Atrial Fibrillation
 RESOURCES FOR PATIENTS

A-Fib News

May 14, 2008 Dr. Andrea Natale has joined Texas Cardiac Arrhythmia in Austin, Texas. His web site is: http://tcaheart.com/physicians/andrea-natale-md

April 9, 2008 (Good news for A-Fib patients with Chronic [constant] A-Fib.)  The first clinical trials focusing on ablation of Chronic A-Fib have begun in the US. The study, known as the Tailored Treatment of Permanent Atrial Fibrillation (TTOP AF) is sponsored by Ablation Frontiers (http://www.AblationFrontiers.com). It uses three innovative catheters with multiple electrodes to produce a variety of different ablations depending on the needs of the patient. Preliminary data show an 80% success rate after two ablations with relatively short ablation times. The purpose of this study is to make effective ablation for Chronic A-Fib available and feasible to all EPs in all clinics. 25 centers will be participating in these Chronic A-Fib trials. For a more detailed, technical description of this study, go to http://www.ablationfrontiers.com/webdocuments/acc-poster-march-20-2008.pdf.
    Patients will be randomly selected into two treatment groups: for every three patients who apply, two will receive ablation therapy, the third drug treatments. The trial allows patients in the control (drug treatment) arm to receive an ablation if they do not respond to drug therapy (a likely occurrence).
    (This may be a major medical breakthrough for patients with Chronic A-Fib. In the past, medical centers were often reluctant to ablate patients with Chronic A-Fib, because they were more difficult to cure. Some centers, for example, had rules excluding patients who had Chronic A-Fib for more than one year. But with the progress of these Chronic A-Fib clinical trials, most centers will be able to ablate Chronic A-Fib patients with a success rate similar to Paroxysmal (occasional) A-Fib patients.)
    If you wish to participate in the this Chronic A-Fib clinical trial, here is contact information. (In the E-mail addresses replace the "at" with "@." The "@" is written out as "at" to prevent access by automated spam search engines.)

March 14, 2008 Dr. Andrea Natale, formerly at the Cleveland Clinic, will be joining the doctors at Texas Cardiac Arrhythmia, P.A. (Texas Cardiovascular) in Austin, TX. Currently he is also working at the Northern California Heart Center/California Pacific Medical Center

December 20, 2007 Vice-President Dick Cheney was diagnosed with A-Fib and successfully Electrical Cardioverted back to normal sinus rhythm at George Washington University Hospital November 27, 2007.¹¹³

December 11, 2007 Roche Diagnostics (maker of the Coumadin home monitor CoaguChek) would like to interview A-Fib patients about Coumadin self-testing, and will reimburse you $50 for your time.
    "Patients on Coumadin (warfarin) who self-monitor at home (or are interested in self-monitoring) are invited to participate in a 30-minute phone interview to discuss their experience with using a monitoring device at home. Questions will focus on patient needs, perceptions and reasons for choosing to self monitor. Please contact Julie Cousens at 619-261-4170 or juliec@davickassociates.com by December 31 if interested in participating. " Information on the CoaguChek is available at www.poc.roche.com.

November 11, 2007 Dr. Andrea Natale is now treating A-Fib patients in San Francisco. Here is his contact information:
Dr. Andrea Natale. Dr. Steven Hao, Dr. Richard Hongo
Northern California Heart Care/California Pacific Medical Center
2100 Webster St., Suite 516
San Francisco, CA 94115
    Appointments: Salwa Beheiry, (415) 925-7153, Fax: (415) 925-7792, E-mail: salwa.beheiryrn [at] gmail [dot] com
 

October 19, 2007 The A-Fib community is shocked to learn that the Cleveland Clinic did not renew Dr. Andrea Natale's contract. There is no word yet where Dr. Natale will work, or where A-Fib patients can be treated by him. For more information see http://www.cleveland.com/news/plaindealer/index.ssf?/base/news/119131405528890.xml&coll=2 . You can leave messages for Dr. Natale at his E-mail address andreanatalemd(at)gmail(dot) com.

