Dr. Nabil El-Sherif, Director of the Cardiology Division, VA New York Harbor Healthcare System, Brooklyn Campus
By Dr. Margaret Dessau
Many years ago, Dr. Michael Simberkoff, Executive Chief of Staff, VA New York Harbor Healthcare System, coined the term, "Translational Domain.” Dr. Simberkoff was describing the remarkable ways in which medical research findings translate into medical practice and meaningful health outcomes to benefit patients.
A shining example of a doctor whose work showcases that very practical goal, Dr. Nabil El-Sherif, Director of the Cardiology Division at VA New York Harbor Healthcare System’s Brooklyn Campus, has made several outstanding contributions to improve the management of cardiac rhythm disorders.
Dr El-Sherif diagnoses and treats two main groups of patients. The first group are patients who would experience palpitations, dizziness or fatigue and other non-life threatening symptoms. These are usually caused by atrial tachycardia, atrial flutter, and atrial fibrillation. These rhythm disorders can be cured in up to 99 percent of the time by a procedure Dr. El-Sherif and others have developed over 20 years ago called trans-catheter radio frequency ablation.
The second more serious rhythm disorders occur in patients, where ventricular tachycardia or ventricular fibrillation may result in sudden death. This usually occurs in patients with organic heart disease, with weakened left ventricular heart muscle such as in ischemic coronary artery disease or cardiomyopathy.
Thirty years ago, working on a long experimental series, Dr. El-Sherif discovered that some of the arrhythmias causing these deaths were caused by an electrical mechanism that he labeled as a “figure of eight reentry” and that’s how it became named. He wryly notes that Paul McCartney borrowed that title, "figure of eight" for a song some years later (without, of course, an acknowledgement that the title was borrowed.)
The problem in treating patients at risk of ventricular tachycardia/ventricular fibrillation/sudden cardiac death is the difficulty in predicting which patient with heart disease is at high risk and then intervening quickly enough to prevent a crisis by implanting an internal defibrillator. “There is no single or combined series of tests at this time to precisely predict high risk patients, says Dr. El-Sherif. His basic and clinical research over the years have helped to introduce several non invasive sudden cardiac death risk predictors to clinical practice such as signal average EKG and T-wave alternans.
Over the last 20 years, Dr El-Sherif and his staff at VA’s Brooklyn Campus have implanted the defibrillator in hundreds of patients at risk of sudden cardiac death. The key problem is that only 25-35 percent of patients with these devices are saved from arrhythmic death while the majority of patients die from other causes such as heart failure, cancer, etc, without the device ever been used. This is costly “redundant” therapy. Therefore, he is currently working on finding more effective risk identifiers.
A researcher and clinician who loves his work, Dr. El-Sherif says “It’s fun. I have written over 450 original papers, reviews, and book chapter on various aspects of disorders of cardiac rhythm, their diagnosis and proper management.
Dr. El-Sherif is a recipient of The American College of Cardiology Distinguished Science award for 2016, in recognition of his major contributions in the Translational Domain, to the advancement of scientific and clinical knowledge in the field of heart arrhythmias. Dr. El-Sherif is very happy to receive recognition both for himself and for VA.
An internationally recognized expert in the field of basic and clinical cardiac electrophysiology, Dr. El-Sherif is proud to be the only cardiologist with a main appointment at VA to be a recipient of this top cardiology award. The award that was initiated by the college in 1982 had so far been awarded to only 55 cardiologists both in the US and Europe. “This is a great acknowledgment of the quality of VA medicine!” says Dr. El-Sherif.
