Cardiology; Clinical Cardiac Electrophysiology
I am a clinical cardiac electrophysiologist and my focus and passion are in evaluating and managing cardiac arrhythmias and their associated symptoms such as palpitations and syncope. I treat patients with bradycardia, heart block, supraventricular tachycardia (SVT) including atrial tachycardia, atrioventricular nodal reentrant tachycardia (AVNRT) and atrioventricular reentrant tachycardia (AVRT), atrial fibrillation (AF) and ventricular tachycardia.
My main clinical responsibilities include diagnostic and therapeutic procedures for arrhythmias such as electrophysiologic studies and ablation of arrhythmias such as atrial flutter, AF, SVT and ventricular tachycardia. I perform implantation and extraction of cardiac implantable electronic devices (CIEDs) such as pacemakers, implantable cardioverter defibrillators (ICDs) and biventricular pacemakers and ICDs for the treatment of certain patients with heart failure. I also perform laser lead extraction in patients with malfunctioning or infected pacemaker and ICD leads. I believe in extensive pre- and post-procedural care and provide in-depth consultation and close communication with my patients, referring physicians and staff. I closely monitor my post-implant patients through the use of remote monitoring systems and I am a strong advocate for appropriate reprogramming to accommodate the needs of patients with CIEDs.
I evaluate and treat inpatients with cardiovascular disease and other cardiac disorders at Buffalo General Medical Center (BGMC) as part of the Cardiac Critical Care Unit and the cardiology consult service and at the Buffalo VA Medical Center (Buffalo VAMC). I also see outpatients at various sites, including the BGMC Heart and Lung Center, UBMD Internal Medicine Electrophysiology Clinic and the Buffalo VAMC Electrophysiology Clinic.
I am involved in the RE-CIRCUIT clinical trial. It evaluates treatment using the drug Pradaxa in patients with paroxysmal or persistent nonvalvular atrial fibrillation (NVAF) who are scheduled to undergo a first ablation procedure. I also have a research interest in using imaging techniques to delineate patients with infection who might require extraction of CIEDs. By the innovative use of PET scan techniques, physicians can differentiate pacemaker lead infection versus fibrosis. The goal of this research is to help physicians decide whether patients really need laser lead extraction or if the procedure could be avoided.
I enjoy teaching. I lecture on arrhythmias in various forums, including continuing medical education classes, and to a variety of trainees, including medical students, residents and fellows as well as other health professionals in internal medicine and emergency medicine. I supervise cardiology fellows during their clinics, inpatient consultation and electrophysiology rotations at BGMC and the Buffalo VAMC.