Progress in a Heartbeat

Igor Efimov bridges disciplines to advance cardiac therapies

In a world where 15 million patients suffer from cardiac arrhythmia (an irregular heartbeat), the work of Igor Efimov, PhD, could make a dramatic difference. “Arrhythmia kills about 400,000 patients a year in the U.S.,” says Efimov, and the number is expected to grow as the population ages.

From the time he began his graduate studies in his native Russia, Efimov, the Lucy & Stanley Lopata Distinguished Professor of Biomedical Engineering, has focused on electrical malfunctions of the heart. Now he is advancing potentially powerful new therapies to treat patients with cardiac arrhythmia, including a revolutionary painless, implantable defibrillator.

“Every heartbeat you have, from conception to death, is preceded by an electrical impulse,” Efimov observes. A variety of factors—fibrosis, genetic predisposition, even infections—can cause changes in the heart muscle, disrupting its electrical impulses and producing arrhythmia.

In his dissertation research, Efimov used computer simulations to investigate drug efficacy in treating the condition and found—unexpectedly—“that some drugs which are routinely used in fact increase chances of arrhythmia. At the time, it was not commonly accepted wisdom.” Given that traditional defibrillators often cause painful electrical shocks in patients, Efimov saw the need for a new kind of solution.

Now, with the aid of a National Institutes of Health grant, Efimov’s team has developed a prototype for a painless implantable defibrillator and plans to begin clinical trials of the device shortly. “The potential market is gigantic,” Efimov says. “Worldwide, there are probably 15 million patients. If we succeed, it could be an important contribution.” This summer, he spent two months in France as a visiting professor at the University of Bordeaux, preparing for the device’s clinical trial and researching further improvements to the therapy.

Efimov has a secondary appointment in medicine—in radiology and in cell biology and physiology at the School of Medicine—and his lab comprises both engineering and medical students. The interdisciplinary approach is indispensable, he believes, and in fact he helped to start a new university-wide NIH-funded training program in medical imaging for chemistry, biology, engineering and medical students. Says Efimov, “This is a unique program; it doesn’t exist anywhere else.”

“Worldwide, there are probably 15 million [afflicted] patients. If we succeed, it could be an important contribution.”

— Igor Efimov, PhD, Lucy & Stanley Lopata Distinguished Professor of Biomedical Engineering

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