BC Cardiovascular Community at the Canadian Cardiovascular Congress

Rising Stars – Dr. Jason Andrade

JAndradeDr. Jason Andrade is a clinical assistant professor at the University of British Columbia and a member of the Divisions of Cardiology at Vancouver General Hospital and St. Paul’s Hospital. He is the associate director of the Atrial Fibrillation clinic, director of non-invasive electrodiagnostics, and director of the electrophysiology laboratory at Vancouver General Hospital. Additionally is involved in the Provincial AF Clinic Revision Working Group, the Provincial EP Standard Operating Procedures committee, the Provincial Heart Rhythm BC Outcomes Committee, as well as serving on the executive of the Canadian Heart Rhythm Society, where he is the chair of the Education Committee.
He received his MD from the University of Ottawa and completed his Internal Medicine residency and Cardiology fellowship at the University of British Columbia before embarking on a clinical and research fellowship in Cardiac Electrophysiology at the Montreal Heart Institute. His clinical and research interests include the management of complex atrial arrhythmias and advanced cardiac implantable device therapy.

Lay summary of program/project:

Atrial fibrillation (AF) is the most common heart rhythm disorder, in which abnormal electrical activity in the heart causes its two upper chambers (the atria) to quiver instead of contract in a coordinated manner. This results in a very fast, irregular heartbeat. Typically a chronic progressive disease, AF is characterised by exacerbations and remissions. While not usually life threatening, AF can reduce quality of life and increase the risk of stroke and death. The contemporary management of AF is centered on symptomatic improvement, as well as reduction in the morbidity and mortality associated with AF (with consequent reduction in AF-related emergency room visits or hospitalizations). A multidisciplinary, focused clinical-research program focused is the most cost-effective means to address the multitude of uncertainties surrounding the contemporaneous management of atrial fibrillation. Through establishment of a collaborative research focused environment we hope to create a system whereby both investigator, and industry-led preclinical and clinical questions regarding AF can be easily addressed. The overall focus of the program is the improvement of outcomes for patients afflicted with AF through a combination of quality improvement research, economic evaluation and technological innovation and evaluation.

Medical Summary of program/project:

A multidisciplinary, focused clinical-research program is the most cost-effective means to address the uncertainties surrounding the contemporaneous management of atrial fibrillation (AF). The overall focus of the program is the improvement of outcomes for patients with AF through a combination of quality improvement research, economic evaluation and technological innovation. The first major focus of the program is a multi-center randomised trial of patients with non-permanent AF who are undergoing an invasive ablation procedure. In this multicenter Canadian study, one third of the patients will have their ablation performed as usual with 240 second cryoablation freezes, one third will have the cryoablation freezes broken-up into two 120 second freezes, and another third will undergo radiofrequency (RF) ablation. A total of 300 patients will be included. Participants will be followed for one year to determine the rates of arrhythmia recurrence, and will be closely followed for potential adverse events. We hypothesize that a repetition of shorter freezing durations will result in a more effective lesion in the heart, which will result in increased cure of the arrhythmia as well as a reduced risk of intervention. While we have previously preformed pre-clinical research on this topic using a canine model, this trial will allow us to definitively address the question as to whether shorter freezing durations are more effective and/or safer. This project will be one of the first randomized clinical trials to assess the cardiac cryoablation dose (or duration of freezing) in patients with AF and to directly compare the two energy sources (cryoablation and RF ablation). The second major focus of the program is the establishment of a collaborative research focused environment utilising the multi-center interdisciplinary provincial AF clinic architecture. This unique and largely untapped resource represents a major opportunity to evaluate the comprehensive scope of contemporary AF care, with a focus on guideline adherence, therapeutic outcomes, and access to specialized care.