EP Lab Digest - January 2008 - (Page 17) JANUARY 2008 10-MINUTE INTERVIEW 17 10-Minute Interview: Mo al-Ahdab, MD and Sambit Mondal, MD Interview by Jodie Elrod rs. Mondal and al-Ahdab from Cypress Heart in Wichita, Kansas were recently nominated by a colleague for EP Lab Digest’s 10-Minute Interview. The person that nominated them said both Drs. Mondal and al-Ahdab “have taken Wichita by storm,” adding that “their perspective is new and fresh.” Seeing this person’s comments made me want to find out more information about these two special EPs! Keep reading to learn their stories. D clinics and two days for procedures. I cover three major hospitals and two smaller ones here in Wichita. My group also pulls patients from the whole state of Kansas, as we have 13 outreach clinics. Since day one, I have worked with the EP lab leadership at Via Christi to build their confidence and experience in performing pediatric EP cases. They are wonderful and passionate about EP. I have opted not to perform any invasive procedures in the very young patients, since we do not yet have the setup and backup needed to handle its complexity. I have teamed up with my partner, Dr. Sambit Mondal, in performing adult and pediatric cases. In addition, I was blessed with hiring a smart and dedicated pediatric nurse practitioner, Jenny Ecord, who has been a great asset to my practice. My practice has grown much faster than I initially expected. My goal is to continue to provide excellent medical care no less than any established academic practice. before and you will learn how to approach it correctly. I think one major challenge here in Wichita is that we do not have an established pediatric cardiovascular surgical program, so we refer all our surgical cases out to surrounding centers.This adds to the inconvenience and anxiety levels of parents of children with congenital heart defects who require surgical repair or interventional procedures. Are you currently involved in any pediatric EP-related research? Yes.We are actively participating as a contributing center in a registry that investigates the safety of sports participation for individuals with an implantable cardioverter-defibrillator (ICD). This study is based at Yale University.Some of these young patients with ICDs do participate in vigorous activities despite the guidelines to refrain from doing so.The risk is unknown on a large scale. The pediatric EP market is obviously much smaller in comparison to adult EP. Having said that, I would like to see companies pay more attention to our needs. Mo al-Ahdab, MD, FAAP What advancements do you hope to see in the field of pediatric electrophysiology in the next five years? What specific areas of EP and/or patient care need more attention? I would like to see more affordable comprehensive genetic testing available for diagnosis of congenital arrhythmias, a better profile of cryoablation technology with similar cost to RF catheters, Stereotaxis being used in more pediatric EP cases, as well as a better understanding and successful ablation results of complicated atrial tachyarrhythmias in adults with congenital heart defects. The pediatric EP market is obviously much smaller in comparison to adult EP. Having said that, I would like to see companies pay more attention to our needs. One specific area that is growing quickly is the management of arrhythmias in adults with congenital heart defects. Mo al-Ahdab, MD, FAAP Why did you choose to work in the field of pediatric electrophysiology? Describe your medical background. My passion for the field started in medical school,during the time I was learning how to read electrocardiograms. During my residency training in pediatrics at the University of Illinois at Chicago, I was exposed to some patients with arrhythmia issues that were medically treated. When Dr. Mark Ovadia joined the program and started to perform EPS and ablations on these patients, I was amazed how a life of a patient can change from one where they were taking one or two anti-arrhythmics to being drug-free and symptom-free after their procedure. During my cardiology fellowship, I knew this was what I wanted to do. I was fortunate to spend the next two years in the world of EP. In my first year at the University of Michigan,I had the pleasure of working with Dr. Macdonald Dick and Dr. Peter Fischback in Ann Arbor.They cemented my interest in electrophysiology and provided invaluable mentoring and guidance during my early career.Afterwards, I pursued more training at Children’s Hospital in Boston, where I further expanded my knowledge and experience by working closely with great faculty and seeing more complicated cases. Name one of the most unusual pediatric EP cases you have ever worked on. There are many. One that stands out in my mind involved a baby who was born with severe Ebstein’s anomaly and severe heart failure, and required ECMO support in the cardiac ICU. He developed incessant SVT that was not controlled with antiarrhythmics. He was taken to the EP lab on ECMO and all the ICU support, and had an EP study and radiofrequency catheter ablation.He had a right-sided accessory pathway mediated tachycardia. He underwent successful RF ablation of the accessory pathways. I learned plenty of things from that case: the pathology, the process, the difficulties and the results. Describe your role as pediatric electrophysiologist at Cypress Heart and Via Christi Regional Medical Center. What is a typical day like? My role is very unique.There is a definite need for my specialty in the state of Kansas, as no other person with this background is practicing in the state. Most cases used to be sent out of town to be treated. Most pediatric EPs establish their practice at a children’s hospital. I found a great potential here in Wichita to build such a practice and to develop many aspects of it. My group is very supportive — they share my vision to become a good resource of care for patients in need. At Cypress Heart, I established a practice that includes general pediatric cardiology care and specialized electrophysiology care. I have two full-day clinics, two half-day What advice can you offer to others who want to a build a successful pediatric EP program? Stay tuned, and always be prepared and detailed. Find a good mentor who is willing to support you and do not hesitate to seek his input, advice and help. Be patient and persistent.Always be available and nurturing. The change on a mother’s face from anxiety to pleasure after a successful procedure on her child is really priceless. What aspects of your work do you find most rewarding? What aspects are most challenging? The fact that I always learn something new every week is what I love about my specialty. I picked up early on in cardiology training that no matter how much you have seen or read about before, there is always something new that you have not seen What is the best advice you have received so far in your medical career? Be humble to the fact there is always someone else that knows more and that sometimes you have to say “I do not know, but I will find the answer.”
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