In January 2017 we lost a giant in cardiac electrophysiology, whose work and teachings touched all of us working in the field. Mark Josephson’s early work, building on the work of Hein Wellens in using programmed stimulation and catheter mapping to understand scar-related ventricular tachycardias, led the way to surgical and then catheter ablation as a viable therapy for that arrhythmia. His seminal observations are many and catalogued in ‘The Josephson School’ a wonderful book with 59 Chapters and extensive commentary devoted to his research.1 In the area of scar-related VT alone his work characterising electrograms in infarct scars and defining their relation to reentry circuits led to the development of substrate mapping techniques in common use today. His attention to the details of recording techniques helped establish the standards for electrophysiology studies. His investigational studies are not limited to ventricular arrhythmias but extend across the spectrum of cardiac electrophysiology. He was a superb observer with a talent for recognising subtle, unexpected events and delving deep to explore their potential mechanisms and significance.
I first met Mark Josephson in the early 1980s at his conference in Philadelphia, which I attended as a trainee. He was an inspiring figure, with his incisive commentary and enthusiasm for the field. It was there that I first heard Al Waldo explain entrainment, which he illustrated by drawing diagrams on a large flip chart. The discussion was spirited! Mark brought people together, then pushed them with intellectual rigour. He used this approach with everyone from medical students to senior investigators. He routinely challenged conventional thinking, pushing the field forward.
From a review of Mark’s publications one would appreciate only part of his impact on the field. He was a tireless and inspiring teacher in the clinic, on the wards, in the electrophysiology laboratory, and in countless conferences and scientific meetings. His passion for electrocardiography and electrophysiology inspired more than a generation of physicians and investigators who can be found in academic institutions and clinics around the world. He was a mentor and friend to those who trained under him, as well as to those who did not have that opportunity but sought his advice. He will be greatly missed.
- The Josephson School: A Legacy of Important Contributions to Electrophysiology. Wellens HJ, Buxton AE, Marchlinski FE, Zimetbaum P (eds). Minneapolis, US: Cardiotext Publishing, 2015.