Blair Grubb

Last updated August 06, 2024

Blair P. Grubb is an American physician, surgeon, researcher and scientist, currently a distinguished university professor of medicine and pediatrics at the University of Toledo.^[1]^[2] He is well known for his contributions to the study of syncope and disorders of the autonomic nervous system (in particular Postural Orthostatic Tachycardia Syndrome) (3).

History and career

Grubb was born in Baltimore, Maryland, on January 21, 1954, and grew up in the then rural Carroll County of Maryland. The son of an electrician, Dr Grubb grew up in very modest surroundings and began working full-time as an electrician and sign maker starting at the age of 14 years, and continued to do so until his mid-twenties. He graduated from South Carroll High School in 1972, and later earned a BA in biologic sciences from the University of Maryland, Baltimore County (UMBC) in 1976. He earned a Medical degree from the Universidad Central del Este in the Dominican Republic in 1980. He then completed a medical residency at the Greater Baltimore Medical Center, where he also served as chief medical resident. While doing a rotation in cardiology at the Johns Hopkins Hospital he became interested in cardiac electrophysiology after watching some of the first human defibrillator implants. He thereafter completed fellowships in both cardiology and clinical cardiac electrophysiology at the Pennsylvania State University's Milton S. Hershey Medical Center in Hershey, Pennsylvania(4). Grubb then joined the faculty of the Medical College of Ohio (later renamed the University of Toledo Medical Center) as an assistant professor of medicine in 1988, where he initiated the institution's cardiac electrophysiology program. He became an associate professor of medicine and pediatrics in 1993, and was elevated to a full professor of medicine and pediatrics in 1999.

Grubb is widely known for his research into the pathophysiology, diagnosis and management of syncope. He was among the first researchers in the United States to employ head upright tilt table testing for the diagnosis of vasovagal (neurocardiogenic) syncope. He is also widely considered one of the world's leading experts on Postural orthostatic tachycardia syndrome (POTS) and orthostatic hypotension. Dr. Grubb has also pioneered new wound closure techniques designed to reduce infection rates and enhance wound appearance during permanent pacemaker and implantable defibrillator surgeries. He has also been a principal investigator in using permanent pacemakers with closed loop stimulation capacity (CLS) in the treatment of refractory neurocardiogenic/vasovagal syncope. His current focus of research is in exploring the role of autoimmunity in the pathogenesis of POTS and other autonomic disorders. He recently has also been investigating the potential role of autoimmunity in patients suffering from Long-Haul COVID syndrome. He has authored over 280 peer-reviewed scientific papers and 34 book chapters. He is co-editor of the textbook Syncope: Mechanisms and Management and the author of the book The Fainting Phenomenon. He was a senior editor of the journal Pacing and Clinical Electrophysiology for 25 years. He is currently the director of the Cardiac Electrophysiology Program and the Syncope and Autonomic Disorders Clinic at the University of Toledo Medical Center (UTMC) in Toledo, Ohio. He is also the director of the Autonomic Disorders Fellowship training program at UTMC.

Dr. Grubb has also published numerous essays on his experiences as a physician and patient, a collection of which were published as a book entitled The Calling(5). He has also published a number of poems. Dr. Grubb achieved the rank of Eagle in Boy Scouts, and earned varsity athletic letters in both high school and college. He has also received numerous awards throughout his career and received UMBC's Distinguished Alumnus Award in 1994, and was elected to the Alpha Omega Alpha (AOA) medical honor society in 1997. Grubb was presented with the Northwest Ohio American Heart Associations' "Legacy of Achievement" Award in 2001. He was named as a Distinguished University Professor by the University of Toledo (UT) in 2009. He was given the Leonard Tow Humanism in Medicine Award in 2006. He received the University's Dean's Award for Career Achievement in 2016 as well as the University's Outstanding Research and Scholarship Award in 2017. Grubb received Dysautonomia International's "Physician of the Year" Award in 2015(6,7,8). That same year the British Arrhythmia Alliance named him "Medical Professional of the Decade"(9). Also in 2015 he was recognized by the Ohio State Senate for outstanding research and clinical practice naming him "One of Ohio's finest citizens". In 2017 he received the Dion D. Raftopoulos/Sigma Xi Honor Society Award for outstanding original research. In 2018 he was given the University of Toledo's President's Award for Outstanding Contributions in Scholarship and Creative Activity. In 2019 he received the "Revolutionary Researcher Award" by the Dysautonomia Support Network. In 2020 he was awarded the University of Toledo Medical Center's "Shining Star Award" for outstanding patient care. Also in 2020 UT presented him with the "Blair P. Grubb Endowed Chair in Syncope and Arrhythmias", one of the highest honors the University can bestow upon a faculty member. In 2021, 2022 and 2024 he again received UT's President's Award for Creative and Scholarly Activity. In 2024 he was given a joint appointment in Neurology in recognition of his contributions to Autonomic Neuroscience. Grubb has been recognized as one of "America's Top Doctors" for 20 years in a row. He is a Fellow of the American College of Cardiology and a Fellow of the American Heart Association as well as a member of the Heart Rhythm Society and the American Autonomic Society. He was married to the late Barbara Straus MD for 38 years(10). He is currently married to Dr. Dena Eber PhD. He has two children, Helen and Alex, and one stepchild, Alex.