September 1, 2007 Dr. Peng-Sheng Chen is moving from Cedars-Sinai in Los Angeles to become the new director of the Krannert Institute of Cardiology at Indiana University.

August 19, 2007 FDA APPROVES GENETIC TESTING LABELING FOR COUMADIN
    The FDA's new labeling for Coumadin will explain that people's genetic makeup may influence how they respond to the drug. In the Precautions section, "Periodic determination of PT/INR is essential. (See DOSAGE AND ADMINISTRATION: Laboratory control.) Numerous factors, alone or in combination including changes in diet, medications, botanicals, and genetic variations in the CYP2C9 and VKORC1 enzymes (see CLINICAL PHARMACOLOGY, Pharmacogenomics) may influence the response of the patient to warfarin."¹⁰⁵
    Genetic variants of the CYP2C9 and VKORC1 genes are individually responsible for anywhere from 35% to 50% of the variable dose response to warfarin, FDA officials say. But the agency stopped short of requiring physicians to use the test: there are no adequate clinical trials proving that genetic testing improves warfarin's safety profile; testing is also not universally available. The CYP2C9 gene is involved in drug metabolism such that certain variations permit the drug to remain active in the blood for longer. The VKORC1 gene represents the site of action of warfarin such that gene variants could affect patient sensitivity to the drug.
    The FDA estimates that 2 million persons start taking warfarin (the generic of Coumadin) in the U.S. every year to prevent blood clots, heart attacks and stroke. Warfarin is the second most common drug--after insulin--implicated in emergency room visits for adverse drug events.
    The FDA's "personalized medicine" initiative may further the study and application of pharmacogenomics---the science that predicts a response to drugs based upon a person's genetic makeup. Healthcare providers may use genetic tests to improve their estimate of what is a reasonable warfarin dose for individual patients. Warfarin is only the second drug in which specific pharmacogenetic details have been used in the label relating to drug dosing. However, this is the first time a widely used agent like warfarin has included these types of genetic details.
    (Author's Note: If your doctor puts you on warfarin (Coumadin) and does not test you for the above gene variations, you should probably get a second opinion. The tests cost between $125 and $500 and are fairly widely available. These tests could save you heart problems related to under- or over-dosing of warfarin.)
(See http://www.sciencedaily.com/releases/2007/08/070817113120.htm) (Thanks to Larry Kushman for calling our attention to this article.)
   

August 12, 2007 (The author recently received contact information for A-Fib patients who wish to participate in the FDA clinical trials of the CryoCath balloon catheter. (In the E-mail addresses replace the "at" with "@." The "@" is written out as "at" to prevent access by automated spam search engines.)

July 18, 2007

    The French Bordeaux group now uses a five-step process to treat Chronic A-Fib.
    1. They start by isolating the Pulmonary Vein openings. They also eliminate potentials at the base of the Left Atrial Appendage, but do not isolate or electrically disconnect the whole of the LAA which could possibly lead to clots forming in the LAA and A-Fib stroke. (Ablating at the base of the LAA as part of the first step in treating A-Fib is a new approach and may become a very important first step in the ablation treatment of A-Fib.)

    2. Next they make a roof line linear ablation linking the Right Superior Pulmonary Vein with the Left Superior Pulmonary vein opening to create complete electrical block

3. They then work in the Inferior Left Atrium and the Coronary Sinus. They make an incomplete blocking line between the Right Inferior and Left Inferior PVs in order to slow down the rapid atrial electrical activity.

They treat the Coronary Sinus as though it were another heart structure or Left Atrium, rather than just another vein opening. They disconnect the CS from the Left Atrium and ablate potentials along the Mitral Annulus. They also slow down Coronary Sinus electrical activity by ablating both inside and outside the CS with a lower wattage power, usually 25 Watts. (Treating the Coronary Sinus as another Left Atrium is a new approach. Most current A-Fib ablation procedures tend to stay away from the Coronary Sinus because of the risk of Stenosis (swelling). The French Bordeaux group, by using a low wattage, irrigated tip catheter, ablates within the Coronary Sinus without damaging it.)

