Top Docs Q&A: Frederic Resnic

He has found a way to combine his engineering background with his cardiovascular expertise.

This post is part of our Top Docs Q&A series where we ask a physician who was selected as one of our Top Docs questions about their field, life as a doctor, and practicing in the Greater Boston area. 

Name: Frederic Resnic

Hospital Affiliation: Lahey Hospital and Medical Center

Title: Chair of Cardiovascular Medicine at the Lahey Heart and Vascular Center; Co-chair of the Comparative Effectiveness Research Institute at Lahey Hospital and Medical Center

Field: Interventional Cardiology 

Specialty: Angioplasty and stent placement, cardiac catheterization

Interventional Cardiologist Frederic Resnic noticed that many cardiac devices were not being monitored once they’d been put on the market, therefore resulting in problems for patients long after receiving certain procedures. In 2013, Resnic received a $1.1 million grant from the Food and Drug Administration (FDA) to create methods of evaluating the performance of these already approved devices.

Why did you choose the field of interventional cardiology?

I actually went to college for engineering and worked in that field for about three years. It wasn’t until later that I decided to go to medical school. I liked cardiology because I was fascinated by the physiology and mechanical workings of the heart. Also I liked how at the time, the late 1980s and early 1990s, that it was one of those fields that was really pioneering minimally invasive treatments like catheterization procedures and angioplasty.

What do you love most about interventional cardiology?

It’s a field that allows you to immediately make a difference for patients, it’s almost got an element of instant gratification to it. For example, we do work on patients who must have an immediate catheterization to interrupt a heart attack while it’s happening. As a doctor being a part of that kind of work really motivates me.

How has interventional cardiology changed in the time that you’ve been practicing?

When I started in the field the procedures to open up a blocked arteries were a bit crude, meaning that there was very high rate of failure. Then in 1994, stents (metal mesh tubes that keep the arteries open) were released and that really improved patient care. Later in 2003 a type of stent came available which releases a drug that helps to reduce the chance of the artery re-narrowing, because of this the patients have a much better chance of not having to return for second procedure.

What are some of the latest advancements happening right now in the field?

Non-surgical minimally invasive treatments are now becoming more commercially available, which allows treatment options for patients who are too high risk to receive traditional surgery. An advancement happening right here at Lahey is that 90 percent of our catheterization procedures are now performed through the wrist rather than the leg. This allows patients to sit up, eat, and walk right after the procedure, and it’s lower risk. It’s taken a while to be adopted in the U.S., but Lahey and Brigham were actually two of the earliest adopters in this country.

What’s your hope for the future of interventional cardiology?

I think that we have the opportunity to someday treat patients that today don’t have many options. In my 20 plus years in this field there have been many patients who we used to think we couldn’t do much to treat, yet today we can.

How has your work in cardiology connected to your engineering background?

The mechanical workings of the heart was always something I felt I could understand because it was similar to mechanical systems. Also the procedural aspects are similar to engineering as well. My work in engineering was specifically on computer systems and operations research which has been huge with my work on device monitoring.

A lot of your work has been focused on creating methods of monitoring medical devices and procedures, what does this entail? 

Essentially, in the U.S. we are developing medical devices at a such a fast pace that we are failing to monitor the ones we’ve already approved. I’ve been working on developing methods of monitoring and organizing this information since 2003. It wasn’t till I think 2006 that I started working directly with the FDA where we have developed software and are working with organizations that have very large collections of medical data. The FDA grant I received in 2013 is for five years and is to continue this work.

Why do you think doctors and the companies that make these devices typically don’t think about their long-term effectiveness?

There’s no engineer who thinks that their product will be permanently functional, eventually any electrical or mechanical system will fail. Somehow in healthcare we convinced ourselves that if it worked initially then it’s always going to be pretty safe. There aren’t many people who work in this arena partially because most investments goes towards designing new devices, not monitoring existing ones. However, I wouldn’t say I’m the first to have concerns about this, but I have been persistent and I’m unique in that my engineering background has given me the skills I need to address it.

What affect do you hope this research will have on medicine? 

Device approval is a balancing act for the FDA because they don’t want to withhold a product that could help a lot of people while they examine risks that won’t arise till much later. So my goal is to have manufacturers be able to address problems with these devices even if they’ve been on the market for years. Secondly if doctors have this information then they can make better decisions for their patients.

What’s your favorite part about practicing in the Boston?

I think Boston is a really unique place. Healthcare is such a fabric of the city itself. It’s also a place with some really remarkable technology research universities and because of that there is a real culture of innovation.

 

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