5 Questions

Andrea M. Russo, MD, emphasizes importance of learning, collaboration

For this issue, Cardiology Today spoke with Editorial Board Member Andrea M. Russo, MD, FACC, FAHA, FHRS, professor of medicine at Cooper Medical School of Rowan University, director of electrophysiology and arrhythmia services, director of the Clinical Cardiac Electrophysiology Fellowship Program and director of cardiovascular research at Cooper University Hospital in Camden, New Jersey, and president of the Heart Rhythm Society.

Russo received her medical degree from SUNY Upstate Medical Center in 1985 and completed her internship and residency at the Medical College of Pennsylvania from 1985 to 1988. She completed fellowships in cardiology and electrophysiology at Cooper in 1992 and then spent 5 years at Robert Wood Johnson Medical School. Between 1997 and 2008, she was a member of the faculty at the University of Pennsylvania School of Medicine and was director of the electrophysiology laboratory at Penn Presbyterian Medical Center. She returned to Robert Wood Johnson (now Cooper Medical School of Rowan University) in 2009.

Andrea M. Russo

In addition to holding many positions with HRS, including being a member of the executive committee and the board of trustees, Russo is also a member of the American Heart Association’s Get With the Guidelines Atrial Fibrillation Clinical Work Group, a member of the American College of Cardiology Cardiovascular Disease in Women Committee and a member of the American Board of Internal Medicine Cardiovascular Board. She has written or co-written numerous peer-reviewed journal articles, abstracts and book chapters and served as co-chair or member on several guideline or consensus document writing groups.

Who has had the greatest influence on your career?

Dr. Russo: In addition to my family, there are two people. One is Anne B. Curtis, MD, an electrophysiologist who has been a great role model for my career. Not only have I been very impressed with her knowledge and leadership skills, but she has been influential on the field of electrophysiology. She has been inspirational and has demonstrated what we can do in terms of volunteer efforts at organizations such as HRS to impact the education of patients and health care providers, including how we can make a global impact.

Similarly, Anne Gillis, MD, also provided leadership and served as a role model, demonstrating what we can do in terms of using evidence-based medicine to improve care and dissemination of information through scholarly activity. As one example, a few years ago, payers were not reimbursing for an atrial lead with dual-chamber pacemakers because of the way the CMS coverage policy was written, and it was outdated. But there was a huge amount of literature showing the benefits of dual-chamber pacemakers. She organized an effort to put together a consensus document that summarized all the evidence and this was presented to CMS, resulting in a change of policy. These are the kinds of achievements that we in the professional societies aspire to.

I also have to emphasize the support that my husband and son have given to our family that has allowed me to travel and take on leadership roles within HRS. I could not have done this without them.

What has been the greatest challenge in your professional career thus far?

Dr. Russo: Trying to do everything that I want to do. Medicine is an exciting and rewarding field and you can really impact patients’ lives, improving their quality of life and even longevity. Being able to do that but in an academic setting can be challenging; combining clinical research and teaching with patient care is not always easy. It is a challenge to be able to juggle all of those things together and do volunteer activities within HRS, the AHA and the ACC and raise my son. On top of all that, there is also time spent mentoring earlier career physicians and having a life outside of work.

What areas of research in cardiology interest you most right now?

Dr. Russo: I am very interested in sex differences in arrhythmias, including disparities and biologic differences. For example, why do women have AF less often than men and why are they not anticoagulated as often as men? Why might women derive less benefit than men from implantable cardioverter defibrillator therapy?

I am also interested in the totally subcutaneous ICD. I have seen the growth from epicardial to transvenous to subcutaneous devices. I am also interested in performance improvement activities, working with our residents and fellows on activities related to evidence-based medicine and adherence to guidelines.

Another more recent area of interest is wearable devices. I was on the steering committee of the Apple Heart Study and it is fascinating the see this new technology in action. We are still working what to do with some of these detected arrhythmias, such as when to anticoagulate short episodes of AF in the population. Now detection is happening in people who are not even patients yet. What do you do with patients who have asymptomatic AF detected by their watch or other device?

What advice would you offer to a student in medical school?

Dr. Russo: Medicine is an incredibly rewarding field. There is nothing better than being able to improve someone’s quality of life or longevity. Pick the field that you love, not because someone else wants you to do it or because of the hours or the pay. Work hard and don’t give up, because there are a lot of changes in health care, especially in reimbursement, and you have to navigate them. You can’t go wrong if you decide to do the right thing for the patient.

If I had to do it all over again, I would have gotten an MBA or a health care administrative degree along with an MD degree because we have to assure that those who provide health care continue to have influence on changes in the health system, keeping evidence-based care of the patient at the center of what we do. If we can speak the language of health care business administrators and policymakers, we may be better accepted in that role as we move forward.

What’s up next for you?

Dr. Russo: I became president of HRS in May. My involvement in HRS leadership has enabled me to meet people from around the world and to understand how other health systems are different from — or much the same as — ours. I have been able to spend more time doing that. Being able to understand how things work in other places, especially in lower-income countries that don’t have access to as many technologies as we do, allows me to come back here and not sweat the small stuff so much. HRS has been a leader in the field for a long time, so people all around the world come to us for advice. That has been leading to a lot of new education and training initiatives. People in other countries want to know what we are doing, and we have learned a lot from them. I am looking forward to more of that collaboration. – by Erik Swain

For this issue, Cardiology Today spoke with Editorial Board Member Andrea M. Russo, MD, FACC, FAHA, FHRS, professor of medicine at Cooper Medical School of Rowan University, director of electrophysiology and arrhythmia services, director of the Clinical Cardiac Electrophysiology Fellowship Program and director of cardiovascular research at Cooper University Hospital in Camden, New Jersey, and president of the Heart Rhythm Society.