4. The fourth step is eliminating organized atrial activity in areas such as:

Anterior Left Atrium & Left Atrial Appendage

Septum

Posterior Left Atrium

Superior Vena Cava

Right Atrial Septum

5. The fifth step is to create a Mitral Isthmus blocking linear ablation line from the Mitral Annulus to the Left Inferior PV. The goal is to eliminate all potentials along this line.

In practice, even after these five steps, rapid atrial activity often remains. It has to be mapped, traced to its source and ablated. Often the top of the Left Atrial Appendage has to be ablated.

This whole procedure requires a great deal more time, effort, persistence, skill and experience than normal left ablation procedures. (Author’s note: Please be advised that this five-step process for treating Chronic A-Fib is relatively new and isn’t available today at most A-Fib medical centers.)

June 20, 2007 An interesting article from the Houston Independent Media Center suggests that President George Bush may have Chronic A-Fib http://houston.indymedia.org/news/2004/12/35839_comment.php#45166.

June 16, 2007 The first local A-Fib support group will meet in Newport Beach June 26 at 3:00 pm. Our host has graciously offered her home and a light supper. For further info contact Joyce at jarintime (at) yahoo.com (the "@" is written out as (at) to prevent access by spam mailing lists).

June 1, 2007 Warfarin bests aspirin for stroke prevention in elderly A-Fib patients
    Results of the Birmingham Atrial Fibrillation Treatment of the Aged trial show that even among A-Fib patients older than 75 years, warfarin was superior to aspirin for primary stroke prevention without a significant increase in hemorrhage risk. (16th European Stroke Conference.) [31 May]
 

May 25, 2007 LOCAL A-FIB SUPPORT GROUPS FORMING.
    Are you interested in forming or participating in a local A-Fib support group? Our goals would be to share our experiences with A-Fib, get advice, learn about new developments, and form friendships with others who understand what A-Fib is like. Those who have been cured of A-Fib are also encouraged to join (and perhaps volunteer to mentor a new A-Fib-er). We'd meet for informal lunch or dinner, or an evening mixer with a speaker.
    We are trying to set up the first local A-Fib support group in the greater Los Angeles/ Southern California area. If you are interested in participating in this local A-Fib support group or in forming an A-Fib support group where you live, contact Joyce at jarintime(at)yahoo.com (the @ is written as "at" to prevent access by spam mailing lists).

May 25, 2007 A-FIB DECREASES MENTAL ABILITIES
    Men with A-Fib had lower levels of cognitive performance compared to men in normal sinus rhythm in the Framingham Offspring Study. This may be due to the reduced cardiac output and decreased blood flow to the brain in persons with A-Fib. Multiple cognitive abilities were tested over a wide age range (37-89 years).
     "...A-Fib may be one of a number of risk factors for conversion from mild cognitive deficit to dementia."⁹⁸ In a previous study persons with chronic A-Fib had a 3-fold risk of cognitive deficit compared with persons in normal sinus rhythm.⁹⁹
    There were too few women with A-Fib for analysis in this study. However, in a previous study women with A-Fib had a higher prevalence of dementia and cognitive impairment.¹⁰⁰ (Thanks to Darrel Seife for calling our attention to this study.)
    (Author's Note: This is an important study, especially for those in Chronic A-Fib. The option of simply staying in A-Fib while controlling the rate and taking blood thinners to prevent stroke may no longer be acceptable, because of the risk of mental impairment and dementia from A-Fib.)