Related Research Articles

Cardiology is the study of the heart. Cardiology is a branch of medicine that deals with disorders of the heart and the cardiovascular system. The field includes medical diagnosis and treatment of congenital heart defects, coronary artery disease, heart failure, valvular heart disease, and electrophysiology. Physicians who specialize in this field of medicine are called cardiologists, a sub-specialty of internal medicine. Pediatric cardiologists are pediatricians who specialize in cardiology. Physicians who specialize in cardiac surgery are called cardiothoracic surgeons or cardiac surgeons, a specialty of general surgery.

Orthostatic hypotension, also known as postural hypotension, is a medical condition wherein a person's blood pressure drops when standing up or sitting down. Primary orthostatic hypotension is also often referred to as neurogenic orthostatic hypotension. The drop in blood pressure may be sudden, within 3 minutes or gradual. It is defined as a fall in systolic blood pressure of at least 20 mmHg or diastolic blood pressure of at least 10 mmHg after 3 minutes of standing. It occurs predominantly by delayed constriction of the lower body blood vessels, which is normally required to maintain adequate blood pressure when changing the position to standing. As a result, blood pools in the blood vessels of the legs for a longer period, and less is returned to the heart, thereby leading to a reduced cardiac output and inadequate blood flow to the brain.

Dysautonomia, autonomic failure, or autonomic dysfunction is a condition in which the autonomic nervous system (ANS) does not work properly. This may affect the functioning of the heart, bladder, intestines, sweat glands, pupils, and blood vessels. Dysautonomia has many causes, not all of which may be classified as neuropathic. A number of conditions can feature dysautonomia, such as Parkinson's disease, multiple system atrophy, dementia with Lewy bodies, Ehlers–Danlos syndromes, autoimmune autonomic ganglionopathy and autonomic neuropathy, HIV/AIDS, mitochondrial cytopathy, pure autonomic failure, autism, and postural orthostatic tachycardia syndrome.

Hypotension, also known as low blood pressure, is a cardiovascular condition characterized by abnormally reduced blood pressure. Blood pressure is the force of blood pushing against the walls of the arteries as the heart pumps out blood and is indicated by two numbers, the systolic blood pressure and the diastolic blood pressure, which are the maximum and minimum blood pressures within the cardiac cycle, respectively. A systolic blood pressure of less than 90 millimeters of mercury (mmHg) or diastolic of less than 60 mmHg is generally considered to be hypotension. Different numbers apply to children. However, in practice, blood pressure is considered too low only if noticeable symptoms are present.

<span class="mw-page-title-main">Reflex syncope</span> Brief loss of consciousness due to a neurologically induced drop in blood pressure

Reflex syncope is a brief loss of consciousness due to a neurologically induced drop in blood pressure and/or a decrease in heart rate. Before an affected person passes out, there may be sweating, a decreased ability to see, or ringing in the ears. Occasionally, the person may twitch while unconscious. Complications of reflex syncope include injury due to a fall.

<span class="mw-page-title-main">Cardiac electrophysiology</span> Science of elucidating, diagnosing, and treating the electrical activities of the heart

Cardiac electrophysiology is a branch of cardiology and basic science focusing on the electrical activities of the heart. The term is usually used in clinical context, to describe studies of such phenomena by invasive (intracardiac) catheter recording of spontaneous activity as well as of cardiac responses to programmed electrical stimulation - clinical cardiac electrophysiology. However, cardiac electrophysiology also encompasses basic research and translational research components. Specialists studying cardiac electrophysiology, either clinically or solely through research, are known as cardiac electrophysiologists.

The University of Toledo College of Medicine and Life Sciences is a medical school affiliated with the University of Toledo, a public university located in Toledo, Ohio, United States. The College is located on the University of Toledo's Health Science Campus in south Toledo.

Orthostatic intolerance (OI) is the development of symptoms when standing upright that are relieved when reclining. There are many types of orthostatic intolerance. OI can be a subcategory of dysautonomia, a disorder of the autonomic nervous system occurring when an individual stands up. Some animal species with orthostatic hypotension have evolved to cope with orthostatic disturbances.

