10-Minute Interview: Dr. Lynne Hung

Dr. Lynne Hung is a cardiac electrophysiologist with Mission Internal Medical Group in MissionViejo, California. Tell us about your medical back- ground and how you came to work in the field of electrophysiology. What interested you about this field?    I attended the University of Southern California (USC) for medical school and Loma Linda University Medical Center for my internal medicine residency. While in residency, I discovered my interest in cardiac electrophysiology (EP). I learned that a simple heartbeat can reveal so much about a patient’s heart condition. I admired the patience and analytical skill that is required in a good cardiac electrophysiologist. With the correct diagnosis, any arrhythmia is potentially curable — not many physicians can say that about the diseases they treat. After my cardiology fellowship at USC, I did my cardiac EP fellowship at Harbor UCLA - Good Samaritan Hospital in Los Angeles. I went to private practice for about 8 months before joining Scott & White / Texas A & M University Medical Center as a full-time EP faculty. I subsequently became the Associate EP Fellowship Director. After several years at Scott & White, I returned to Southern California and joined Mission Internal Medical Group. Describe your role as an electro- physiologist at Mission Internal Medical Group. What is a typical day like for you?    Mission Internal Medical Group is a multispecialty group with 50-60 physicians. I practice 100% EP in my group. I am the newest member and I joined the group in February 2010. I share EP call with another electrophysiologist, Dr. Aseem Desai, in my group. I typically do hospital rounds between 7:30-8:30am, and my clinic begins at 8:30am until 4:30pm. I see new hospital consults as well as schedule simple EP procedures between patients and after my last clinic patient. I have a full day of EP procedures once a week, and I often do complex ablation on that day. What is one of the more unusual EP cases that you have ever worked on?    I approach every case as an unusual case, and this keeps me from missing important diagnoses. However, one particular case comes to mind when talking about unusual cases. I saw a 72-year-old female with documented atrial tachycardia for several years. The P-wave on surface EKG during tachycardia was identical to her sinus rhythm P-wave. Furthermore, the intracardiac atrial electrogram sequence during tachycardia appeared to be very similar to sinus rhythm. It could be argued that it was sinus tachycardia, but the tachycardia could be induced by atrial pacing and could be pace terminated. On close analysis of the intracardiac tracing, the atrial signals showed subtle changes in polarity during tachycardia. We diagnosed her as having sinoatrial reentry tachycardia, which is a rare arrhythmia. She underwent successful ablation. From this case, I learned that very subtle clues can give you the diagnosis. What aspects of your job are most challenging? How do you stay motivated in the lab?    Because I only recently started this job, I believe the most challenging aspect is developing a practice, which includes obtaining referrals. I find EP fascinating, and for this reason, I am never bored at my job. I am constantly motivated to learn new procedure and techniques. By keeping up with the latest literature, I feel that I am learning all the time in the EP lab. Tell us about your research interests. Are you currently involved in any research initiatives or clinical trials?    I am interested in basic science research. My master’s thesis was on oxidative stress; I would like to develop a protocol looking at oxidative stress in the heart during atrial fibrillation. Currently, I am one of the investigators in the leadless ICD clinical trial. In addition to your work as an electrophysiologist, are you currently involved in any writing projects?    I recently finished writing a chapter on AV nodal ablation with Dr. Stephen Huang for the textbook Catheter Ablation of Arrhythmias. What advancements do you hope to see in the field of cardiac electrophysiology in your lifetime?    Like most electrophysiologists, I would like to see a cure for atrial fibrillation and ventricular tachycardia. I hope future technology will help us to improve our ablative success rate and to reduce procedure time. What advice would you give to others in EP who are currently at the start of their career?    I believe the field of EP is rapidly growing and that technology will push us to new frontiers. My advice is to keep an open mind and constantly keep up with the literature. As I have always told my fellows, it is not about you trying to prove your skills, it’s about the patient underneath the drapes. There is nothing wrong with asking for help on a procedure. It is all about doing the right thing for the patient. Has anyone in particular been helpful to you in your growth as an electrophysiologist? In addition, what medical textbooks or online EP resources have you utilized that you can recommend?    Dr. Shahbudin Rahimtoola has taught me to be a caring and compassionate doc- tor. His guidance has led me to become an electrophysiologist. Dr. Stephen Huang essentially taught me EP. He taught me about the subtlety in intracardiac tracings and tricks of catheter ablation. More importantly, he taught me to appreciate EP. Dr. Rahimtoola and Dr. Huang are my greatest resources. In addition, I find two textbooks to be very helpful: Clinical Cardiac Electrophysiology by Mark Josephson, and Catheter Ablation of Arrhythmias by Stephen Huang and Mark Wood. I also search for articles in Pacing and Clinical Electrophysiology, the Journal of Cardiovascular Electrophysiology, and the HeartRhythm Journal for answers. Is there anything else you'd like to add?    It is an exciting time to be an electrophysiologist. EP is truly a comprehensive field, combining surgery, imaging, and internal medicine into one area.