Samir Saba, M.D., Interim Director
William Barrington, M.D.
David Schwartzman, M.D.
Raveen Bazaz, M.D.
Susan Brode, M.D.
Ogundu Ngwu, MD
Sandeep Jain, M.D.
Dr. Saba's current research work has focused on the phenotypic effects of gene overexpression or knockout in transgenic mouse models of heart failure and conduction abnormalities. He has also on-going research aiming at identifying the regional, cellular, and molecular mechanisms underlying the benefits attributed to cardiac resynchronization therapy, using a novel rabbit model of myocardial infarction and biventricular pacing. Barry London, M.D., Ph.D., has been an important collaborator of Dr. Saba's in this work. Dr. Saba is also conducting clinical research looking at the effects of genetic polymorphisms on outcomes in patients with heart failure requiring biventricular defibrillator implantation and in patients with hypertrophic cardiomyopathy. Dr. Saba is also the inventor of a new method to discriminate between life-threatening ventricular arrhythmias and the more benign supraventricular tachycardias. This novel method is being evaluated for possible incorporation in future generations of defibrillators. Of note, Dr. Saba is the recipient of the American College of Cardiology career development award in cardiac electrophysiology for the year 2001.
Dr. Barrington's main academic interests focus on teaching of fellows, medical residents and medical students the basics of cardiac electrical conduction and arrhythmia genesis. He is the program director of the electrophysiology fellowship program of the University of Pittsburgh. His research interests focus on the conduction and management of large multi-center trials of cardiac Implantable devices.
Dr. Schwartzman's work has focused on the pathophysiology and nonpharmacologic treatment of atrial fibrillation using a porcine model. Animal work involving ablation techniques that translates directly to the human electrophysiology laboratory is the continued focus of Dr. Schwartzman's investigations. Dr. Schwartzman is also conducting research focusing on the effects of genetic polymorphisms on outcomes in patients with atrial fibrillation. Other interests of Dr. Schwartzman's include but are not limited to studying the effects of alternate ways of pacing on cardiac hemodynamics and arrhythmia prevention.
Dr. Bazaz is initiating innovative animal research with the goal of linking cardiac anatomy, histology, and pathology to function. Dr. Bazaz is focusing his current efforts on studying the atria (upper chambers of the heart) but has already plans to study the more complex ventricular chambers.
Dr. Brode is the director of the outpatient cardiac device clinic. Her research focus has been on evaluating the efficacy and accuracy of newer tools, such as device programmers, on the follow-up of patients implanted with cardiac devices.
Dr. Jain's research interests focus on examining the potential triggers and markers for electrical storm in patients with implantable defibrillators using microarray genetic technology in patients who present with a high burden of ventricular. Also, Dr. Jain is interested in the role of cardiac resynchronization therapy in patients with narrow-QRS complexes, with the ultimate goal of expanding the indications for biventricular pacing to larger fractions of heart failure patients who might benefit from it.
Dr. Ngwu has research interests in the epidemiology of various cardiac conditions relating to arrhythmias. She is currently working on organizing a database of patients presenting with atrial fibrillation.
In addition to the abovementioned personal research interests of the individual faculty members of the electrophysiology section of the cardiovascular institute, numerous multi-center clinical trials are on-going at the University of Pittsburgh, which offer patients treated in the UPMC facilities great opportunities for potentially receiving today, the therapies of the future.
The following is a list of some of the electrophysiology clinical trials currently on-going at the University of Pittsburgh:
ACT REGISTRY
St. Jude Medical ICD Registry - National Registry of 5000 ICD patients
Data collected q 6 months for 24 months
ESTEEM-CRT
IDE - New Bi-V Indication - Narrow QRS Pts. with and ICD indication
(QRS < 120, EF < 35 %, NYHA Class III)- 6 Month Follow-up
HOUSECALL PLUS
Evaluation of a home monitoring St. Jude Medical ICD system -12 Month Follow-up
MADIT-CRT
IDE - New Bi-V Indication - NYHA Class I and II patients with an ICD indication 24 Month Follow-up
REDUCE
Evaluation of AutoIntrinsic Conduction Search vs. programmed AV Delay in relation to AT, AF, VT, FT, Inappropriate ICI therapy during AT/AF, Frequency of ICD therapy for VT/VF 3 Month Follow-up
RISK
Identify if the combined use of cTnT and BNP measured at baseline and follow-up can predict and risk stratify HF improvement and all cause mortality in pts. with CRT-D. Also includes proteomic analysis. 12 Month Follow-up
ULV Study - Upper Limits of Vulnerability Timing
Collection of high quality near and far field human EGMs from ICD leads during manual ULV determination for use in development of an automatic algorithm for ULV determination One day study done in the EP lab on ICD implant
VT STORM - GENE EXPRESSION IN ICD PATIENTS WITH ELECTRICAL STORM
Internal Study - Identify factors measurable from peripheral blood which are associated with periods of high ventricular arrhythmia burden, specifically gene expression in addition to levels of known markers of CHF - 3 Month Follow-Up
PREDICTORS OF RESPONSE TO BIV PACING IN HEART FAILURE
Internal Study - This study aims at identifying predictors of benefit from Biventriclular. Subjects are randomized in a 1:1 ratio to empiric vs. echo-guided LV lead positioning, and blood samples are obtained for analysis of genetic polymorphisms. - 12 month follow up
GENETIC PREDICTORS OF OUTCOME IN HYPERTROPHIC CARDIOMYOPATHY PATIENTS
Internal Study - Subjects and family members with known HCM are tested for ß-AR polymorphisms and common genetic polymorphisms that can contribute to the morphologic differences seen in this population. It is a prospective medical record review over a 4 year period. - Medical record information collected, no follow up visits
SHORT ATRIOVENTRICULAR DELAY PACING
Internal study - To examine the effects of temporary elevation of atrial wall stress by shortening of the AV delay in patients with dual chamber pacemakers, and to collect samples for analysis of genetic polymorphisms. - follow up at 30 days post enrollment.
