otello and pitch an appeal to the audience. The Indy paper the next day said, “Otello was wonderful, and Dr. Zipes’ presentation, though tacky, was necessary.” anywhere—in print and online. Threats to Cardiologist Compensation in Post-alignment Years | Advocating for Equal Treatment CardioSource WorldNews vol 5, no 7 / JULY 2016 A publication of the American College of Cardiology Print EXPERT COMMENTARY fred bove: Is AF Contributing to Dementia?…p.7 gerard martin, md: Pediatric Cardiac Care and the Global Health Agenda…p.43 CLINICAL NEWS Study Explores Prescribing Habits for AF Patients at Risk for Stroke…p.13 Pharmacists’ Interventions May Cut CVD Risk…p.13 Leaders Trial Shows Benefit of Liraglutide for Type 2 Diabetes Patients…p.15 Low-income Countries in AMI Outcomes…p.16 SAVE YOUR BRAIN PCI vs. OMT for Stable IHD: What Part of ‘Optimal Medical Therapy’ Is Confusing?...p.19 Disturbed Sleep, Aging and CVD…p.20 More reasons to optimize AF therapy Online What advice would you give early career cardiologists? 1) Follow your love and pursue what you want to do, not what others tell you to do. 2) Focus on a particular area to be the best there is in that area. 3) Family first, always. ■ Katlyn Nemani, MD, is a physician at New York University. CardioSource WorldNews 25