May 13, 2007 Cox maze operation for patients with Chronic A-Fib. People with Chronic long-standing A-Fib and large left atria were generally thought not to benefit from a Maze operation. This Cox maze operation, which also utilizes supplemental RF ablation, cuts out sections of the atria to reduce atrial size and improve ejection fraction.⁹⁷

May 6, 2007 Dr. Shephal Doshi of St. John's Health Center in Santa Monica, CA performed what may be the first visually guided catheter ablation for A-Fib, using  the investigational "Visually Guided Endoscopic Ablation System." A steerable catheter with fiber optics and a transparent dome at the end works as a video camera using infrared signals to see through the blood in the heart  The system was developed by CardioFocus, Inc. of Marlborough, MA. For more info call (508) 658-7200 or visit http://www.cardiofocus.com.⁹⁶ For a list of the 20 medical centers participating in the clinical trials of this system, go to: http://www.cardiofocus.com/afib_trial_enable.htm

April 26, 2007 Additional centers participating in the CryoCath balloon catheter trials are: Bay Heart Group, Iowa Heart Center, Massachusetts General Hospital, Mayo Clinic, Virginia Commonwealth Medical Center Baylor Heart and Vascular Hospital, Arrhythmia Associates/Inova Research Center, Stanford Hospital, Quebec Heart Institute/Laval Hospital. See Cryo Cath balloon catheter trials.

April 16, 2007 The University of Chicago Hospitals announces new developments in their treatment of A-Fib. Joining their staff are: Drs. John F. Beshai, Martin Burke, Bradley P. Knight, and Al Lin.

March 21, 2007 A gentleman from India with A-Fib needs financial help in getting a Pulmonary Vein Ablation (Isolation) procedure. If you have the financial means to help him (or if you have any contacts in India), his E-mail address is: alexander_john123@yahoo.com. 

February 8, 2007 The A-Fib ablation doctors formerly associated with Riverside Methodist Hospital/MidOhio Cardiology have moved to the Ohio State University. Their new address is:
The Ohio State University
DHLRI, Suite 200
473 W. 12^th Avenue
Columbus, OH 43210-1252
(877) 478-2478
    Dr. Emile G. Daoud, Dr. Ralph S. Augostini, Dr. John D. Hummel, Dr. Steven J. Kalbfleisch, Dr. Raul Weiss

January 19, 2007 CRYO BALLOON CATHETER ABLATION TRIALS TO BEGIN
     Dr. Walter Kerwin of Cedars-Sinai Medical Center in Los Angeles and Dr. Christopher Cole of Colorado Springs Cardiologists will begin clinical randomized FDA trials of the Arctic Front-TM balloon CryoAblation catheter made by CryoCath Technologies Inc. Patients receiving Cryo (freezing) balloon ablation will be compared to patients taking antiarrhythmic drug therapy (Sotalol, Rhythmol or Flecainide).
    For every three patients, two will be randomly assigned to receive a CryoCath balloon ablation, while the third will take drug therapy (a 2:1 randomized ratio). After 90 days, patients in the drug therapy group who are still in A-Fib (a likely occurrence) can cross over and receive a CryoCath balloon ablation. Patients will be followed carefully during a one year follow-up.
    (To this author, Cryo ablation seems to be significantly safer for patients than standard RF ablation. However, Cryo ablations currently take more time to perform than RF ablations. The Cryo balloon catheter will likely allow a doctor to perform a Cryo ablation and isolation of the Pulmonary Vein openings more easily and much faster than current methods. The Cryo balloon catheter may become a major improvement in the treatment of A-Fib. It has already been approved in Europe, with close to 100% success rate in isolating the PVs, and 75-80% success in keeping patients free of A-Fib without anti-arrhythmic drugs.)
    The trial will be covered by most good insurance policies that provide for clinical research participation. Patients will not be paid or separately charged by the clinical trial for participation. If you're interested in participating in this Cryo balloon catheter ablation trial for A-Fib, here is the contact info:
Cedars-Sinai Medical Center
8631 W. 3rd. St., Suite 1017-E
Los Angeles, CA 90048
(310)-289-5901
    Dr. Walter Kerwin
Colorado Springs Cardiologists
2222 N. Nevada Ave., Ste 4007
Colorado Springs, CO 80907
(719) 634-6671
    Dr. Christopher Cole
   