OPTIMIZATION OF AV DELAY
Internal study to examine the impact of optimal atrioventricular delay programming in patients with dual chamber pacemakers and defibrillators, and to collect and store samples for analysis of genetic polymorphisms - follow up at 30 days post enrollment.
MERLIN PATIENT CARE SYSTEM IN-CLINIC PROGRAMMER EVALUATION (ARMS A AND B)
This is an evaluation of hardware, software performance and design and routine follow up duration of the Merlin PCS programmer in subjects who have been implanted with St. Jude Medical devices. - 1 visit, no follow up.
GDT2000 ACUTE RV AUTO THRESHOLD STUDY
This is the use of a non-implantable box to test the RV Auto Threshold feature that will be used in future implantable devices. The study device has an IDE and will be used during the clinically scheduled implantation of approved Guidant devices. - No follow up
BLOCK HF: BIVENTRICULAR VERSUS RIGHT VENTICULAR PACING IN HEART FAILURE PATIENTS WITH AV BLOCK
This is a prospective, multi-center, randomized, double-blind parallel controlled clinical study comparing right ventricular pacing to biventricular pacing in Class I,II and III heart failure patients with AV block. The study will determine if this cohort will benefit from the use of BIV pacing compared to RV pacing; this study has an IDE. - 24 month follow up or until approval, whichever comes first.
MEDTRONIC CONCERTO AT CLINICAL STUDY
This study assesses the safety of the Concerto system and the efficacy of atrial shock therapy in patients with a current indication for CRT and ICD therapy. The study device will be given an IDE (pending FDA submission). - follow up at 1, 3, and 6 months and every 6 months thereafter or until study closure.
OPTIMA
Extension of normal procedures done during an EP study. BP and echo obtained during intracardiac pacing in order to find the optimal pacing site. Subjects must have standard indication for EPS and/or RFA. Study participation during EP study only, no follow-up.
BACHMANN'S BUNDLE
Evaluation of pacing in the Bachmann's Bundle region will improve atrial function and ventricular filling compared to Right Atrial Appendage pacing. Subjects must have Class I indication for pacemaker implant. follow-up at 6 and 12 months.
GENETIC BASIS OF AF
Evaluation of DNA and serum markers in 2000 subjects-1000 with AF and 1000 without AF. One blood draw (3 tubes). No follow-up.
MASTER
Study to evaluate the predictive value of a Microvolt T-Wave Alternans test to risk-stratify patients who would benefit from ICD therapy. (Study fully enrolled)
MAPP
Sub-study of MASTER. Genetic testing of MASTER pts to determine if ICD patients with at least one LTVTE (life threatening ventricular tachyarrhythmic event) have gene markers for arrhythmia compared to ICD patients without LTVTEs. (Study limited to MASTER pts.)
LEFT ATRIAL APPENDECTOMY
Study to examine the outcome of surgical eradication of the left atrial appendage in patients referred for elective coronary revascularization. Randomized, single-blind study. Preop TTE, 1 hour holter monitor and blood draw. Itraoperative-right atrial sampling, LA appendectomy (if randomized to + LAA). 3 months post op- phone call interview. 6 mo follow-up TTE, 1 hr holter, blood draw.
LA MECHANICS
Study to evaluate the influence of atrial activation sequence and AV delay on the intrinsic mechanical properties of the left atrium as well as on left AV coupling. Subjects must have paroxysmal AF and be referred for RFA. Intracardiac pacing will be performed and measurements of heart chamber size and function will be taken. Study duration is during RFA, no follow-up.
SECONDARY PREVENTION OF AF
Study to examine the importance of RAAS inhibition therapy: (1) to confirm that RAAS inhibition reduces the incidence of AF recurrence, (2) to test the hypothesis that incidence of AF recurrence in the absence of RAAS inhibition is higher among pts with the D allele, (3) to explore the hypothesis that RAAS inhibition is more effective in patients with the DD genotype than in those with the DI or II genotypes. Drug (losartan) and no-drug arms of the study, follow up for 1 year.
ATRIAL TISSUE BANKING
Study to correlate atrial histology and gene expression with preoperative AF history, demographic data, cardiac structure/function, postoperative AF. Develop a tissue bank for further studies. Subjects must be referred for non-emergent heart surgery for standard indication. Blood will be drawn for DNA analysis, and residual atrial tissue banked for histology. No follow-up.