Author + information
- David J. Wilber, MD, FACC, Editor-in-Chief, JACC: Clinical Electrophysiology∗ ()
- ↵∗Address for correspondence:
Dr. David J. Wilber, Editor-in-Chief, JACC: Clinical Electrophysiology, American College of Cardiology, Heart House, 2400 N Street NW, Washington, DC 20037.
When I heard the news of the death of Mark Josephson in mid-January, I drifted back to the time of my medical residency in the late 1970s. I remembered the enthusiasm with which I and some of my friends pored over each new publication from the University of Pennsylvania’s highly successful and expanding program for treatment of post-infarction ventricular tachycardia (VT) by intraoperative mapping and directed endocardial resection. Along the way, these studies pioneered catheter-based endocardial mapping as a tool for dissecting the anatomic and functional underpinnings of VT circuits, and helped lay the foundation for contemporary interventional electrophysiology. The novelty of these studies, and their implications for improving arrhythmia management and patient care, had a galvanizing effect on our residency class, such that nearly one-third subsequently devoted a substantial part of their future careers to clinical electrophysiology.
As the years passed, I had frequent opportunities to come to know Mark both professionally and personally. Over all that time, I continued to feel caught up by his passionate commitment to inquiry, skepticism of accepted truths, openness to new ideas, and patient-centered focus. He could be challenging and relentless in discussion and debate, but his comments were typically backed by a wry and often mischievous sensibility. I am grateful for his many contributions to my own understanding of cardiac arrhythmias, and fondly acknowledge his role as mentor and friend.
Mark was the consummate clinical investigator. He used careful observation of clinical phenomena in the laboratory and controlled manipulation of the underlying physiology to facilitate understanding of arrhythmia mechanisms. His interests were protean: not simply VT, but the spectrum of supraventricular arrhythmias, sudden cardiac death, and electrocardiogram (ECG) and electrogram interpretation. The latter interest would evolve into one of the longest running ECG and complex arrhythmia training courses, reaching more than 6,000 clinicians and trainees over a period of more than 30 years. Throughout his career, Mark continued this commitment to the education and training of the next generation of clinical electrophysiologists. His textbook, Clinical Cardiac Electrophysiology: Techniques and Interpretations, the first edition published in 1979, and the fifth and most recent in 2016, is the electrophysiology trainee’s bible, and remains close at hand in programs and laboratories worldwide.
For both seasoned veterans and those new to the field looking to better understand Mark’s legacy, another book, The Josephson School, edited by Wellens, Buxton, Marchlinski, and Zimetbaum, provides an excellent overview of his most important contributions and the context from which they arose. Mark had a talent for pithy statements summarizing important ideas. Each of us likely has our favorite “Josephsonism.” One that personally resonates is his caveat to budding trainees: first and foremost, be an electrophysiologist, not just a proceduralist, Understanding the mechanism of arrhythmias, and their clinical context, will ultimately lead to more successful and rationally chosen therapy. Sound advice, both for clinicians and JACC: Clinical Electrophysiology.
- 2017 American College of Cardiology Foundation