10-Minute Interview: Peter S. Fischbach, MD, MA

What prompted your move to Children's Hospital of Atlanta (CHOA)? The cardiology program at Children's Healthcare of Atlanta Sibley Heart Center is an expanding, exciting group in a dynamic big city. The opportunities for clinical research and busy clinical service were very inviting.

How did you get into the field of pediatric electrophysiology (EP)? What do you like best about working with pediatric patients? Prior to medical school I knew I wanted to go into pediatrics. During medical school, I became very interested in cardiovascular physiology. I completed a combined MA/MD program, spending a year with Dr. Peter Corr using patch clamp techniques to investigate the mechanisms of arrhythmia initiation during ischemia. During cardiology training, I had the pleasure of working with Dr. Macdonald Dick in Ann Arbor. He cemented my interest in electrophysiology and provided invaluable mentoring and guidance during my early career. Regarding the pediatric patients, while it frustrates many physicians, I like taking care of entire families.

What pediatric patient case was most challenging or memorable for you? I recently had a very difficult ectopic atrial tachycardia that was rather disabling to the patient. The two medications that were effective for suppressing the arrhythmia were sotalol, which resulted in a resting heart rate of 40 and significant fatigue, and verapamil, which led to treatment-limiting constipation. After 18 months of trying, we eventually were able to ablate the focus, and she has returned to full activities.

Cryoablation was used in pediatric patients at your previous institution. Is cryo utilized at CHOA? What has been your success rate with cryo? We will be using cryo at CHOA. We have a manuscript that should be published soon; it will report on our early results (first 90 cases) using cryoablation, which were equivalent in efficacy to RFA for AVNRT and septal accessory pathways.

What advice can you give for those just starting out in the field of EP? Keep your eyes and ears open. Find the person you admire most in the field (Macdonald Dick for me), and then pick their brain all day, every day. Finally and most importantly, don't be afraid to ask for help, particularly from your adult colleagues.

What research or clinical goals to you hope to achieve at CHOA? Are you currently involved in any research projects? We hope to expand the clinical service and continue to provide state-of-the-art, cutting-edge clinical care. We will be continuing research investigating biventricular pacing in children, as well as rate response algorithms and alternative ablation techniques.

You have been a frequent contributor at the Heart Rhythm Society scientific sessions. Will you also be presenting at the upcoming American Heart Association meeting? Nothing at this year's AHA meeting; however, I do have an abstract regarding short QT syndrome at the upcoming American Academy of Pediatrics meeting.

Is there anything else you'd like to add? I feel very fortunate to have worked at the University of Michigan, and am very excited by the new opportunities at CHOA.