CANet has helped Dr. Ian Steill share an important fact with hospitals across Canada – the majority of AAFF patients can be effectively and safely treated in the emergency room and then discharged to return home. Steill, a CANet Investigator, clinical epidemiologist, and emergency medicine physician at The Ottawa Hospital Research Institute, received CANet’s Strategic Research Grant totaling $718,600 and $3 million in matching funds for his project, Decreasing Hospital Admissions from the Emergency Department for Acute Atrial Fibrillation. The tour-de-force of Steill’s CANet-funded project – the first-of-its-kind collection of guidelines for emergency room (ER) physicians that standardizes AAFF treatment across Canada, and helps them provide a higher quality of care for AAFF patients. Most emergency rooms in Canada treat AAFF – abnormally rapid heart rates that have been present for less than seven days and are often disabling to most patients – by using drugs or electricity to help return the heart to its normal ‘sinus’ rhythm. The procedure is known as cardioversion. Patients are usually discharged soon thereafter. “We have seen more and more Canadian ER physicians willing to cardiovert AAFF patients and then discharge them directly home from the ER,” Steill says. In fact, Steill’s ER group...

Calgary, AB, June 11, 2018 – Paramedics in Calgary and surrounding areas are now able to increase capacity in the Emergency Medical Services (EMS) system, thanks to the CANet-funded project, CASMER, Community Alternatives for Syncope Management in the Emergency Room. CANet investigator, CASMER project lead and professor at University of Calgary’s Faculty of Medicine Dr. Satish Raj, together with a team of medical researchers, doctors, and paramedics, recently launched CASMER in Calgary and surrounding areas within a radius of 45-60 minutes. “Most patients with low-risk syncope, otherwise known as a temporary loss of consciousness or fainting, have excellent outcomes because the diagnoses – vasovagal syncope and initial orthostatic hypotension – are non-life threatening and thus, do not merit a trip to the hospital,” Dr. Raj says. Both, however, are continually recurring features of low-risk syncope, and alarm patients to such a degree that it often prompts unnecessary trips to emergency departments where tests and costs rapidly escalate. Even worse, often patients inconveniently have to wait several hours to be seen, adding to the overcrowding in the emergency departments. With CASMER, paramedics are now using simple checklists to determine whether syncope patients are low-risk or not. If they are low-risk, paramedics...

As far back as 2005, Dr. Venkatesh Thiruganasambandamoorthy felt that the outcomes of adults with syncope seen in Canadian Emergency Departments (EDs) needed to be more fully investigated. So he led the study Outcomes in Canadian Emergency Department Syncope Patients – Are We Doing a Good Job? to see what could be learned. The study, published in 2012, came to the conclusion that ED physicians should be aware of the significant risk for serious adverse outcomes in syncope patients after seven days, and that future studies should be done to develop a risk-stratification system to identify which ED syncope patients need to be admitted, and which ones can be safely followed up in an outpatient clinic. This led Dr. Thiruganasambandamoorthy to develop the Optimal Management of Low-Risk Syncope Patients program. This program looks at all aspects of syncope care at both patient and health system levels and will impact patients, communities at large, EMS workers, and hospital EDs. One project within the program is the validation of the Canadian Syncope Risk Score (CSRS), which will be used to standardize ED syncope management and identify low-risk patients for early disposition. Using the CSRS, ED physicians can predict 30-day serious outcomes for...

Among patients in septic shock and other forms of distributive shock, the addition of the antidiuretic hormone vasopressin to standard anti-hypotensive treatment is associated with a lower risk for atrial fibrillation (AF), researchers report. In a meta-analysis that included 23 randomized clinical trials involving more than 3,000 patients in distributive shock, adding vasopressin to catecholamine vasopressors led to a statistically significant reduction in AF risk (relative risk 0.77, 95% CI 0.67 to 0.88). Sepsis is the most common cause of distributive shock, but the condition can also occur after cardiovascular surgery, spinal cord injury, anaphylaxis, and prolonged shock. AF is a common adverse event among patients in distributive shock, and is associated with an increased risk for death, morbidity, and longer hospital stays. The endogenous peptide hormone vasopressin can be used as a vasopressor, and its use may result in adverse events including AF, organ injury, and death by reducing the requirement for catecholamines. “The theoretical basis for vasopressin administration stems from research identifying relative vasopressin deficiency in patients with distributive shock,” William McIntyre, MD, of McMaster University in Ontario, Canada, and colleagues, wrote in the study online in the Journal of the American Medical Association. In an effort to determine...

Syncope research pioneer Dr. Robert Sheldon has teamed up with patients across Canada to produce cutting-edge treatments through the execution of a first-in-world trial. Sheldon, a CANet Investigator, and professor at University of Calgary’s Faculty of Medicine received a CANet Strategic Research Grant totaling $249,929 for his project, ‘Assessment of Norepinephrine Transport Inhibition to Prevent Recurrent Vasovagal Syncope.’ The CANet-funded project has helped doctors and researchers answer critical yet often over-looked questions such as – what is the acceptable threshold of side effects and discomfort for patients in exchange for them taking drugs for the treatment of syncope? How often and when are patients willing to take pills? Currently, there are no proven medical treatments for syncope. “We have to make it worthwhile for them to take the drug,” Sheldon says. “What drives us is patient involvement. It’s a complete eye-opener and the experience has been overwhelmingly positive.” The answers to these questions are critical in shaping and defining the way Sheldon and his teams conduct clinical trials of Atomoxetine, and increase the chances of a successful trial. Atomoxetine is an experimental drug projected to reduce the occurrence and suffering of syncope in Canada, decrease emergency room visit and empower...

