Morgan, Professor John Mark

MA MD FRCP FESC

Speciality

Cardiology

Sub-speciality

Cardiac Rhythm Management

Training and Education

1976-1979      Gonville and Caius College, Cambridge: BA (1979)
1979-1982      Westminster Medical School: MB BChir (1982)
1983               MA (Cambridge University)
1985               MRCP (UK)
1991               MD (Cambridge University)
1995               FRCP (UK)

Experience

Professor Morgan has worked for Southampton University Hospitals Trust since 1992. 

During my professional training I became proficient in all cardiology sub-specialities, including paediatric cardiac catheterisation and adult congenital heart disease under the tutelage of Dr J Somerville. I gained wide experience of management of cardiovascular disease. I became competent in all cardiology procedures.

As a junior I developed particular interest in interventional cardiology and electrophysiology and was initially trained by Dr Edward Rowland. I developed operative skills in all aspects of interventional cardiology. By June 2000 I had performed more than 8000 interventional proceduresI am among a small group of UK clinicians who are trained and highly experienced both in coronary intervention and in interventional electrophysiology. I have developed unique skills in the use of complex mapping technologies and have played a significant role on the world stage in bringing such techniques into mainstream clinical practice. In particular I have a unique experience in the management and ablation of arrhythmias in complex congenital heart disease.  I am recognized as an opinion leader and leading clinician in the UK.

Under my leadership the Cardiac Rhythm Management Service of the Wessex Cardiac Centre became nationally and internationally recognized for the management of cardiac arrhythmias and has made novel contributions to the understanding of internal cardiac defibrillation and management of complex arrhythmias in adult congenital heart disease patients.

Key achievements

1992 - Consultant Cardiologist and Electrophysiologist, Wessex Cardiothoracic Centre
1993 - Honorary Consultant Cardiologist to the Triservices Hospital, Haslar, Portsmouth
1995 - Honorary Consultant Cardiologist, Royal County Hospital Winchester 
2000 - Honorary Senior lecturer, University of Southampton                          2006 - Honorary Professor, University of Teesside
2007 - Professor, University of Southampton

Key awards and prizes

Undergraduate:
1977-1978: Junior Scholar, Gonville and Caius College
1978-1979: Senior Scholar, Gonville and Caius College
1979: Senior Sophist, Gonville and Caius College
1979:  1st Class Honours, Parts I and II Natural Sciences Tripos, Cambridge University
Medical School:
1979-1982 Clinical Scholar, Gonville and Caius College
1980 Inaugural Cup, Westminster Medical School
1980 Chadwick Prize in Surgery, Westminster Medical School
1981 Hanbury Prize in Paediatrics, Westminster Medical School
1981 Abrahams Prize in Pathology, Westminster Medical School
Postgraduate:
1988 British Heart Foundation Junior Research Fellowship
2004 ACCEA Bronze Clinical Excellence Award
   

Research

Background to Research Activity
My research team comprises two/three research fellows, two/three research nurses and a full time “academic coordinator”.
The UK’s clinical research effort has been severely disadvantaged in the past decades by excessive preoccupation with molecular biology research. For this reason clinical researchers such as myself have encountered difficulty in obtaining research funding from nationally recognized grant giving bodies. I have overcome this obstacle by obtaining research bursaries from industry that have allowed me to explore research avenues of direct clinical relevance, but with no commercial or intellectual property commitment to industry. Areas of investigation are:

Current Projects
Internal Defibrillation
I have been investigating novel shock mechanisms and configurations for internal defibrillation (in the manner employed by implantable cardioverter defibrillators) for many years. I first conceived and described use of middle cardiac vein for internal defibrillation and have pursued a programme of work to demonstrate and assess its clinical feasibility and potential clinical advantage. Most recently we have been investigating the impact of pre-shock conditioning on defibrillation threshold, the strategy being to define means of achieving very low energy ventricular defibrillation and novel approaches to subcutaneous defibrillation which avoids the need for endocardial lead placement. Attention is now shifting to use of technologies that allow cardiac defibrillation with implanted devices that do not require placement of endocardial sensing electrodes or use of endocardial shocking coils with particular interest in the use of these technologies in patients with adult congenital heart disease.

