Mount Sinai Heart has long played an important role in developing our understanding of the causes and treatments for various types of heart disease. We are the lead center for a number of large clinical trials which gives our patients access to the most advanced treatments available. We have made particular strides in the areas of arrhythmia, heart disease prevention, pediatric and congenital heart conditions, and valvular heart disease. Some highlights of our research activities include the following:
Mount Sinai Heart is in the forefront of developing techniques for diagnosing and treating arrhythmia, or irregular heartbeat. Currently, we are involved with several studies:
- Atrial Fibrillation: Treatments for atrial fibrillation aim to reduce its burden and prevent its most devastating complication—stroke. Doctors at Mount Sinai Heart are researching new techniques for atrial fibrillation ablation as well as the Watchman device, a small mesh device which is placed inside the heart to prevent stroke in patients with atrial fibrillation.
- Ventricular Tachycardia: We are participating in multiple clinical trials investigating safer and more effective ways to perform ablation of ventricular tachycardia.
- Renal Denervation: Mount Sinai Heart has forged new techniques for performing renal sympathetic denervation, which has been shown to be effective for treatment of hypertension that is not easily treated with medications. The procedure works, at least in part, by decreasing the adrenaline response (sympathetic tone) throughout the body. This helps to decrease blood pressure, and some data suggests that it may also be beneficial for cardiac arrhythmias. We are conducting research authorized by the Food and Drug Administration (FDA) using this procedure for treatment of refractory hypertension and cardiac arrhythmias.
- Pacemakers, Implantable Cardioverter Defibrillator (ICD), and Devices for Heart Failure: The Mount Sinai Hospital is the lead center for the U.S. trial of a new Leadless Cardiac Pacemaker. We implanted the device directly inside the patient’s heart during a minimally invasive, catheter-guided procedure. In addition, we were also involved in the study that gained Food and Drug Administration approval for the subcutaneous implantable cardioverter defibrillator (ICD). These devices use an electrode placed beneath the skin to help correct heart arrhythmias. As of October 2013, Mount Sinai is the only center in the New York City area performing subcutaneous ICD implants. We are also testing new devices for treatment of congestive heart failure.
Heart Disease Prevention
Heart disease is one of the most common causes of death in the United States. At Mount Sinai Heart we believe that preventing the disease from happening in the first place is critical. To this end, we are working on a variety of community-focused programs to intervene before problems begin. Some of the most important programs are:
- Increasing cardiovascular health among at-risk youth: Led by Valentin Fuster, MD, PhD, to develop a family-centric approach to the prevention of heart disease in New York City's highest-risk communities.
- Improved identification of heart disease markers and Early-Stage Detection: Zahi Fayad, PhD, Professor of Cardiology and Director of the Translational and Molecular Imaging Institute, in collaboration with the Translational and Molecular Imaging Institute, is coordinating three national projects to identify visible markers of heart disease at the earliest stages.
- Targeting drug delivery: A potential application for MRI technology involves drug delivery. Oral medications are diluted in the bloodstream, so they are typically given at much higher doses than necessary. Detailed imaging allows doctors to better pinpoint the inflammation, and this could lead to more precise treatments.
Pediatric and Congenital Heart Conditions
Mount Sinai Heart's pediatric cardiologists have tremendous experience in diagnosing and treating congenital heart defects. Our groundbreaking research is key to this endeavor. Here are some of our activities:
- Patent ductus arteriosis, Noonan syndrome: Bruce D. Gelb, MD, Professor of Cardiology and Professor of Genetics and Genomic Sciences and colleagues have found the genes responsible for patent ductus arteriosis, a failure to close a tube present in fetal hearts, and Noonan syndrome, the most common genetic syndrome associated with congenital heart disease.
- Secundum atrial septal defects: Researchers in the Center for Molecular Cardiology are participating in a study on the genetic causes of secundum atrial septal defects (ASDs), a condition in which the wall separating the upper chambers of the heart does not close completely prior to birth.
- Hybrid surgeries: Barry Love, MD, Assistant Professor of Cardiology and Director of the Pediatric and Congenital Cardiac Catheterization Laboratory and the Pediatric Electrophysiology Laboratory, is advancing the use of hybrid surgery to treat patients with complex congenital heart conditions. He combines many cardiac catheterization techniques with surgical ones to produce methods that are safer and less traumatic.
- Axillary Incision Technique: Khanh H. Nguyen, MD, Associate Professor of Cardiovascular Surgery, has developed a way to use this less invasive surgical technique to minimize scarring and shorten hospital stays for children. The technique is sometimes used to repair congenital heart defects in adults.
Valvular Heart Disease
When any of the heart’s four valves breaks down, blood stops moving in the proper direction. At Mount Sinai Heart, we are involved with a variety of research projects to improve our diagnosis and treatment of these disorders:
- Opening the door for more patients to benefit: David H. Adams, MD, Professor and Chair of Cardiothoracic Surgery and Program Director of the Mitral Valve Repair Reference Center, is the co-principal investigator for a groundbreaking FDA clinical trial. The trial will test an innovative way to replace malfunctioning aortic valves in patients who cannot withstand the rigors of open-heart surgery.
- Improved grafting process: The homograft is a part of the Ross Procedure, in which a patient receives a donated pulmonary valve. New technology available at Mount Sinai Heart improves the homograft process by allowing the patient's own cells to grow onto the donated valve's flaps, better integrating it into the recipient's body and potentially strengthening it over time.
- Improved mitral valve repair: David H. Adams, MD, together with Alain Carpentier, MD, PhD, invented annuloplasty rings, which are support devices that reinforce patients' repaired valves, notably the Carpentier-Edwards Physio II Annuloplasty Ring. In addition, Drs. Carpentier and Adams have written Carpentier’s Reconstructive Valve Surgery, which has become the standard text for surgeons wanting to hone the craft of valve reconstruction.