My personal philosophy

A person’s heart rhythm can be thought of as a barometer of his or her well-being and overall health status. While most of us have the gift of a well-regulated heart rhythm, many people develop irregular rhythms that are uncomfortable and may be a sign of other health problems. I have designed my practice as an integrated approach to the management of heart-rhythm disturbances, focusing on improving the individual’s health status and providing tailored treatment options to achieve therapeutic goals.

A passion for catheter ablation

Among my passions is catheter ablation of atrial fibrillation, a rapid, irregular heart rhythm that affects over 3 million Americans and accounts for a substantial increase in the lifetime risk of stroke. As a senior Fellow in Cardiac Electrophysiology at the University of California San Francisco in the late 1990s, I was among the first operators in California to reproduce the results of the French electrophysiologists Dr Michel Haissaguerre and Dr Pierre Jais in the elimination of focal triggers culminating in atrial fibrillation.

After joining the full-time academic faculty at Cedars-Sinai Medical Center in Los Angeles and the David Geffen School of Medicine, UCLA in May of 2000, I continued my quest to refine catheter ablation of atrial fibrillation at Cedars-Sinai Medical Center. Top among my goals has been to improve procedural success while reducing risks to patients “as close to zero as possible.” To that end, I have played a central role in the adoption of non-fluoroscopic mapping and navigation systems, intra-cardiac echocardiography and catheter cryoablation at Cedars-Sinai Medical Center.

The first catheter cryoablation in the western U.S.

In 2005, I performed the first catheter cryoablation of atrial fibrillation in the western United States, and am now involved as Principle Investigator in the STOP-AF Trial at Cedars-Sinai Medical Center. STOP-AF is an FDA-monitored trial that will determine the potential role of a novel balloon cryoablation catheter for the treatment of atrial fibrillation.

Cardiac Resynchronization Therapy

Cardiac Resynchronization Therapy (CRT) – otherwise referred to as biventricular pacing – is a specialized form of pacing the heart used to treat patients with advanced heart failure. Biventricular pacing for heart failure constitutes a large segment of my clinical practice and represents a continuation of my research into this topic stemming from pre-clinical studies that I performed in the mid-1990s while a senior Fellow at UCSF.

While clinical trials results confirm the utility of CRT in improving patient survival and quality of life (MIRACLE Trial, COMPANION, CARE-HF), there has been a disturbing observation that up to 35% of patients may fail to respond to this treatment. Methods to improve individual patient’s response to this therapy are among my clinical passions and ongoing research interests.

A synchronized heart rhythm is a thing of beauty and may restore one’s joy in life. I share in my patients’ passion in getting their life back on track with a normal heart rhythm.