10-Minute Interview: Dr. Scott Pham

Scott Pham, MD, FACC is located at Sanford Heart Hospital in South Dakota.

Tell us about your medical background and how you came to work in the field of electrophysiology. What interested you about this field?

   I attended the University of Minnesota in Minneapolis, where I did all my training and practiced there for 4 years as a general internist. I decided to go back and get training in cardiology and electrophysiology because I was fascinated by the physiology of the heart. After my fellowship, I decided to move to the smaller community of Sioux Falls, which is the perfect setting for both my practice and my family. I have been with Sanford Health for the last 7 years.

Discuss your role as a cardiac electrophysiologist at Sanford Heart Hospital. What is a typical week like for you?

   As with any practice, I don't know if there is a typical week. I spend a lot of my time as an electrophysiologist seeing patients. I perform all of the EP studies, radiofrequency ablations, and management of device implants and explants. One of the things that I also enjoy is my role as Chief of Cardiology for the University of South Dakota Medical School and sharing my expertise with the next generation of physicians.

Describe the first laser lead extraction procedure at Sanford Heart Hospital. Why was lead extraction being performed in this patient? What laser lead extraction technology was used?

   The patient who had this procedure winters in Texas. He had a pacemaker implanted while in Texas a few years ago at a specialty heart hospital. While he was in Texas this winter, he began to have problems; the leads for the pacemaker were actually coming up through his skin. Ironically, when he returned to the specialty heart hospital, he was informed that they do not do the procedure he needed and instructed him to drive 5 hours to Austin. Instead, the patient put a bandage over the leads on his chest and drove to his home in Worthington, Minnesota, about an hour's drive from Sioux Falls where I practice. He called our office and I subsequently performed the lead extraction procedure, which was the first of this type in the state. During the procedure, a "cool" ultraviolet laser light is used to safely, effectively and efficiently dissolve scar tissue that binds the lead to the body. Once the scar tissue is dissolved, the lead can be safely removed.    The patient was amazed that the procedure could be done in Sioux Falls. In the past, patients would be sent to Minneapolis or Mayo Clinic. This procedure is not a lucrative one for the physician as it can take hours to do, and reimbursement is low, as it is also low for the hospital. However, the procedure is done here because Sanford takes all patients and invests in cutting-edge technology to give patients the best possible treatment with- out regard for the amount of money they can make on the procedure.

What are the benefits of laser lead extraction to both the electrophysiologist and the patient?

   We are always looking at ways to improve the way we deliver care to our patients. Because of the equipment and the way the procedure is performed, there is less risk of infection and it is a safer procedure for the patient. For me, it was the ability to perform a procedure that I knew would help the patient.

How many patients at Sanford do you expect will need this procedure annually?

   I don't expect to do a large number of these types of cases per year — probably only 20-40. I am happy to say that the first patient is doing well.

What aspects of your work do you find most rewarding? What aspects are most challenging?

   I enjoy electrophysiology because it is very, very methodical. There is no guessing — it is either black or white, and I like that because it's very logical. I also like the fact that I work at a large integrated clinic. Most physicians are always skeptical about integrated clinics, but Sanford Clinic is very physician-driven. I love that, because I'm involved in much decision- making in terms of what is best for my patients, and that is my main interest.    I also enjoy the challenge of what I do. This latest procedure is very complex and needs a great team to be able to perform it. For our patients, this means that they don't have to travel far and that innovative technology is available to them right here.

Tell us about your research interests. Are you currently involved in any research initiatives or clinical trials?

   I am very interested in device management and am a part of multiple, ongoing studies involving ICD leads. In addition, although it is not related to research, I am also very involved in a comprehensive statewide initiative called Take Heart South Dakota. This program is designed to increase sudden cardiac arrest (SCA) survival rates by educating the public on what SCA is and how they can save lives by knowing what to do in this type of emergency.

What advancements or changes do you hope to see in the field of cardiac electrophysiology in the next year?

   I am looking forward to seeing advances in the use of robotic navigation for ablation of atrial fibrillation.

Is there anything else you'd like to add?

   I am excited to be able to bring this technology to the region. It fits with my personal philosophy: Do the right thing and avoid shortcuts. In this profession, you can't afford to do any shortcuts. If you do the right thing, you always will be very busy. For more information, please visit: https://www.sanfordhealth.org/