Russo received her medical degree from SUNY Upstate Medical Center in 1985 and completed her internship and residency at the Medical College of Pennsylvania from 1985 to 1988. She completed fellowships in cardiology and electrophysiology at Cooper in 1992 and then spent 5 years at Robert Wood Johnson Medical School. Between 1997 and 2008, she was a member of the faculty at the University of Pennsylvania School of Medicine and was director of the electrophysiology laboratory at Penn Presbyterian Medical Center. She returned to Robert Wood Johnson (now Cooper Medical School of Rowan University) in 2009.

Andrea M. Russo

In addition to holding many positions with HRS, including being a member of the executive committee and the board of trustees, Russo is also a member of the American Heart Association’s Get With the Guidelines Atrial Fibrillation Clinical Work Group, a member of the American College of Cardiology Cardiovascular Disease in Women Committee and a member of the American Board of Internal Medicine Cardiovascular Board. She has written or co-written numerous peer-reviewed journal articles, abstracts and book chapters and served as co-chair or member on several guideline or consensus document writing groups.

Who has had the greatest influence on your career?

Dr. Russo: In addition to my family, there are two people. One is Anne B. Curtis, MD, an electrophysiologist who has been a great role model for my career. Not only have I been very impressed with her knowledge and leadership skills, but she has been influential on the field of electrophysiology. She has been inspirational and has demonstrated what we can do in terms of volunteer efforts at organizations such as HRS to impact the education of patients and health care providers, including how we can make a global impact.

Similarly, Anne Gillis, MD, also provided leadership and served as a role model, demonstrating what we can do in terms of using evidence-based medicine to improve care and dissemination of information through scholarly activity. As one example, a few years ago, payers were not reimbursing for an atrial lead with dual-chamber pacemakers because of the way the CMS coverage policy was written, and it was outdated. But there was a huge amount of literature showing the benefits of dual-chamber pacemakers. She organized an effort to put together a consensus document that summarized all the evidence and this was presented to CMS, resulting in a change of policy. These are the kinds of achievements that we in the professional societies aspire to.

I also have to emphasize the support that my husband and son have given to our family that has allowed me to travel and take on leadership roles within HRS. I could not have done this without them.

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What has been the greatest challenge in your professional career thus far?

Dr. Russo: Trying to do everything that I want to do. Medicine is an exciting and rewarding field and you can really impact patients’ lives, improving their quality of life and even longevity. Being able to do that but in an academic setting can be challenging; combining clinical research and teaching with patient care is not always easy. It is a challenge to be able to juggle all of those things together and do volunteer activities within HRS, the AHA and the ACC and raise my son. On top of all that, there is also time spent mentoring earlier career physicians and having a life outside of work.

What areas of research in cardiology interest you most right now?

Dr. Russo: I am very interested in sex differences in arrhythmias, including disparities and biologic differences. For example, why do women have AF less often than men and why are they not anticoagulated as often as men? Why might women derive less benefit than men from implantable cardioverter defibrillator therapy?

I am also interested in the totally subcutaneous ICD. I have seen the growth from epicardial to transvenous to subcutaneous devices. I am also interested in performance improvement activities, working with our residents and fellows on activities related to evidence-based medicine and adherence to guidelines.

Another more recent area of interest is wearable devices. I was on the steering committee of the Apple Heart Study and it is fascinating the see this new technology in action. We are still working what to do with some of these detected arrhythmias, such as when to anticoagulate short episodes of AF in the population. Now detection is happening in people who are not even patients yet. What do you do with patients who have asymptomatic AF detected by their watch or other device?

What advice would you offer to a student in medical school?

Dr. Russo: Medicine is an incredibly rewarding field. There is nothing better than being able to improve someone’s quality of life or longevity. Pick the field that you love, not because someone else wants you to do it or because of the hours or the pay. Work hard and don’t give up, because there are a lot of changes in health care, especially in reimbursement, and you have to navigate them. You can’t go wrong if you decide to do the right thing for the patient.

If I had to do it all over again, I would have gotten an MBA or a health care administrative degree along with an MD degree because we have to assure that those who provide health care continue to have influence on changes in the health system, keeping evidence-based care of the patient at the center of what we do. If we can speak the language of health care business administrators and policymakers, we may be better accepted in that role as we move forward.

What’s up next for you?

Dr. Russo: I became president of HRS in May. My involvement in HRS leadership has enabled me to meet people from around the world and to understand how other health systems are different from — or much the same as — ours. I have been able to spend more time doing that. Being able to understand how things work in other places, especially in lower-income countries that don’t have access to as many technologies as we do, allows me to come back here and not sweat the small stuff so much. HRS has been a leader in the field for a long time, so people all around the world come to us for advice. That has been leading to a lot of new education and training initiatives. People in other countries want to know what we are doing, and we have learned a lot from them. I am looking forward to more of that collaboration. – by Erik Swain