Contributions to Science

Scientific work that contributed to current therapy of arrhythmias

➢ 1981- Firs and pivotal description of the anatomic location of the slow AV nodal pathway which established the basis for slow pathway mapping and ablation ( Circulation 1981)

➢ 1981 – First implantation of antitachycardia pacemakers for ventricular tachycardia, later extended to supraventricular tachycardia

➢ 1983: Principal Investigator in first clinical FDA trials of the implantable defibrillator ( AID, Mirowski)

➢ 1983- First pivotal study of DC shock AV junctional ablation (Scheinman) and later for ablation of AV nodal reentry, accessory pathways in the right atrium , coronary sinus and left sided endocardial ablation

➢ 1983: Intraoperative spectral analysis of ventricular electrograms during sinus rhythm and ventricular tachycardia. PACE 1983

➢ 1983- Mechanisms of left ventricular dysfunction during ventricular pacing and ventricular tachycardia in man. (PACE 1983)

➢ 1983-85: Direct hemodynamic during spontaneous and induced ventricular tachycardia in man which were the first human studies ( JACC 1984)

➢ 1984- Pivotal study on antitachycardia pacing that established it as first line electrical therapy in ventricular tachycardia in preference to shock therapy ( Circulation 1985;1:571- 578))

➢ 1984- Echocardiographic studies of ventricular and mitral valve function during spontaneous and induced ventricular tachycardia in man which were the first human studies (PACE 1984)

➢ 1983-85 – Demonstrated experimental and clinical feasibility of laser ablation of VT, later SVT in the

intraoperative studies and published first clinical results ( Am. J. Cardiology 1986)

➢ 1984- RF ablation experimental studies published from experimental lab and development of active fixation and suction electrode catheters for both DC and RF ablation .

➢ 1985- Reported the first 3 lead non-thoracotomy lead system for cardioversion and defibrillation and was issued a patent by the US government for the first non-thoracotomy lead system for human defibrillation

➢ 1987 – Performed first successful implantation of an ICD without thoracotomy (JAMA 1988)

➢ 1987- First radiofrequency AV junctional ablation with first RF ablation generator in NJ and ( Osypka RF device, Am J Cardiol 1989)

➢ 1985-88- Subcutaneous electrode mapping studies that now are used in subcutaneous defibrillators and extravascular ICD lead placement

➢ 1987- Development of the first sequential pacing and cardioversion algorithm for use in ICDs and now is standard in all devices (Circulation 1987;76:601-609)

➢ 1987-1994: Developed and tested new endocardial defibrillation lead systems for ICDs including the Medtronic, Endotak series leads , braided electrode system for Telectronics

➢ 1989- First report of defibrillation lead fracture and failures ( Arch, Int.Mmed 1989)

➢ 1991: First studies on biphasic shock defibrillation with threshold reduction in humans which is now the standard for ICDs (PACE 1991)

➢ 1987 – Established first scientific standards for antitachycardia pacemakers and ICDs: NASPE Board of Trustees and co-chaired first policy conference and position statement on implantable antitachycardia devices ( with J. Camm) in 1987 and the indications for the ICD ( with M. Lehmann) 1990

➢ 1988: Implantation of the first pacemaker defibrillator

➢ 1994-95- First coronary sinus ablation of left sided accessory pathways with RF PACE 1995, AJC 1995)

➢ Proposed the terms ICD (implantable cardioverter-defibrillator) in 1987 and Interventional Electrophysiology in 1990

➢ 1991: Began his collaboration with the NHLBI resulting in the development of the AVID trial (1992) and AFFIRM trial (1996); Joint policy conferences with the ACC,AHA, ESC and FDA

➢ 1994-Developed Dual Site Atrial Pacing and clinical results (JACC 1996), RCT ( JACC 2002)

➢ 1998-2010: Bi-atrial Mapping &Origin of Atrial Fibrillation first proposed , not widely accepted with mainstream PVI hypothesis but continued to championed by us, and now extra PV sources are widely accepted (AJC 1998-JCE 2005)

➢ 1999: First report on the AVID trial on ejection fraction as a stratifier for ICD benefit on whose basis the entire series of MADIT 2 and SCD-HeFT trials were based

➢ 1999: Co-chaired first Round Table with the NIH/NASPE on future research directions in EP which led to NIH placing atrial fibrillation and sudden death in their top 5 public health priorities for NHLBI in 2002

➢ Directed the development of new intracardiac echo technology (ViewMate,EP Med Systems) which now still is in use.

➢ 2010 –Principal investigator for the First RCT of intracardiac echo (ICE CHIP) which was reported in Circulation EP

➢ 2004- Joined NIH HFpEF planning group and TOPCAT study group and Steering Committee of the TOPCAT RCT ( NEJM 2014)

➢ Established research interest in the AF-HFpEF syndrome ( JICE 2018)

➢ 2020- Pivotal AFFIRM substudy showing the benefits of rhythm control in preventing HF emergence in AF ( AHJ 2020);

➢ 2020- Developed and initiated the first trial to compare rhythm control options( ablation vs. AAD) in AF with HFpEF: Study Chair TAP-CHF trial ( 2022-2024)

➢ 1982 – 2024 Principal investigator in in over 69 clinical trials

➢ Published over 375 original research papers with the majority as first author, over 475 research presentations, faculty and lecturer > 500 national and international meetings

➢ Many of his early studies and later studies are only now being mined as the basis for new directions in understanding pathophysiology, hemodynamics and new therapeutic directions in tachycardia therapy.

➢ Edited 9 textbooks of Cardiology and Electrophysiology