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My research interest is at the interface of cardiac electrophysiology (EP) and other medical specialties to ultimately improve human health. Current collaborations include cardiothoracic surgery, radiology, radiation oncology, genetics, and obstetrics. I am a member of the Cardiac Bioelectricity and Arrhythmia Center (CBAC) at Washington University and have led development and testing of a noninvasive imaging system (electrocardiographic imaging, ECGI) to create three-dimensional maps of arrhythmias, with a focus on atrial fibrillation (the most prevalent arrhythmia worldwide) and ventricular tachycardia (the most common cause ofsudden cardiac arrest).
My transdisciplinary approach to solving clinical problems has brought me into close collaboration with radiation oncologists to develop an entirely noninvasive method to map and treat heart rhythm disorders, which is currently in Phase 1/Phase 2 testing (bringing radiation oncology into clinical EP to alleviate suffering from ventricular tachycardia) through work sponsored by the Barnes-Jewish Hospital Foundation. This approach has also allowed me to lead a team to develop a noninvasive method to study uterine contractions during pregnancy (bringing EP into obstetrics), though work sponsored by the March of Dimes. The ultimate goal of this research is to improve survival from preterm birth (the most common cause of infant morbidity and mortality worldwide).
Through better understanding of basic mechanisms of electrical physiology and innovative, collaborative, forward-looking ways to solve problems, the ultimate clinical application of my research effort is to tailor specific therapies for individual patients based on the unique characteristics of each arrhythmia or disease.
I am an Associate Professor of Radiation Oncology at Washington University in St. Louis where I serve as Chief of the Stereotactic Body Radiation Therapy (SBRT) service, and Director of Clinical Trials and Clinical Informatics. An overreaching theme to my research interests is the development and optimization of advanced radiotherapy delivery, with a particular focus on integrating and testing these methods with other specialties through collaborative, multidisciplinary clinical trials.
In my work with cardiothoracic surgery, I am the PI of an institutional trial exploring comprehensive outcomes after SBRT or surgery for early stage lung cancer, including development of patient selection models and piloting a bundled-payment model across the two disciplines. Through collaborations with medical oncology, I am a co-chair on cooperative group protocols (NRG BR001, LU002) exploring the safety and efficacy of SBRT as a means to improve survival for metastatic cancer, and PI of an institutional trial testing the novel combination of a PD-1 inhibitor with esophageal brachytherapy to enhance immune response in metastatic esophageal cancer.
In my first foray outside of cancer, I have partnered with cardiology in the development of a novel, totally noninvasive treatment for arrhythmia using SBRT. In this capacity, I am a co-PI on an ongoing investigator initiated institutional trial exploring the safety and preliminary efficacy of this treatment for high risk patients with refractory ventricular tachycardia.