Complex Ablation in Palliated Congenital Heart Disease
I have applied new technologies that rapidly and accurately identify endocardial activation patterns and define arrhythmia mechanisms in patients with congenital heart anomalies most of whom have undergone palliative reconstructive surgery. This work has already assisted optimization of surgical and catheter-based ablation techniques for arrhythmia control. As a result of this work the Wessex Cardiothoracic Centre has acquired a national reputation for management of arrhythmias in patients with GUCH disease.

Sudden Cardiac Death Risk in Palliated Adult Congenital Heart Disease
I have commenced a project that will characterise arrhythmia burden and contribute to the understanding of sudden cardiac death risk stratification in this complex patient group.

Conception and Development of New Linear Lesion Ablation Technologies
In conjunction with C.R.Bard Inc I developed a novel ablation electrode system for the creation of endocardial linear lesions, which are necessary for correction of some arrhythmia substrates. This technology is now being evaluated for left atrial ablation procedures.

Assessment of Abnormality of Repolarisation
I am currently conducting studies validating and investigating the use of non-contact mapping in assessing abnormality of cardiac repolarisation and electrical restitution.

Foetal Origins of Cardiac Disease
In partnership with Professor Mark Hanson, I am undertaking experimental work to characterize the impact of foetal nutritional challenge on coronary vascular reserve and integrity of the foetal electrophysiological system.
Genetic Origins of Arrhythmia

I recently collaborated with Professor Iain Day in investigating population-wide screening techniques for long QT syndrome and Professor David Wilson in the genetic determination of a previously undescribed “channelopathy” identified by myself.

Studies of Management of Ventricular Arrhythmias/Heart Failure by CRT and ICD Therapies

I have participated in the design and implementation of a multi-centre study to assess the efficacy of prophylactic ICD implantation in patients at high risk of sudden cardiac death post myocardial infarction. I was a principal investigator leading studies on CRT in cardiomyopathy (Pacing in Cardiomyopathy, a European Study {PACMAN}).. I was European principal investigator in a study of empiric versus physician tailored ICD therapy in the management of ventricular arrhythmias (EMPIRIC Study), designed by myself, Dr B Wilkoff (Mayo Clinic) and Dr L Sterns (British Columbia). This was a multinational investigation of optimal ICD programming, comparing “one-button” enhanced “empiric” device programming with “best physician practice” in a randomized fashion in a population of more than 800 patients.
I was principal investigator in the “Concerto” study investigating remote data management systems in the contexts of defibrillation therapy and cardiac resynchronization.

Remote Disease Management – Intelligence-Based Care
In collaboration with the University of Southampton and the Faculty of Health, Medicine and Lifecare Sciences, I am helping to establish a new institute that will investigate the use of novel implanted technologies in monitoring and managing chronic disease. In cardiology I have lead the way in introducing this technology to. It has gained the attention of public figures and lead to the visit of Prime Minister Gordon Brown to the Southampton University Hospital in October 2007, after which visit he mentioned the institution by name in his landmark speech on the future of the NHS. I am commencing a study to evaluate new care pathways and their cost efficacy for remote disease management strategies. This endeavor will be a major collaboration between the University and the Trust in coming years. This work continues to receive support from the Department of Health and in particular Lord Darzi.

Proteomic Assessment of Sudden Cardiac Death Risk
In collaboration with Dr Paul Townsend, Senior Lecturer, Department of Genetics, I have co-written a project that is investigating the ability of a proteomic fingerprint to identify sudden cardiac death risk. This project will commence in August 2008.

Sudden Cardiac Death in the Community
In partnership with Professor Paul Roderick, Dr Patrick Gallagher and Dr Debbie Chase, I have investigated sudden cardiac death and ventricular arrhythmia incidence in a primary care population. This work contributes to the understanding of the public health challenges that sudden cardiac death and its prevention offers in the UK.

Much of my work has been published in journals such as, Europace, European Heart Journal, PACE, Heart, Journal of Electrophysiology, Circulation to name a few.