|Sumeet Mainigi, MD, FACC, FHRS. He holds the Laptop pressure monitoring device. It was part of a clinical trial Einstein was involved in that measured left atrial pressure in patients with heart failure. Einstein was the only hospital in Philadelphia involved in the clinical trial.|
|Photo by Wesley Hilton|
Perspectives: What’s new in cardiac electrophysiology (diagnosing and treating heart rhythm disorders)? What can be done now that couldn’t be done earlier in the field?
Dr. Mainigi: The field has exploded and advanced dramatically in the last few years. We can now very precisely target and destroy arrhythmias, and offer patients effective control or cure of these potentially life-threatening problems. We can really change peoples’ lives. And the best thing about it is that these procedures are faster and more effective than ever before.
For example, catheter ablation for atrial fibrillation (an irregular rapid heartbeat) used to take up to eight hours. Now, it’s about a two-hour procedure, with better effectiveness and better safety. Aggressive treatment can radically improve lives.
Perspectives: Can you give us an example of a new procedure or device that exemplifies this kind of radical change?
Dr. Mainigi: In addition to our standard work with catheter ablation procedures and pacemaker and defibrillator implantation, we’ve actually branched out to other areas: for example, implantation of the Cardiomems™ pressure sensor. We have established a multidisciplinary team of electrophysiologists, interventional cardiologists and heart failure doctors and nurses and nurse practitioners to identify patients with advanced heart failure—people who are the highest users of our hospital system, the people who are readmitted to the hospital over and over again with too much fluid overload.
We implant this sensor into an artery in the lungs. It takes only 20 to 30 minutes to put in, the patient goes home, typically the same day, with a remote monitor that will communicate wirelessly with this device to record their blood pressure, record the flows of their heart, and transmit them to us so that we can adjust their medications, maybe get them seen in the office more frequently if we need to, and then keep them out of the hospital. Studies have shown that this device helps to keep people out of the hospital without decompensated heart failure, and it actually extends lives. We’re happy to be using that device quite frequently right now.
We were part of the clinical trial that led to its approval. We were one of the first sites to get access to it. It is slowly being rolled out at other centers around the city and across the country. Not everybody has it yet.
We have a lot of exciting avenues were moving into.
Perspectives: How did you get into this field?
Dr. Mainigi: I was always attracted to cardiology. I studied biomedical engineering and chemical engineering in college, so when I got to medical school the heart just made sense. It was a pump; it was a mechanical device to some extent. I initially thought I was going to do interventional cardiology, the treatment of heart disease with stents and so on. That was partly because of my background. I did a lot with material science and drug delivery and things like that.
But then I ended up doing all of my training at the University of Pennsylvania, and while I was there I got exposed to the field of electrophysiology. It was easy to get excited by the field because Penn has one of the best training programs in electrophysiology in the country. I was completely enthralled by the crossroads of advanced technology and medicine. Again, it appealed to my background. You had these devices—pacemakers and defibrillators—that could save lives, that required a good understanding of how they worked in order to do so. And then you had catheter ablations and the advanced mapping technology that went along with it. They were using these new GPS-like technologies that often had come out of the defense industry but were now being applied to medical care. It was very exciting. I also was excited by a field in which I could offer patients a cure of their illnesses rather than just medications and chronic treatment. I got a feel that 10 years ago, when I was making my career decision, I was at the crossroads of a field that was about to explode, that I was on the cusp of something that was going to be exciting—and that turned out to be 100 percent true.
Perspectives: Why did you come to Einstein?
Dr. Mainigi: When I was looking for jobs back in 2006, I was very lucky that I was in a position where I was graduating very well-trained in the field of electrophysiology. The jobs were plentiful. I had my choice of going to almost any hospital in the Philadelphia region or nationally because everyone wanted to build this program up.
What I saw at Einstein was a unique opportunity. Einstein is this little powerhouse of a hospital that does tremendous things, has outstanding doctors, and provides opportunities that you’d only see at other very, very large academic institutions.
We have very well-trained and educated faculty here who like to be on the cutting edge of new things, and that’s an important thing in cardiology, to be able to bring in new technologies, new research studies to advance the field. What I saw here was an opportunity to create a program that would rival almost any program in the region.
On top of it, I just liked the "small hospital" mentality. You get to know people here. Everything is about relationships, and I liked the fact that the same people who we work with every day, and who administer things are also patients of mine. I take care of them and their families. It’s a nice environment to work in. Nobody ever leaves this place—it’s a unique thing. I have nurses and nurse practitioners that I’ve worked with my entire time at Einstein, and many of them were born at Einstein. This was my first job. I would not be surprised if it’s my last job. That’s unusual to say in medicine these days.
Perspectives: What’s your favorite movie?
Dr. Mainigi: True Colors. It’s an older movie. It has John Cusack, and it’s a story of these two guys who become friends in law school, and it follows them over the course of the rest of their careers as they intertwine in their lives. Their perspectives change, and they see their values being questioned, and the moral lines in the sand that they don’t cross move as time goes on. I’ve always loved that storyline of seeing how lives progress.
Perspectives: Favorite book?
Dr. Mainigi: I’m a voracious reader. I have a lot that I like. I will half-jokingly say that there are two different ones I really love. One is Life after Life, and then the kid in me loves the Harry Potter series. I’m reading it now for the third time with my youngest daughter. The journey through life is what I think is interesting, the loss of innocence, and the progression to adulthood as you realize what the world is like around you.
Perspectives: What is one thing that people might not know about you?
Dr. Mainigi: The thing that most people probably don’t know about me is that I practice mindfulness meditation, which I started doing in the recent past, and it has been a wonderful experience, almost life changing.