Why did you choose to work in the invasive cardiology field?
In 1979, the field of invasive cardiology was relatively new and it was my ambition to be one of the pioneers in the area. I achieved that.

Can you describe your role in the CV lab?
I am responsible for the daily schedule of my staff. I assist the cardiologists in interventional and diagnostic procedures. I set the rules to maintain our facility™s ISO certificate, which is the International Organization for Standards. I manage the supplies of the cath lab and EP labs, and am responsible for the contacts with the suppliers. I maintain the highest standards of work and safety in the cath lab.

What is the biggest challenge you see regarding your role in the CV lab?
My biggest challenge in the CV lab is to maintain the safety of the patients, provide excellent care to them, and maintain a good team in the cath and EP lab. All of these elements affect the outcome of these procedures.

What motivates you to continue working in the CV lab?
The cardiology field is continuously developing in techniques, instruments, and products. It is a challenge for me to keep track of all these developments. I feel it is my duty to attend courses, seminars, congresses, etc. to keep up to date with these developments. In Jordan, the cath lab technologists do not have a society to govern their work and protect their rights. I am truly motivated to bring this society to light.

What is the most bizarre case you have ever been involved with?
In the EP laboratory, we had a patient present with a fast SVT and a hemodynamically unstable wide complex tachycardia with left bundle morphology. The patient was being maintained on Cordarone. During the study, we could not assess the patient™s baseline EP measurements because of the induction of several forms of SVT. We noted too that the patient had a right paraseptal accessory pathway, which was ablated.

Subsequently we found that the patient had a left lateral accessory pathway and the wide complex tachycardia was using the right paraseptal accessory pathway for antegrade conduction, and left lateral concealed accessory pathway for retrograde conduction. This explained the high rate the patient had during tachycardia.
The left lateral accessory pathway was ablated successfully. Post ablation EP demonstrated induction of classic atrial flutter (AF), and therefore an AF cut was done.

When work gets stressful and you experience low moments (as we all do), what do you do to help keep your morale high?
I usually try to take a deep breath, relax, think quietly, and if needed, take few moments off and then solve the problem. At times, I invite my team to my house to have a good time and a barbeque.

Are you involved with the SICP or other cardiovascular societies?
Yes, I am a member and fellow of the SICP and a member of the following societies:
Heart Rhythm Society (HRS)
Cardiac Electrophysiology Society (CES)
Alliance of Cardiovascular Professionals (ACVP)
Pan Arab Pediatric Congenital Heart Disease Association
(PAPHDA)

Are there websites or texts that you would recommend to other CV labs?
Heart Rhythm Society online (www.hrsonline.org)
American College of Cardiology (www.acc.org)
Cath Lab Digest (www.cathlabdigest.com)
Middle East Health magazine (www.middleeasthealthmag.com)
Cardio Text (Cardiology book specialists, www.cardiotext.com)

Do you remember participating in your first invasive procedure?
I attended my first interventional training course at the Texas Heart Institute in April 1985. I participated in my first angioplasty procedure in Jordan at Queen Alia Heart Institute, with technology very similar to that of a U.S. cath lab, which I personally assembled. Instead of the patient being transferred to a facility outside of Jordan, we were able to successfully perform the PCI procedure inside of Jordan, saving the patient and his family the trouble and expenses of going outside the country. This is why it felt great to be of help.

If you could send a message back to yourself at the beginning of your CV lab career, what advice would you give?
My message to myself would be what I always tell my staff: work hard, be persistent, do not give up, and give your patient your best care.

Where do you hope to be in your career when it is time to retire?
At the end of my career, I would like to be the honorary president of the Jordan Cath Lab Technologists Society (to be). I would like also to contribute to the knowledge of junior cath lab technologists by passing onto them my experience and information through courses, which I would like to hold in a CV school.

It would be great if I could develop an international chapter of the SICP, along with some of my colleagues at Jordan University and other technicians in the Middle East.

Has anyone in particular been helpful to you in your growth as a cardiovascular professional?
I started my career in the military hospital (King Hussein Medical Center) in Jordan. My superiors in the army gave me the opportunity to attend courses outside Jordan and I learned from great physicians in the U.S. and Europe. I received training in the following centers: St. Luke™s Episcopal Hospital and Texas Heart Institute, Cleveland Clinic, Columbus Hospital (Italy), Prucka Eng Europe Center (Netherlands), Gant Hospital (Belgium), St. Jude Medical Educational Center (Italy), Medtronic Medical Education Center (Switzerland), and University Medical Center Hospital (The Netherlands).

I owe my career to the Jordanian army, which invested in me, and I owe it also to Alkhalidi Hospital, Jordan Hospital, and the many doctors who helped me to attend several courses and conferences.

Where do you think the invasive cardiology field is headed in the future?
The outcomes of procedures and intervention will be much better and safer. Perhaps one day we will perform these procedures even without fluoroscopy. Perhaps too we will see a day where we can achieve disease treatment by cytogenesis and with a new DNA laboratory.

Can you share with readers about the cath labs in Jordan, the types of procedures performed, and the patient volumes?
We have 19 cath labs in Jordan. Seventeen are in Amman and two are in Irbid. In Amann the distribution of cath labs is as follows: four cath labs in the military hospital (Queen Alia Heart Institute); two at Jordan Hospital and Medical Center; two at Alkhalidi Medical Center; and two at the Arab Center for Heart and General Surgery. There is one cath lab at Jordan University Hospital and eight cath labs at several other hospitals. In Irbid there are two cath labs at King Abdullah Hospital (The Science and Technology University).

In 2005, the total number of procedures for all Jordanian cath labs was approximately 20,000. At my facility we performed 2,700 diagnostic and interventional procedures in 2005, which included infant, pediatric, and adult diagnostics, coronary, peripheral, and carotid stenting, PTCA, balloon valvuloplasty, EP studies and RF ablations, pacemaker implants, biventricular implants (triple chamber) with and without ICD, PDA, ASD and VSD closures, rotational atherectomy, intracranial embolization, AAA (abdominal aortic aneurysm), and balloon trial septostomy.

I would add too that most of the cardiologists in Jordan have received their training in the United States.

Taha Abahreh can be contacted at abahreh54@yahoo.com