The Ohio State University
DHLRI, Suite 200
473 W. 12^th Avenue
Columbus, OH 43210-1252
(877) 478-2478
    Dr. Emile G. Daoud, Dr. Ralph S. Augostini, Dr. John D. Hummel, Dr. Steven J. Kalbfleisch, Dr. Raul Weiss
    (There will be twenty different centers in the US participating in these cryo balloon ablation randomized trials. That info will be published here as it becomes available.)
    (Added April 26, 2007: Other centers participating in the CryoCath balloon trials are: Bay Heart Group, Iowa Heart Center, Massachusetts General Hospital, Mayo Clinic, Virginia Commonwealth Medical Center, Baylor Heart and Vascular Hospital, Arrhythmia Associates/Inova Research Center, Stanford Hospital, Quebec Heart Institute/Laval Hospital.)

November 1, 2006 Stereotaxis announces Initial U.S. Clinical Usages of Cardiac Ablation Catheter with Company's Niobe R) System. The Niobe system utilizes a computer-controlled magnetic field to remotely steer a magnetic ablation catheter that applies a consistent, "soft-touch" contact with the heart which may reduce the risk of perforation during ablation procedures.⁹⁴

October 21, 2006 A study comparing the Pappone Circumferential Anatomical PV Isolation procedure with an integrated approach using both the Pappone method followed by a Segmental ablation (with electrophysiological confirmation of PV disconnection) was found to be more effective than the Pappone method alone. "Electrophysiological confirmation of PV disconnection could be a useful marker of successful RF treatment of A-Fib."⁹³

October 14, 2006 In a major medical breakthrough the French Bordeaux group reported a 95% success rate in curing Persistent/Chronic A-Fib.⁹² See Jaïs Chronic A-Fib.

August 5, 2006 According to a Wall Street journal article by David Armstrong, four patients are known to have died after having the AtriCure (Wolf) Mini-Maze surgical operation to cure A-Fib.⁹¹

August 5, 2006 According to a Wall Street Journal article by David Armstrong, surgeons at the Cleveland Clinic may have or may have had extensive financial ties to manufacturers of medical equipment these surgeons use to treat A-Fib patients.⁹¹

June 11, 2006 Dr. Andrea Natale and the Cleveland Clinic now call their catheter ablation procedure to cure A-Fib "Pulmonary Vein Antrum Isolation (PVAI)." This procedure still involves making circumferential lesions around the outside of the PV openings.

June 11, 2006  Low-dose steroids have been reported to prevent recurrence of A-Fib, possibly because they suppress systemic inflammation.⁸⁵

June 10, 2006 "The Journal of Thoracic and Cardiovascular Surgery has admonished a Un. of Cincinnati surgeon (Dr. Randall K. Wolf who developed the Wolf Mini Maze operation for A-Fib) for failing to disclose financial ties to AtriCure, the West Chester, (Ohio) maker of heart-surgery equipment he and other researchers evaluated in a published study." Cincinnati Business Courier and The Wall Street Journal December 28, 2005. ⁸¹ "An AtriCure filing with the SEC in August, (2005) reports Dr. Wolf owns 18,402 shares of company stock (approximate current value $140,000) and has warrants or options to purchase 13,913 additional shares of stock. (ArtiCure's recent stock price was $7.60.) In November, AtriCure reported a four-year royalty agreement with Dr. Wolf that will pay him a minimum of $200,000 a year up to a total of $2 million over the entire length of the agreement."⁸¹

June 6, 2006 Flecainide or propafenone can be safely self-administered by outpatients for control of recurrent atrial fibrillation. This "pill-in-the-pocket" approach resulted in fewer emergency room visits. http://www.medscape.com/viewarticle/495111?rss, New England Journal of Medicine 2004;351:2384-2391.

