In Memoriam: Dr. Bramah Singh, Cardiologist, Helped Develop Classification System for Drugs to Treat Arrhythmia
Dr. Bramah N. Singh, a world renowned cardiologist and longtime professor of medicine, pioneered a novel classification system used by researchers and clinicians worldwide to study and develop anti-arrhythmic medications. In addition, groundbreaking studies which he conducted early in his career at Oxford University in Oxford, England, enabled identification of a new class of anti-arrhythmic drugs which became some of the most widely used anti-arrhythmic drugs in history. Singh died at his home in Encino, CA, on September 20. He was 76.
A UCLA professor of medicine in the division of cardiology from 1980 to 2009, Singh also served as chief of cardiology from 1988 to 1996 and a staff physician and cardiac researcher at the VA Hospital in West Los Angeles until his retirement in 2009. He has held a UCLA emeritus title since 2009.
Singh was a leading expert on arrhythmias and the pharmacology involved in controlling and treating these severe irregular heart rhythms that affect millions of people. His distinguished career spanned several continents and five decades.
Born in the Fiji Islands in 1938, Singh graduated from medical school at the University of Otago in New Zealand in 1963. He completed a medicine residency at Auckland Hospital, and a cardiology fellowship at Green Lane Hospital, also in Auckland, New Zealand.
In 1969, Singh was awarded the Nuffield Travelling Fellowship and as a doctoral candidate at Oxford University in Oxford, England, working with the esteemed E.M. Vaughan Williams, he identified the anti-arrhythmic properties of two medications, amiodarone and sotalol. Singh categorized these medications as a new class of anti-arrhythmic drugs, which he called Class III, nomenclature which has endured for more than four decades and is used to define the research and bedside application of drugs with similar properties.
Singh, working with Vaughan Williams at Oxford, developed what is commonly referred to today as the Singh Vaughan Williams Classification System for all anti-arrhythmic drugs. This system is studied worldwide and used universally at medical schools and research centers around the world to understand and classify these drugs targeting irregular heart rhythms. With Vaughan Williams as his thesis advisor, Singh received his doctorate in 1971 from Oxford for his work. Several decades later, both Oxford and the University of Otago awarded Singh a Doctorate of Science for his lifelong contributions to medicine and cardiology.
"Since many anti-arrhythmic drugs have multiple modes of action, this early classification system was very helpful in guiding research and patient care. Dr. Singh's contributions have helped pave the way for further exploration and categorization of these important medications," said Dr. Kalyanam Shivkumar, professor of medicine and radiology and director, UCLA Cardiac Arrhythmia Center, UCLA Health System and David Geffen School of Medicine at UCLA.
Singh's pioneering work with anti-arrhythmic drugs and also his work targeting heart disease resulted in more than five hundred publications and book chapters. He was invited to lecture and teach at medical schools all over the world.
A 2009 tribute, written by Dr. Robert A. Kloner in the Journal of Cardviovascular Pharmacology and Therapeutics, where Singh had served as founding editor-in-chief, described his work as follows:
"It was shortly after 1988 that I moved to Los Angeles and had the opportunity to meet with and learn from Dr. Bramah Singh. This soft-spoken academic leader is one of the founders of the field of Class III anti-arrhythmic drugs. His seminal work on drugs such as amiodarone, sotalol, and, recently, dronedarone explored the basic electrophysiology of these unique agents and then applied them to the care of the cardiac patient. Dr. Singh's impact on the field of electrophysiologic pharmacology has been profound."
Another article by J. Desmond Fitzgerald in a 2004 issue of the journal Dialogues of Cardiovascular Medicine, described the importance of Singh's work in translating research from the bench to the bedside:
"The field of Class III anti-arrhythmic drug research has been illuminated by numerous publications in a most fruitful manner over the last 30 years by Professor Bramah Singh, who provides an elegant example of what is now translational medicine, i.e., applying data from the laboratory to the bedside."
Singh mentored hundreds of young of physicians who studied under him or with him, inviting them into his labs, clinics, departments, and his home.
"I owe Bramah for everything I have achieved in academic medicine: He taught me the nuances of cardiology and electrophysiology of anti-arrhythmic drugs, of which he was a giant. My practices in research, as well as the method in which I write manuscripts and present research data, were all based on Bramah's teachings. I was lucky indeed to have Bramah as my mentor and I will forever be in his debt," said Dr. Koonlawee Nademanee, director of the Pacific Rim Electrophysiology Research Institute, Los Angeles, CA and Bangkok, Thailand.
After receiving his doctorate, from 1971 to 1972, Singh served as Nuffield Demonstrator in the Department of Pharmacology at the University of Oxford and as an International Postdoctoral US Public Health Service Fellow at Harvard Medical School and Peter Bent Brigham Hospital in Boston. In 1972, Singh returned to New Zealand as a senior lecturer in medicine and therapeutics at Auckland University of Medicine and consultant cardiologist at Green Lake Hospital.
Singh joined UCLA in 1976 and until 1980 served as an associate professor of medicine in the division of cardiology and was also the director of inpatient cardiology and an attending physician at Cedars-Sinai Medical Center.
"As an accomplished and respected cardiologist, Dr. Singh's life and work touched many and he will be greatly missed," said Dr. Noel Boyle, professor of medicine and director of the Cardiac Electrophysiology Labs, UCLA Health System and the David Geffen School of Medicine at UCLA.
Singh is survived by his wife Roshni Singh, two sons, Dr. Pramil Singh and Dr. Sanjiv Singh and daughter Dr. Nalini Singh. He is also survived by his siblings Vimla Singh, Dr. Nirbhay Singh, Dr. Yadhu Singh, and Urmila Singh.
A memorial service remembering Singh's life and major contributions to cardiology is being planned for early 2015 to enable some of his colleagues from around the world to attend. It will likely be timed around the time of the American College of Cardiology meeting to be held in March 2015 in San Diego, California.