Electrophysiology Specialist Adds New Element to Cardiac Care

It’s a prevailing moment in nearly any television hospital drama: the paddles are placed on the chest, someone yells out “Clear!” and the doctor tries to shock the patient back to life.

But for some people with hypertrophic cardiomyopathy, such as 10-year-old Riaghlee Lagoner, that shock can come from a device that’s already inside the body.

For the past eight months, Riaghlee has had an implantable cardioverter defibrillator (ICD) in her chest, ready to automatically deliver a life-saving electric shock to her heart should any dangerous arrhythmias arise. Jeffrey M. Vinocur, M.D., installed the device at UR Medicine’s Golisano Children’s Hospital last October.

“It’s really hard — and I talk with Dr. Vinocur about this — that it’s a waiting game to see what, if anything, might happen to her,” said Micollette Lagoner, Riaghlee’s mother, who also has hypertrophic cardiomyopathy, a condition that causes the heart muscles to become abnormally thick. “But my ICD has saved me many, many times.”

ICDs have been used at Golisano Children’s Hospital before, but Vinocur, who joined the hospital last year, specializes in pediatric electrophysiology and is adept with the devices. So rather than a more invasive cardiac surgery to place the defibrillator, Vinocur was able to install Riaghlee’s ICD through a vein near her collarbone.

“It’s about a 2-inch incision compared with a sternotomy,” said Vinocur. “Plus, the recovery time is much shorter, and the long-term durability of the device is much better.”

Vinocur is the Division of Pediatric Cardiology’s first electrophysiology specialist. He joined the children’s hospital after fellowships at the University of Toronto’s Hospital for Sick Children and the University of Minnesota’s Amplatz Children’s Hospital.

“Dr. Vinocur’s specialization adds to our already-robust team of cardiologists and care providers,” said Roger Vermilion, M.D., chief of the Division of Pediatric Cardiology. “We were thrilled that we had the opportunity to bring him aboard.”

For Vinocur, pediatrics runs in the family; his father is a pediatric general surgeon. But he didn’t initially start out in medicine. He first went to Cornell for computer science, which, for him, partly explains why he was drawn to electrophysiology.

“Electrophysiology is the computer science side of cardiology,” said Vinocur. “It’s very technical and mathematical: you’re measuring things in hundredths or thousandths of a second and making decisions based on that data.”

But despite the array of measurements and calculations, patients have embraced the way Vinocur can easily walk them through a complex condition or treatment.

“Dr. Vinocur is absolutely wonderful,” said Micollette Lagoner. “He’s great with my kids — he’s patient and he explains everything to them.”

As for Riaghlee, she’s been doing well after a recent change in medication. Though her condition might require a more invasive procedure down the line, she currently has no restrictions and has continued to participate in all manner of outdoor activities, including softball, her favorite sport.

“She’s one of the smaller ones, so it’s funny to see her out there with all the other bigger girls on the field,” said Micollette Lagoner. “Some of the other girls don’t want to get their nails dirty, but she’s out there playing basketball, jumping on the trampoline, hunting, fishing, sliding into home. She’s always been like that — she’s really something.”