Syncope is a transient loss of consciousness, described as fainting or passing out. It usually relates to a temporary insufficient flow of blood to the brain. Syncope is a common condition, which can occur at any age and in people without other medical problems. Neurally mediated syncope (NMS), the most frequent cause of fainting, is benign. It is most common in children or young adults but can occur at any age. If this type of syncope is prolonged, it can trigger a seizure. Cardiac syncope is caused by a heart or blood vessel condition that affects blood flow to the brain. These conditions can include arrhythmia, structural heart disease, blockages in the cardiac blood vessels, valve disease, aortic stenosis, blood clot, or heart failure. A challenge with syncope is to accurately identify low-risk syncope patients in the emergency department avoiding hospitalization, better still, have paramedics identify these patients and avoid going to the hospital altogether. Click here to view ‘On Track: Syncope’

Sometimes, all it takes to make a difference is a handshake, a smile and the words ‘tell me about yourself.’ Mary Runte is reaching out to arrhythmia patients – including families and support groups – to document and share their experiences of living and dealing with the illness. Runte, a CANet Investigator, Chair of the CANet Patient Advisory Committee, and professor at University of Lethbridge’s Faculty of Management, recently received CANet’s dedicated Social Sciences Grant totaling $240,000, for her project, ‘Mapping the Arrhythmia Patient Journey’ which documents the social, emotional and psychological impact of arrhythmia in patients. Her research will provide Canada’s first in-depth and comprehensive record of the patient experience of arrhythmia through the perspective of the patients themselves. From this information, doctors will be able to design more efficient, effective and holistic interventions that will take into account patient priorities. It is also essential to take into account the economic, social, and psychological impacts of the illness in patients suffering from arrhythmias. For example, doctors are often unaware of arrhythmia’s effect on a patient’s employment situation, family responsibilities, and lifestyle choices. “Real world measures are important when real-life problems are being investigated,” Runte says. She is an arrhythmia patient...

Sometimes, all one needs to do is listen. With CANet’s social sciences initiatives to support the examination of new approaches to research critical to the transformation of arrhythmia care practices in Canada, Hearts in Rhythm Organization (HIRO) has embarked on a pioneering nation-wide journey to listen to the problems faced by Canadians suffering from inherited heart rhythm disorders (IRD) such as inherited arrhythmia conditions and the unpredictable sudden cardiac death. The main goal of HIRO’s journey is to provide standardized IRD care that addresses the unique psychological needs of all Canadians. Over the next two years, with the financial support provided for this CANet-funded study, along with multiple network investigators working across four provinces, HIRO will conduct a nation-wide online survey (both in English and French) of approximately 400 IRD patients, their family members and their caregivers. “CANet’s funding of the Social Sciences is critical in helping us reach as many Canadian inherited heart rhythm patients & families as possible,” says Brianna Davies, a Research Genetic Counsellor and CANet Highly Qualified Personnel (HQP) Trainee. Aligned with CANet’s patient engagement goals, the HIRO survey team, consisting of cardiologists, nurses, and genetic counsellors, worked with three ‘patient-partners’ who helped develop the survey...

Two national projects led by Ottawa emergency medicine researchers received a total of $5.5 million from the Cardiac Arrhythmia Network of Canada (CANet) and matching funders. Dr. Christian Vaillancourt’s team* aims to help 9-1-1 communication officers save the lives of more people who experience cardiac arrest. About a quarter of individuals whose hearts stop suddenly will gasp for air, which can fool 9-1-1 callers and communication officers into delaying life-saving CPR. Dr. Vaillancourt’s team will test whether a piloted educational tool can help 9-1-1 communication officers recognize cardiac arrest when abnormal breathing is present, and improve survival rates across Canada. Dr. Ian Stiell’s team** aims to standardize care for patients with acute atrial fibrillation so that most patients with this irregular heart beat are treated in emergency departments and discharged home without needing to be hospitalized. Dr. Stiell’s team will test new guidelines they helped developed in 10 Canadian hospitals with the goal of decreasing hospitalizations for atrial fibrillation by at least 20 percent. See CANet news release for details. *Co-investigators: Ian Blanchard, Jamie Brehaut, Manya Charette, Jim Christenson, Kathryn Cyr Katie Dainty, Paul Dorian, Michael Feldman, Judah Goldstein, Stephanie Hodges, Colette Lacroix Shannon Leduc, Laurie Morrison, Matthew Spidel, Monica Taljaard, John Tallon, Venkatesh...

For some of the best minds in cardiac care, the successful treatment of atrial fibrillation has been a moving target. Until now. CANet’s Commercialization grant is funding the development of the Catheter Contact-Force Controller (CFC), a pioneering device that will result in more effective atrial fibrillation (AF) treatments, fewer repeat procedures, and lower healthcare costs. Dr. Drangova, a scientist at the Robarts Research Institute and a professor in the Department of Medical Biophysics in the Schulich School of Medicine and Dentistry at Western University, recently received CANet’s Commercialization Grant totaling $300,000, for her project, ‘Catheter Contact-Force Controller for Cardiac Ablation Therapy.’ Daniel Gelman, a CANet Highly Qualified Personnel (HQP) Trainee, is an electrical and computer engineer who invented and continues to enhance the CFC with Drangova. He first presented his research at the Heart Rhythm Society in San Francisco – the leading conference in cardiac electrophysiology, where he received an overwhelming amount of attention from the academic, clinical and industry arenas. His research poster received top prizes at the Imaging Network Ontario Symposium, London Health Research Day, and CANet annual meeting. He previously received a CANet Discovery Grant totaling $25,000. “I greatly benefited from CANet’s HQP-trainee program,” Gelman says. “It provided valuable resources and opportunities for me to...