Postural orthostatic tachycardia syndrome (POTS) is a condition characterized by an abnormally large increase in heart rate upon sitting up or standing. POTS is a disorder of the autonomic nervous system that can lead the individual to experience a variety of symptoms. Symptoms may include lightheadedness, brain fog, blurred vision, weakness, fatigue, headaches, heart palpitations, exercise intolerance, nausea, diminished concentration, tremulousness (shaking), syncope (fainting), coldness or pain in the extremities, numbness or tingling in the extremities, chest pain, and shortness of breath. Other conditions associated with POTS include myalgic encephalomyelitis/chronic fatigue syndrome, migraine headaches, Ehlers–Danlos syndrome, asthma, autoimmune disease, vasovagal syncope and mast cell activation syndrome. POTS symptoms may be treated with lifestyle changes such as increasing fluid, electrolyte, and salt intake, wearing compression stockings, gentler and slow postural changes, avoiding prolonged bedrest, medication, and physical therapy.

A tilt table test (TTT), occasionally called upright tilt testing (UTT), is a medical procedure often used to diagnose dysautonomia or syncope. Patients with symptoms of dizziness or lightheadedness, with or without a loss of consciousness (fainting), suspected to be associated with a drop in blood pressure or positional tachycardia are good candidates for this test.

Inappropriate sinus tachycardia (IST) is defined as sinus tachycardia that is not caused by identifiable medical ailments, a physiological reaction, or pharmaceuticals (a diagnosis of exclusion) and is accompanied by symptoms, frequently invalidating and affecting quality of life. IST symptoms include palpitations, chest discomfort, exhaustion, shortness of breath, presyncope, and syncope.

<span class="mw-page-title-main">Mark Josephson</span> American cardiologist and writer

Mark E. Josephson (1943-2017) was an American cardiologist and writer, who was in the 1970s one of the American pioneers of the medical cardiology subspecialty of cardiac electrophysiology. His book titled Clinical Cardiac Electrophysiology: Techniques and Interpretations is widely acknowledged as the definitive treatment of the discipline. He served as Herman Dana Professor of Medicine at Harvard Medical School, director of the Harvard-Thorndike Electrophysiology Institute and Arrhythmia Service and the chief of cardiology at Harvard University's Beth Israel Deaconess Medical Center in Boston.

The Bezold–Jarisch reflex involves a variety of cardiovascular and neurological processes which cause hypopnea, hypotension and bradycardia in response to noxious stimuli detected in the cardiac ventricles. The reflex is named after Albert von Bezold and Adolf Jarisch Junior. The significance of the discovery is that it was the first recognition of a chemical (non-mechanical) reflex.

Syncope, commonly known as fainting or passing out, is a loss of consciousness and muscle strength characterized by a fast onset, short duration, and spontaneous recovery. It is caused by a decrease in blood flow to the brain, typically from low blood pressure. There are sometimes symptoms before the loss of consciousness such as lightheadedness, sweating, pale skin, blurred vision, nausea, vomiting, or feeling warm. Syncope may also be associated with a short episode of muscle twitching. Psychiatric causes can also be determined when a patient experiences fear, anxiety, or panic; particularly before a stressful event, usually medical in nature. When consciousness and muscle strength are not completely lost, it is called presyncope. It is recommended that presyncope be treated the same as syncope.

The Lilavati Hospital and Research Centre is a private hospital located in Bandra, Mumbai, India. The hospital was established in 1978 by the Lilavati Kirtilal Mehta Medical Trust.

Orthostatic syncope refers to syncope resulting from a postural decrease in blood pressure, termed orthostatic hypotension.

The Ohio State Richard M. Ross Heart Hospital is located at Ohio State University in Columbus, Ohio. The hospital specializes in cardiology, and is ranked number 46 in the United States for its heart program by U.S. News & World Report for 2020. Care is provided for patients with cardiovascular disease or peripheral vascular disease. The hospital was the first in the country to perform robotic surgery.

Orthostatic hypertension is a medical condition consisting of a sudden and abrupt increase in blood pressure (BP) when a person stands up. Orthostatic hypertension is diagnosed by a rise in systolic BP of 20 mmHg or more when standing. Orthostatic diastolic hypertension is a condition in which the diastolic BP raises to 98 mmHg or over in response to standing, but this definition currently lacks clear medical consensus, so is subject to change. Orthostatic hypertension involving the systolic BP is known as systolic orthostatic hypertension.

Charles Antzelevitch is an American cardiovascular research scientist in the fields of cardiac electrophysiology and cardiac arrhythmia syndromes.

Bruce B. Lerman is a cardiologist. He is the Hilda Altschul Master Professor of Medicine at Weill Cornell Medical College, and was chief of the Division of Cardiology and director of the Cardiac Electrophysiology Laboratory at Weill Cornell Medicine and the New York Presbyterian Hospital.

References

↑ "Blair P. Grubb". utoledo.edu. Retrieved March 6, 2017.
↑ "Blair Grubb". utoledo.edu. Retrieved March 6, 2017.

10. http://www.legacy.com/obituaries/toledoblade/obituary.aspx?pid=173940796

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[1] "Blair P. Grubb". utoledo.edu. Retrieved March 6, 2017.

[2] "Blair Grubb". utoledo.edu. Retrieved March 6, 2017.

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