Closing the distance key to managing advanced heart failure • Cardiovascular Network of Canada — CANet

Closing the distance key to managing advanced heart failure

At the heart of CANet’s quest to combat sudden cardiac death lies a few millimeters of cardiac muscle.
For Dr. Jamie Manlucu, it will be enough.
With CANet’s help, she is refining a groundbreaking technology that may give 40 per cent of Canadians suffering from advanced heart failure a second lease of life.
The project is a crucial step towards CANet’s strategic goal to reduce sudden cardiac death cases in Canada by 10 per cent.
Manlucu, a CANet Early Career Investigator, and professor at the Schulich School of Medicine & Dentistry, recently received CANet’s Major Industry-Partnered Research Grant totaling $400,000, for her project, ‘Resynchronization For Ambulatory Heart Failure Trial – LV Endocardial Approach (RAFT-LVendo)’ .
Advanced heart failure often results from impaired electrical activation of cardiac muscles.
In the conventional approach – Cardiac Resynchronization Therapy (CRT) – doctors place pacemaker wires at specific areas of the heart to deliver precisely timed electric shocks that restore normal cardiac rhythm.
CRT has been a success story for patients with acute heart abnormalities.
For those with less severe cases – who count among Canada’s most vulnerable populations at risk for ventricular arrhythmias and sudden cardiac death – it has not worked.
Enter LVendocardial CRT.
LVendo CRT uses a larger surface area of the heart to place the wires, unlike conventional CRT, which is limited to small specific areas.
Those extra few millimeters make a world of difference.
Recently completed, in a first-of-its-kind pilot study, patients were recruited and showed that the technique is safe and feasible – compared to conventional treatments for mild heart abnormalities, LVendo CRT stimulates cardiac muscles more efficiently, and helps in better blood flow.
Now, CANet is helping her make a good thing even better.
Over the past few months, Manlucu and her team have expanded the project at 11 cardiac centres across Canada.
They will treat at-risk patients with LVendo CRT and track their progress for a year using a series of extensive tests, interviews, and surveys.
The study will help improve the efficiency and safety of LVendo CRT, introduce it to a wider community of doctors and patients, and make it more cost-effective.
Manlucu has partnered with Baylis Medical and Medtronic of Canada to advance the LVendo CRT tools that both companies have created for the pilot study.
This key industry-partnered research project has also contributed towards CANet’s strategic business and capacity development targets by commercializing new technology.
“This project is a collaboration between experts from the fields of heart failure management, arrhythmia, implantable cardiac devices and cardiac imaging across the country,” Manlucu says, adding that they are mentoring medical trainees and junior engineers working on the project.
With this, CANet continues to grow its highly qualified personnel to tackle sudden cardiac death in Canada and worldwide. Manlucu is also working with CANet’s Patient Engagement and Empowerment team to better understand and incorporate the patient’s perspective.
“Most clinicians are relatively new at collaborating with patients in research,” Manlucu says. “Identifying appropriate patient partners may be challenging in this potentially fragile patient population.”

Through CANet’s Patient Engagement and Empowerment Strategy, support for the identification inclusion and education of patient partners within the research team as well as education for clinicians and highly qualified personnel is being provided. This support is instrumental in ensuring patient engagement is embedded across funded research projects.