Letter from the Section Editor: Innovative Collections
DOI: 10.19102/icrm.2011.020313
Brian Olshansky, MD, FHRS, FACC, FAHA
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Innovative Collections
The prospective, adequately powered, double-blind randomized placebo-controlled clinical trial has evolved to become the gold standard methodology by which we measure the efficacy of a therapy. Despite this, advancements in medicine hardly originate from such methodologies. We, in electrophysiology, have witnessed an explosive growth is diagnostic modalities, risk assessment, therapeutic interventions, technological advancements and innovative approaches that are by any standard remarkable and groundbreaking.
Consider from where we have come: from early explorers who discovered re-entry (and, in some cases have perished in the process); to pioneers who have invented devices in their garage; to draft dodgers who attempted to place catheters inside the heart attempting to induce arrhythmias just to see what happens; to dedicated doctors who developed new devices to save lives with defibrillators and cardiac resynchronization therapy; to investigators who have lived on the edge and tested radiofrequency catheter ablation as a methodology to cure arrhythmias; to engineers who developed new tools for electro-anatomical mapping; to technologists who have further perfected the art of catheter positioning and ablation; to investigators who have explored the autonomic nervous system; to clinicians who have tested new drug therapies; to basic scientists who have carefully defined mechanisms responsible for arrhythmogenesis and sudden cardiac death; and to clinicians who have explored unknown territories (to attempt to cure atrial fibrillation)…
We, electrophysiologists, are an odd lot, and yet we have come a very long way in a very short time. Many of the accomplishments of our predecessors have been performed without a double-blind, placebo–controlled trial to prove the benefit and yet many of the investigated approaches were ultimately shown to be the case. Clinical cardiac electrophysiology demands a dedication to novel thinking. And while many of these fanciful ideas have gone by the wayside, ultimately, it is our destiny that has been molded by this commitment to Innovation.
Living on the edge is part of our profession, a part that distinguishes us from other areas in medicine, and most of us love it just this way. We chose our field because of its rapid advancement and tremendous innovation that takes place on an almost daily basis. Our ability to think outside of the box- and be comfortable with it- is a big part of what makes us unique and has crafted our profession into what it is today. Innovation continues despite the challenges faced in today’s practice and is critical for the continued advancement and perfection of treatment options for our patients.
As such, on behalf of Dr. John Day, the editorial board, and my section editor colleagues, I am greatly honored to personally introduce the newly created Innovative Collections Section within The Journal of Innovations in Cardiac Rhythm Management. This section will publish real-world clinical experiences from our colleagues around the globe, within engaging manuscript categories of Unique Image Reviews, Complex Case Studies, and Clinical Decision Making Perspectives. Selected articles will also receive digital integration within the Innovations in Cardiac Rhythm Management website, www.InnovationsinCRM.com, to enhance published content through animated streaming video and to exceed other media presentations.
As Section Editor, I look forward to further examining select contributions that embody this spirit of electrophysiology. All article formats will be considered, including didactic lectures or case based reviews that discuss new uses for devices, implications of FDA decisions, new and/or expanded guidelines and emerging techniques/technologies, to name a few.
My goal is to provide a taste of what is yet to come within this section, as we live on the edge of new approaches in electrophysiology. We would be grateful to receive any of your manuscript contributions, image reviews, clinical videos for the Innovations website or ideas that have the potential to further advance this field, as we realize, of course, that not every innovation will come to pass.
Within the current section, please enjoy an original contribution from Drs. Mulpuru, Holland and Narayan on the topic of an adenosine responsive narrow complex tachycardia. This report teaches us an important lesson: the earliest site of activation recorded may be the responsible for an atrial tachycardia, but is not always the case. When a wide area appears to have early activation, consider that the origination of the tachycardia has yet to be identified. When assessing the mechanism of a supraventricular tachycardia, sometimes the etiology is obvious but occasionally it is necessary to think on our feet, and most assuredly, to think outside the box.
I am certain you will enjoy the Innovative Collections section each month and look forward to continuing our goal of driving innovation to enhance patient care.
Brian Olshansky, MD, FHRS, FACC, FAHA
E-mail: brian-olshansky@uiowa.edu
Professor of Medicine
Cardiac Electrophysiology
University of Iowa Hospitals
Iowa City, Iowa
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