GoKawiilDr. Melvin Scheinman
Photo credit: Marco Sanchez, UCSF
Forty years ago, patients with abnormal heart rhythms had few treatment options: frequently ineffective medications, or open-heart surgery.
UCSF cardiac electrophysiologist Melvin Scheinman, MD, now the Walter H. Shorenstein Endowed Chair in Cardiology, spent years developing a new approach. In 1981 he performed the first catheter ablation in humans, threading a catheter through a blood vessel into the heart and successfully delivering an electric shock to short-circuit the arrhythmia. That innovation has revolutionized the care of millions of patients worldwide, relieving their suffering and even curing many of their arrhythmias.
“Dr. Scheinman’s contribution to the field has been one of the most transformative in all of electrophysiology,” said Jeffrey Olgin, MD, Ernest Gallo-Kanu Chatterjee Distinguished Professor in Clinical Cardiology and chief of the UCSF Division of Cardiology.
Treating Arrhythmias without Surgery
Dr. Scheinman arrived at UCSF in 1965 as a cardiology fellow, drawn by exciting research underway at the Cardiovascular Research Institute, as well as the chance to work with leaders such as electrocardiographer Maurice Sokolow, MD, chief of the Division of Cardiology, and Lloyd Hollingsworth “Holly” Smith, Jr., MD, legendary chair of the Department of Medicine.
After fellowship, Dr. Scheinman joined the UCSF faculty, and founded the Coronary Care Unit (CCU) at San Francisco General Hospital (SFGH). That experience fueled his fascination with heart rhythm disorders. In the mid-1970s, he spent a sabbatical year at Duke University working with cardiac electrophysiologists Harold Strauss, MD, and John Gallagher, MD. “I learned about fundamental electrophysiology, and how to do mapping of heart rhythm disorders in humans,” said Dr. Scheinman.
The idea for catheter ablation evolved from the surgical experience of treating arrhythmias. “Surgeons could open the heart and find the key areas in the electrical system in patients who had very, very severe heart rhythm disorders like atrial fibrillation with very rapid rates,” said Dr. Scheinman. “They destroyed the conducting system that allowed impulses to go from the top of the heart to the bottom.” While this could help control atrial fibrillation, many patients were ineligible for the surgery because they would be unable to withstand such an invasive procedure. “The idea was to devise a way to put a catheter in through a vein, pass it into the heart, and do the same thing that surgeons did – only without opening the heart,” he said.
He spent the next three years pursuing this vision. Until this point, catheters had only been used to detect electrical signals in the heart for diagnostic purposes. Dr. Scheinman conducted experiments to identify catheters that had sufficient strength to carry large electrical currents that were powerful enough to strategically destroy heart tissue. “It was a whole different use for these electrode catheters,” he said.
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