Internal medicine residents Angela Khidhir, DO, and Ronak Bharucha, DO.

Internal medicine residents Angela Khidhir, DO, left, and Ronak Bharucha, DO, won the top two prizes in the 2023 Shark Tank Challenge sponsored by the New York State Chapter of the American College of Cardiology.

Residents Take Top Spots in Cardiology Innovation Contest

By Dirk Hoffman

Published February 6, 2024

A pair of trainees in the Department of Medicine’s internal medicine residency program in the Jacobs School of Medicine and Biomedical Sciences won the top two prizes in the 2023 Shark Tank Challenge sponsored by the New York State Chapter of the American College of Cardiology (ACC).

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For Angela Khidhir, DO, her first-place finish marked a repeat of her 2022 win in the competition.

Ronak Bharucha, DO, claimed the second-place prize in the 2023 competition, where participants had to submit an idea for an innovation in cardiology.

Khidhir and Bharucha were among the four finalists selected to present their ideas before a panel of judges aboard the Cloud Nine IV Yacht last fall in New York City.

Novel Use of Cardiac Electrophysiology

Khidhir’s winning presentation was titled “Conduction Tissue Tomography: A New Look into Cardiac Electrophysiology.” She received $3,000 and a certificate of achievement.

Cardiac electrophysiology is the field of study focused on diagnosing and treating heart conditions that affect the electrical activity of the heart muscle.

“It is a very intriguing field, and it is one that I am strongly considering,” Khidhir says. “I always found it fascinating how an exchange of ions across two layers of phospholipid molecules can generate an electrical impulse that can be propagated across the entire heart, translating into coordinated, timed, muscular contractions, and those contractions are so powerful they allow the blood to circulate all over the body, beat after beat.”

Tomography is based on producing a three-dimensional image of the internal structures of a solid object by noting the differences in the effects on the passage of waves of energy impinging on those structures, Khidhir explains.

“It works in a similar way as ultrasound waves, except that in tomography, we use light waves,” she says.

New Way to Visualize Conduction System

optical coherence tomography image of Purkinje fibers.

This optical coherence tomography image of Purkinje fibers is an example of what Khidhir's innovation aims to produce. Adapted from: Jenkins M, Wade RS, Cheng Y, Rollins AM, Efimov IR. Optical coherence tomography imaging of the purkinje network. J Cardiovasc Electrophysiol. 2005 May;16(5):559-60. doi: 10.1046/j.1540-8167.2005.30621.x. PMID: 15877631.

The technology has been used in ophthalmology to visualize the retina, the part at the back of the eye consisting of all the nerves. It was later developed to visualize the inside of the coronaries, the arterial vessels around the heart, to help understand the anatomy of the walls of those vessels and the diseases that develop inside them.

“My idea is based on using this same technology to visualize another part of the heart, and that is the electrical conduction system,” Khidhir says.

“Some of the heart muscles are specialized to conduct electrical currents across the heart, generating contractions, and allowing the heart to beat. There are many disorders related to the conduction system of the heart. However, many times we do not fully understand the structural defects, if any exist, associated with these disorders.”

Currently, the only way to visualize the conduction system is to take a sample of it, either through a cardiac biopsy, which is rarely performed due to the invasive nature of it, or in an autopsy.

“My goal with tomography is to be able to visualize this conduction system in a live beating human heart.” Khidhir says. “If we understand what normal tissue should look like, then we can identify any structural changes associated with conduction tissue disorders, which would allow us to develop methods to fix them.”

Only ‘Airtight’ Innovation Ideas Need Apply

Khidhir says although she also won the 2022 competition, each year’s contest is independent from previous years, so she did not feel she had any advantage other than being familiar with the format and the type of questions one may be asked.

She did say she feels the innovative ideas must be “airtight” to have a chance at being successful.

“It does not matter how big or small it is. What matters is that it serves a purpose or fulfills an existing need, is scientifically plausible, and is feasible to create, distribute, and use, allowing better care for our patients,” she says.

“If you can demonstrate all of that, then you would leave no room for the judges to poke holes into your project. That is the recipe to win,” Khidhir adds.

Smartwatch Can Aid Defibrillation Attempts

An image from a Powerpoint presentation depicting the “ShockWatch.”.

An image from Bharucha’s PowerPoint presentation for the competition depicts usage of the “ShockWatch.”

Bharucha received $2,000 and a certificate of achievement for the second-place finish of his project titled “ShockWatch.”

Sudden cardiac arrest is a life-threatening emergency that occurs when the heart suddenly stops beating. As a result, it can lead to death in minutes if the person does not get help right away. For every minute that passes, survival odds decrease by 10%, he explains.

While the most effective way for a bystander to treat sudden cardiac arrest is defibrillation using an automated external defibrillator (AED), barriers such as cost, accessibility, and user friendliness can pose limitations to care, Bharucha adds.

“Thus, the ShockWatch is a smartwatch that monitors atrial and ventricular arrhythmias and can help coordinate and deliver defibrillation,” he says. “It utilizes a wrist strap that houses an external battery and AED case that will have folded AED pads with microleads inside which will plug into the side of the watch dial.”

“Once the microleads are plugged into the watch, AED mode and AED App will be activated with voice commands and analysis to advise for placement of pads and when to shock.”

Training ‘Advances Science Behind Medicine’

Bharucha says his second-place finish in the competition “proved to be a humbling and invaluable opportunity to showcase my knowledge and creativity among innovative leaders in the field of cardiology across NY state to better patient care.”

Originally from northern New Jersey, he obtained his DO degree from the Rowan University School of Osteopathic Medicine in Stratford, New Jersey.

Bharucha says he wanted to attend an internal medicine residency program that would equip him with the proper tools to excel as a physician and serve others in a diverse community like that of Buffalo.

“Through its unique emphasis on research, clinical education, and diversity and inclusion, the program at University at Buffalo has challenged me to become the best version of myself,” he says.

“In particular, the program’s commitment on a university level to fostering innovation and personal development has provided me with the opportunity to work with amazing mentors and pursue unique research efforts aimed towards advancing the science behind medicine,” Bharucha adds. “And it has provided me with a stepping stone to pursue a career in cardiology.” In fact, Bharucha will be starting his cardiology fellowship this July at SUNY Upstate Medical University in Syracuse, New York.