May 27, 2006 Obesity (BMI over 30) and Smoking, but not Age, affect reoccurrence rates of A-Fib after ablation. Dr. Dimpi Patel of the Cleveland Clinic hypothesized that obese patients have larger left ventricles, often due to hypertension or diabetes, and left atrial dilation, resulting in an increased substrate (structure of the heart). These conditions may lead to reoccurrence of A-Fib after ablation.
    In a Mayo Clinic study by Dr. Jared Bunch reoccurrence rates were basically the same for patients under 50, between 50 and 65 years old, and over 65. (Studies presented at the Heart Rhythm Society 2006 Scientific Sessions in Boston, MA. http://www.theheart.org/article/706883.do

May 24, 2006 The long-term use of warfarin appears to increase the risk of bone fractures in men (not women). Warfarin prevents coagulation by blocking the vitamin K-dependent activation of certain clotting factors. Because vitamin K is also used to activate osteocalcin and other bone matrix proteins, "vitamin K antagonists might increase the risk of osteoporotic fractures." The study also found that taking beta-blockers decreased the risk of fractures, perhaps because they increase bone mass. (Archives of Internal Medicine, Jan. 23, 2006.) http://www.medscape.com/viewarticle/522264

April 23, 2006 "Bottom Line Health," Vol. 20, number 5, May, 2006. "Aspirin vs. stroke. Because aspirin can cause bleeding, it is typically avoided by people who have had a hemorrhagic stroke, which occurs when a blood vessel bursts in the brain. New Finding: In a study of 207 hemorrhagic stroke survivors, those who took an antiplatelet drug, such as aspirin, were not at increased risk for another hemorrhage. Implication: Aspirin therapy may be appropriate for hemorrhagic stroke survivors who are at high risk for heart attack or ischemic stroke, in which a blood clot blocks blood flow to the brain."

April 15, 2006 The Cleveland Clinic has an E-Clinic Consult program that allows patients to receive a second opinion and start the registration process at the Cleveland Clinic. In cooperation with your cardiologist, all records pertaining to your A-Fib are sent to the C.C. for evaluation. An extensive medical questioner is also completed. Then all the data are evaluated by the C.C. cardiology staff. If deemed a candidate for ablation, the pre-registration process is then completed, and a procedure date is given for the ablation. The current fee is $565.

January 28, 2006 Dr. Christopher Cole of Colorado Springs Cardiologists will be starting CryoCath balloon trials in the spring of 2006.

 December 1, 2005 Resolution Research wants to interview people who have had A-Fib for at least eight months and who have declined or discontinued the use of Coumadin. The interview will last from 45-60 minutes, and you will receive $50 as a thank you. The purpose of the interview is to develop info for a new anticoagulant drug.
    Contact Wendy Maynard at 800-800-0905 or by E-mail Wendy (at) re-search.com.

    November, 2005 A recent report from England suggests that the veterinary antibiotic "Lasalocid" found in eggs and poultry meat may cause or trigger A-Fib.
    Lasalocid is given as a feed supplement to certain farm animals particularly poultry as a preventative treatment against "coccidiosis"---an infectious disease caused by a parasite which damages the birds' intestines and causes illness and sometimes death. Outbreaks of coccidiosis are likely to occur when large numbers of animals are crowded together in warm and moist conditions. Lasalocid is considered a "highly toxic heart poison. ...It belongs to a group known as the ionophores, all of which are potent heart poisons many of which are in regular use in animal feed."⁶⁵ (Thanks to Richard Gee of the UK for providing this info.)

    June, 2005 Dr. Moussa Mansour of Massachusetts General Hospital reports that MGH now uses a mapping system called Carto-Merge to do PVIs. This  system incorporates an MRI (or a CT) of the pulmonary veins with real-time electroanatomical mapping. This image integration provides the operator with significantly better navigation of the left atrium and thus a safer and more effective procedure.

