Innovations in Cardiology

Bringing the latest in cardiovascular care to our community

John is a healthy and fit 65-year-old who’s run three Boston Marathons. When a nurse reviewing his vitals during a routine procedure noted that he had atrial fibrillation, he hastily assured her, “I don’t have AFib.” But she was right. Later, in a follow-up visit, his primary care doctor said they’d keep an eye on it. After all, some people simply live with AFib.

As John came to realize, “having an irregular heartbeat can be distracting and, at times, frightening. You just want to sit down, not talk, not do anything,” he explains. He understood that AFib can cause poor blood flow and lead to serious conditions such as stroke.

In wanting to know more, John wisely turned to the Elfers Cardiovascular Center at Newton-Wellesley. He is one of hundreds of grateful patients who have received stateof-the-art care and treatment for cardiovascular issues, thanks to its multidisciplinary team of specialists.

Patient-centered collaboration both within the team and across Mass General Brigham has fueled innovation, notes George Philippides, MD, longtime Chief of the Division of Cardiology. “It’s really upped our game, and it’s only going to get better for patients.”

Under his direction, Elfers has continued to grow, adding specialized programs for areas ranging from atrial fibrillation to South Asian heart health and nutrition and investing in state-of-the-art technology such as the new Cardiac CT Scanner.

John’s story: advances in AFib treatment

John’s case exemplifies the life-changing care offered by the center’s Atrial Fibrillation Program.

One in four people over the age of 70 develop AFib, explains Megan Grady, CNP, a core member of the program’s team from its start. For some patients, medication will manage the condition, and Elfers has a leading pharmacist specializing in cardiology on staff. Others will undergo a cardioversion, an outpatient procedure offered at Elfers that relieves symptoms by resetting the heart’s rhythm.

“The opportunities are constantly changing, and we’re working on the forefront,” Megan reflects. When she’s seeing a patient at the center, “I can pop out of the exam room and have an expert right there.”

In John’s initial meeting with her, she recommended that he see Moussa Mansour, MD, the Center’s medical director of electrophysiology, who considered him as a candidate for a new technique of AFib ablation. The treatment uses heat or cold energy to create tiny scars in the heart to block the faulty electrical signals and restore a typical heartbeat.

“From the moment we met, I felt as if I was in really good—and confident—hands,” says John.

Dr. Mansour performed the minimally invasive surgery at Massachusetts General Hospital, where he also directs its Atrial Fibrillation Program. “The recovery time and outcome were exactly as he and his team described,” adds John, who has continued to receive his follow-up care at Newton-Wellesley.

Our AFib Program provides a multifaceted array of services, including a group visit educational series for patients, offered twice a year for six weeks. Along with learning from lectures, they learn from and support each other.

Since his surgery, John is taking things a bit slower but feels his quality of life has improved drastically. He doesn’t think he will run another marathon, but he’s eager to pull his running shoes back on.

Detecting heart disease in seconds

On Valentine’s Day 2023, Newton-Wellesley rolled out its new Siemens Force CT Scanner, a dual-force scanner that takes scans in 10 seconds using two high-power, high-resolution cameras that offer reproductive precision.

“This top-of-the-line CT scanner is rare in a community setting, and we are already seeing it’s impact,” says Stefan Parpos, MD, Assistant Chief of Cardiology.

The scanner can take images of moving targets—not just of the main arteries but also the small structures— with more precision and better image quality. “Think of the branches of a tree. There are three big coronary branches on top that wrap around the outside of the heart, but there are also many, many smaller, squiggly branches that taper in, down, and around,” says Dr. Parpos. Arteriosclerosis is one of the main causes of heart disease—known colloquially as “hardening of the arteries.” Due to genetics, unhealthy cholesterol levels, and/or unhealthy lifestyle habits, plaque can build up along artery walls making it more difficult for oxygen-rich blood to travel to and from the heart to all of the body’s tissues and organs.

Thanks to that capability to reveal early signs of arteriosclerosis, “we can be proactive rather than reactive,” he explains. “It can detect plaque build-up long before it’s in the danger zone when surgery becomes a necessity.”

