Dr. Robert J. Myerburg Reflects on Career in Electrophysiology

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When Robert J. Myerburg, M.D. joined the University of Miami faculty in 1970, the field of cardiac electrophysiology was entering an exciting new era. “Being able to record the electrical activity inside the human heart was the turning point in diagnosing, treating and preventing dangerous arrhythmias,” said Dr. Myerburg, professor of medicine and physiology at the Miller School of Medicine. “I had the good fortune to be in a position to participate in this evolution.”

Robert J. Myerburg, M.D.

Dr. Myerburg discussed the advances of the past 50 years in an article, “Reflections on a Career in Cardiac Electrophysiology — Parallel Pathways and Intersections” in the 40th anniversary volume of Heart Rhythm, a publication of the Heart Rhythm Society. He was among the physicians practicing for at least 40 years who were asked to contribute to the project.

Dr. Myerburg is also the American Heart Association Chair in Cardiovascular Research, and former president of the Association of University Cardiologists, the Association of Professors of Cardiology, and the Association of Medical Subspecialties. He received an honorary doctorate from Oulu University in Finland in 2009.

Growing up in Baltimore, Dr. Myerburg became interested in cardiology at an early age, and in sudden cardiac death in particular, spurred by the early deaths of a family member, a neighbor, and the father of a friend in middle school. In medical school and postgraduate training, his mentors encouraged him to build both basic and clinical research and clinical skills.

“The interaction between research and clinical practice is a living and continuing relationship, which is bidirectional in nature,” he said. “My advice to fellows throughout the years has always been to include meaningful research experience into their development, whether bench, bedside, or population-based. Understanding research methodology, interpretation, and limitations is invaluable for clinicians.”

Dr. Myerburg’s early career was molded by a combination of experimental and clinical electrophysiology, community emergency response systems, and cardiovascular epidemiology. “These fields were complementary to one another,” he said. “The ability to conduct experimental electrophysiology was one of the main reasons I joined the medical school faculty here. In a curious example of institutional commitment, the Department of Surgery generously provided funding for establishing my research laboratory when I was recruited — with no strings attached.”

Significant advances occurred in electrophysiology in the 1970s and ‘80s, including the invention of the implantable defibrillator and ablation treatments for cardiac arrhythmias. Dr. Myerburg spent several years working intensively on mapping of the interventricular conduction system in an experimental model.

“My laboratory efforts led to many long conversations with my longstanding colleague, Dr. Agustin Castellanos, weaving his expertise in clinical electrocardiography and electrophysiology into new observations from the experimental observations and generating new ideas for the next projects,” he said.

Later in his career, Dr. Myerburg studied ion channel physiology, along with inherited genetic syndromes and acquired arrhythmias. “Our next steps include a better understanding of the genetics of common heart disorders,” he said. “We also need more research on the underpinnings of coronary artery disease to provide better risk assessments for individual patients.”