    January, 2004 Australia and New Zealand now has a doctor from the French Bordeaux group practicing in Australia. Here is his address:
AUSTRALIA
Royal Perth Hospital
Wellington St., Perth 6000
Perth, Australia
(+618) 9224 2388
Fax: (+618) 9389 5261
E-mail: ruk(at)ziplip.com (the @ is  written out as "at" to prevent it from being accessed by spam mailing lists)
    Dr. Rukshen Weerasooriya

    We also have names but not complete addresses of doctors in England doing Pulmonary Vein Ablation (Isolation) procedures:

ENGLAND
King's College Hospital Cardiology Dept.
London SE5 9RS
E-mail: francis(at)sinusrhythm.com (the @ is  written out as "at" to prevent it from being accessed by spam mailing lists)
    Dr. Francis Murgatroyd (Starting May 1, 2004. Dr. Murgatroyd is currently at Papworth Hospital, Cambridge CB4  1BX till the end of April, 2004.)   
    (The author apologizes for not having more info on England. The author has heard of three other doctors in England but does not have their addresses. They are:
    Dr. D. Wyn Davies, St. Mary's Hospital, Imperial College of Science, Technology and Medicine, London
    Dr. Jaswinder S. Gill, St. Guy's and Thomas' Hospital, London (NHS patients) and London Bridge Hospital, London
    Dr. Steve Furniss, Newcastle Freeman Hospital)

April 25, 2003 Massachusetts General Hospital Tribute to Dr. Brian McGovern

Brian McGovern, MD: Remembering a physician, colleague and friend
 

Every seat in the O'Keeffe Auditorium was taken April 19. Two overflow rooms were filled beyond capacity. The aisles of the auditorium were crowded with people craning to see the podium and hear the words of remembrance for a beloved and world-renowned cardiologist, Brian McGovern, MD (right), who was killed April 8 in a senseless tragedy that stunned and saddened the hospital community. The memorial service, which was designed for McGovern's patients, also included colleagues, family, friends and MGH employees who came to hear eloquent words and heartfelt messages about the man who touched so many lives in his extraordinary 23-year career at the MGH.

"We can't put a good face on this terrible tragedy, but every time I think of Brian – which will be often – I will aspire in that moment to be a little more patient, a little nicer, a little more like the ideal that he personified," said David Torchiana, MD, chairman and CEO of the Massachusetts General Physicians Organization. "If that can happen a thousand times to all of us, maybe a million times over the years, I believe this world might be a better place."

With McGovern's widow, Anne Jennings, MD, and one of their daughters, Caitriona, in the audience, Torchiana introduced the service, which also included tributes from physicians, colleagues, patients, friends and family members of McGovern. While each shared personal anecdotes, tearful remembrances and even a few light-hearted memories, a common theme surfaced: McGovern was a brilliant physician who possessed the precious gift of genuine compassion and empathy for all he came into contact with – patients, friends and colleagues alike.

"When you met him, he made you feel like you were so important to him and that he was so happy to see you," said Guillermo Sosa-Suarez, MD, a colleague of McGovern's at St. Peter's Hospital in Albany, NY. "He drew people to him. They liked him because of his skills as a physician and because of his personal warmth."

During his tenure at the MGH, McGovern grew into a master clinician and was well known as a doctor's doctor – a physician who many colleagues confided in, consulted with and looked to for advice and wisdom. He built one of the largest referral practices in New England and was widely known as an expert in cardiac arrhythmia.

He was a sought-after lecturer, a highly respected teacher and, in addition to his commitment to patient care, he devoted much time to important clinical research. For many years, he served as medical director for the Ellison 10 Cardiac Step-Down Unit. Every Wednesday, McGovern traveled to Albany, NY, to see patients at the highly successful outreach arrhythmia program that he had founded and built. But beyond the impressive credentials and the lauded achievements, McGovern was what Torchiana described as a "good man" who was highly accomplished yet humble and self-effacing.

"Despite his incredible accomplishments, Brian never took himself too seriously, which is what we loved most deeply about him," said Jeremy Ruskin, MD, a colleague of McGovern's in MGH Cardiology and a close friend. "Everyone knew him for his sense of humor, which was kind-hearted and borne of intelligence and generosity. He was always funny, but his humor was never at anyone's expense. He was able to defuse countless difficult situations with his humor."
 