The scanner also offers the benefit of being non-invasive, unlike procedures such as cardiac catheterization that have been the norm. The new scanner gives Dr. Parpos and the team a way to get a complete picture of all the coronary arteries in seconds, which helps them clarify diagnosis, streamline next steps, reduce risk, and allow for better treatment options.

“And the incredible technology of this scanner has given us a chance to change our overall dogma and start with anatomy—start with a scan, get more precise and conclusive results, and from there, treat and prevent with more certainty,” he says.

The experience of the scanner’s very first patient reminds him why it is a such a game changer. A 45-year-old opted for a scan because of family history. That scan revealed extensive blockage in his arteries and the need for bypass surgery. Thankfully, he is now recovered and healthy.

Dr. Parpos adds, “Being able to help people, even during life’s most frightening moments, is a privilege. Being part of a supportive and collaborative team that has the resources and abilities to play a meaningful role of their lives is a true honor.”

Addressing South Asian heart health

At the end of an American Heart Association lecture on the specific cardiovascular pathology of South Asian people—one of the fastest growing segments of the US population—NWH cardiologist Yamini Levitzky, MD, witnessed many participants raising questions about where they could get individualized, culturally appropriate care.

Reflecting on the genesis of NWH’s new South Asian Heart Health and Nutrition Program, “that was the catalyst,” she says. After further discussion by the Elfers team led to a decision to tackle this unmet need, Dr. Levitzky took on the role as program director.

As she explains, South Asians make up 25 percent of the world population and 60 percent of the world’s cardiovascular disease, though the reasons for their higher risk are not yet fully understood.

Although most South Asians are vegetarians and nonsmoking, those living in the US face increased risk from easier access to processed foods and less exercise in part due to cultural norms.

Opening in March 2023, the innovative program includes, among others, three doctors and a nutritionist of South Asian descent. “Because many of us in this program understand the culture personally and professionally, we can get down to the nitty-gritty in directly translatable ways,” Dr. Levitzky says. That may mean suggesting local grocery shops that offer healthier ingredients for favorite South Asian dishes connecting them with our trainer for personalized exercise coaching.

“Although we are just one program at Newton-Wellesley, I think we are helping the hospital as a whole and our community at large become more inclusive and culturally competent in our care,” she reflects.

In promoting healthier habits and prevention across generations, the team sees themselves on the forefront of mitigating what could be a national health crisis. They hope that the program will serve as a model for other hospitals—small and large.

“We see more and more people feeling comfortable coming to our clinic to understand their risks, learn strategies for better health, and even simply to ask questions,” says Dr. Levitzky. “I think they appreciate the comprehensive and personalized care we give and our culturally appropriate approaches.”

For her, “it’s a privilege to be part of a program like this, especially at a smaller hospital where we get to have a real voice in the types of care we deliver. We all have a deep and vested interest in helping our community.”

"New and better ways to stay heart healthy"

In all of these many ways, being able to bring new technologies, innovations, insights, and community programs to Newton-Wellesley has translated to better care that is genuinely patient-centered.

Today, Newton-Wellesley occupies a sweet spot for offering top-notch multidisciplinary cardiovascular care while staying true to a commitment to community. “We have a level of expertise that most community hospitals simply don’t have,” reflects Dr. Philippides.

At the same time, stronger clinical relationships and research collaborations within Mass General Brigham means access to academic medical center-level of care—right here, close to home.

“This community is made up of our neighbors, our families, our friends,” says Dr. Philippides. With that in mind, the cardiovascular center team is innovating on the prevention side, including championing the initiatives of the Hearth Health and Wellness Council, part of the Community Collaborative.

“We care deeply about having a local impact on our community,” he adds, “and being a place where people can come to learn new and better ways to stay heart healthy.”

Powered by philanthropy

Newton-Wellesley Hospital recently held a ribbon-cutting ceremony with donors for our cardiac-capable CT scanner, which went into operation in February. This state-of-the-art tool will help enable early diagnoses and prevent the advancement of heart disease. We are especially grateful to Roger and Kathy Marino, who made a significant gift to support the project and name the CT scanner room.