Which developing techniques and technologies are you watching closely for the future?
As mentioned, 4–5 dimensional integrated imaging will become progressably easier to apply. Virtual approaches with robotics will likely continue to emerge as reasonable components of our armamentarium. I am more enthusiastic about the cell therapies and external ablation approaches, which will emerge over the course of the next five years.
What is your opinion on the US healthcare reform and how it will affect the electrophysiology field?
This is a critical issue. The cost of healthcare has sky rocketed, with no sign of improvement in the near future. Because of that, we have a finance system that simply is not sustainable. Too many people do not have healthcare while the techniques and technologies that could be of benefit to many patients are simply unavailable. Because of that, healthcare reform is not only critical, it is mandatory. It is of substantial importance that the current models undergo iteration and improvement to make them more accessible and affordable. Foremost, physicians need to remain in the middle of the healthcare delivery process. Placing this in the hands of others pushes patients one further step away from critical care givers. I believe that there will be consensus building within the US bipartisan political machine and that better reform will be possible.
While we are not completely sure of the form that will take, it is clear that we will have to do more with less. That means that there will need to be greater efficiency, a quest for improved safety, and value of healthcare delivery. Pursing quality and performance measures will be critical. In the meantime, we need to ensure that we will not lose our vision for the future, and that we will continue to pursue critically important research, which will be our best insurance policy against arrhythmias. We also need to be sure that we improve our training and mentoring programmes for the next generation of practitioners.
What have been your most memorable clinical cases?
The ablation of complex cardiac arrhythmias, whether those are ventricular tachycardia or atrial fibrillation, under 3D ultrasound guidance combined with activation and voltage mapping, has provided the greatest fulfilment. This is particularly the case in patients who have given up. Being able to help those patients has been very rewarding. Of equal importance is the life-saving device therapy for ventricular arrhythmias. I remain very enthusiastic about the application of technology, but even more so about the development of techniques used in the EP lab. The development of those techniques provides the most memorable clinical cases.
Outside of medicine, what other interests do you have?
The majority of my outside interests are very much nested around my family. The greatest gift in my life has been my wife Janet and four sons, Ryan, Greg, Brad, and Aaron. To see them achieve in their own life’s endeavours has been most rewarding. Also, watching the next generation of our five grandchildren come along is of even greater importance. I believe we all have an obligation to leave the world a better place than what we have found. In raising my own children, our goal was to prepare them to go out and conquer the world. With our grand-children, we simply do not want them to be conquered by the world or its problems. There is a great role that we can each play in the lives of our own family members and others and should spend a substantial amount of our time pursuing those goals. Experience has to count for something, and it is best used in the improvement of our patients, families, and friends.
1998–present Professor in Medicine, Mayo School of Medicine
2009–present John M Nasseff, Sr, Professorship in Cardiology in Honor of Dr Burton Onofrio
1993–1998 Associate professor in Medicine, Mayo School of Medicine
1989–1993 Assistant professor in Medicine, Mayo School of Medicine
1987–1998 Assistant professor in Medicine, Duke University
1985–1987 Associate in Medicine, Duke University
1982Assistant chief resident, Internal Medicine, Duke University
1983–1985 Fellowship: Cardiology/ Electrophysiology, Duke University
1981–1983 Residency: Internal Medicine, Duke University
1980–1981 Internship: Internal Medicine, Duke University
1980Medicine: University of Utah College of Medicine, MD
1976Undergraduate: Brigham Young University, BA Chemistry, Summa Cum Laude, with highest honours
1971High School: Box Elder High School, Brigham City, Utah
Certification and licensure
1983–presentDiplomat American Board of Internal Medicine
1985–presentDiplomat American Board of Internal Medicine/Cardiology
1993–2012Diplomat American Board of Internal Medicine/Cardiac Electrophysiology
1989–presentMinnesota State Medical License #32505
1982–presentNorth Carolina Medical License #26340
2006Distinguished Service Award, Brigham Young University
2006Honorary Professorship, Dalian, China
1983Haskel Schiff Award in Internal Medicine, Duke University
1979–presentAlpha Omega Alpha
1976Graduated BA in Chemistry, Summa cum Laude
1976University Scholar Designation, Brigham Young University
1976Outstanding Undergraduate Biochemist, BYU
1975Phi Kappa Phi
Heart Rhythm Society, American Heart Association, American College of Cardiology
24 fellows trained
1,017 invited lectures
8 visiting professorships