For Ruskin, this memorial tribute was a deeply personal one. Ruskin first met McGovern in 1981 when the young medical school graduate came to the MGH from Ireland to interview for a fellowship. During McGovern's training at the MGH and his subsequent career, Ruskin grew to rely on him for his insightful medical expertise and thoughtful advice. "Brian was my student, but he became my teacher," said Ruskin. "I'll always be grateful for his friendship, his loyalty and everything that he taught me. A piece of each of us is lost with Brian, but a part of him is alive in all of us. As we try to take care of each other – as he did so often for us – we must continue the extraordinary work he did with such grace, skill and generosity."

It is that extraordinary work of providing the highest quality patient care that was honored by McGovern's patients, who also spoke of his compassion, caring and commitment to the many people who walked into his exam room.

Bud Mueller, MD, was one of those patients. Mueller credited McGovern for saving his life and saving the lives of thousands of other cardiac patients. "His expertise and kindness gave and continue to give individuals and families the ultimate gift – the gift of time," he said. "His work improved beyond measure the quality of time for patients by decreasing the anxiety that is part of the condition that patients and their families must endure. Brian delved into his life's work in a way that showed compassion, caring, respect, empathy and love. We should try to do the same. If we can try to make the world a better place, we can honor Brian, his wife, his children, his MGH team, and then Brian can live on in an important way through each of us whose lives he enriched."

While McGovern touched the lives of many of his patients and his physician colleagues, the staff of the Arrhythmia Service, Electrophysiology Laboratory, the Ellison 10 Cardiac Step-Down Unit and the entire Cardiology Division also are particularly feeling the void left by the loss of a cherished colleague and friend.
Katie Lynch, RN, a nurse from Ellison 10, spoke of the profound impact McGovern had made on the step-down unit staff, both professionally and personally. "He cared for his patients with the utmost respect and compassion," she said. "He elevated our practice to do our very best work. Personally, he made us better because his happiness and love of life were evident and contagious. His presence in our lives was a gift from God, and we will try to honor his memory by caring for patients as he had taught us."
 

While many spoke about McGovern's dedication to his career and his unflagging support of his colleagues and friends, many also spoke of his deep devotion to his family. Although, McGovern's time was filled with caring for patients, consultations with colleagues, preparing lectures and teaching future clinicians, he always found time for his wife and two daughters. "Brian had two passions in life," said Sosa-Suarez. "One was his passion for medicine. The other was his passion for his family. Those of us who were privileged to be close to him knew this. He loved his wife and daughters. Everyone knew how important they were to him."

As McGovern's MGH family continues to struggle to make sense of this unbelievable tragedy, many of his patients, friends and colleagues now are embarking on the daunting task of beginning the healing process.

For those who were so deeply touched by his loss, Rev. Felix Ojimba of MGH Chaplaincy offered words of consolation and prayer: "We now must come together and be free to feel our grief, release our emptiness and treasure our memories – conscious of our inability to prevent the death of one we so loved. As we gather here to comfort and support one another, nothing can separate from us Brian's legacies that now live in and among us."
 

Dr. Jeffrey E. Olgin moving to UCSF
    Dr. Jeffrey E. Olgin of the Krannert Institute of Cardiology in Indianapolis, IN is moving to the Un. of California San Francisco June 1, 2003. He will be the Chief of Cardiac Electrophysiology. UCSF will have an A-Fib Center. He has been performing PVA(I)s since 1997 and has done several hundred. Among other initiatives he will study the genetics of A-Fib. He is moving his NIH-funded lab on researching the mechanisms of A-Fib to UCSF and will start an A-Fib research group.
    His address will be:
    Dr. Jeffrey E. Olgin
    University of California San Francisco
    Cardiac Electrophysiology
    500 Parnassus
    MU E4/Box 1354
    San Francisco, CA 94143
    Tel: 415-476-5706
    E-mail:olgin(at)medicine.ucsf.edu (the @ symbol is written out to prevent automatic search engines from accessing this address to spend spam)