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Realizing His Genetic Destiny
After graduating from the University of Toronto in internal medicine and cardiology, Dr. Verma attended the world-renowned Cleveland Clinic to study to become an electrophysiologist. An electrophysiologist is a cardiologist specializing in the diagnosis and treatment of abnormal heart rhythms, essentially the electrical workings of the heart. He was born and raised in Winnipeg and, fittingly, his father is an electrical engineer and his mother a physician.

Dr. Verma very quickly became a star in his field—an innovator bound and determined to find better methods of treatment. In 2005, at the encouragement of Dr. Zaev Wulffhart, Dr. Verma came to Southlake to continue the groundbreaking work he had begun in Cleveland.

Much of Dr. Verma’s work centres around cardiac arrhythmia (irregular heart beat) and specifically atrial fibrillation (AF). Affecting millions of people worldwide, AF is a condition in which the upper chambers of the heart beat rapidly and erratically, affecting the heart’s ability to adequately pump blood to its lower chambers and the rest of the body. The condition is responsible for 15 to 20 per cent of all strokes and is a leading cause of hospitalizations. The most common treatment for AF is ablation or burning inside the heart. The resulting scar tissue helps return the heart to a regular rhythm.

Dr. Verma has authored or co-authored more than 70 articles and abstracts on electrophysiology issues, ablation and arrhythmia, including a study recently published in the New England Journal of Medicine. He has also received many honours and awards, including the first ever Southlake Research Award of Excellence in 2012.

Since joining Southlake, Dr. Verma has helped put the hospital on the worldwide radar. AF ablation is a relatively new procedure and there are only a few centres that offer this type of care. Southlake has the highest volume ablation program in Canada and Dr. Verma receives referrals from across the GTA and Canada, not only for patients undergoing their first ablation, but also from patients who have had the procedure at other centres and are looking for follow-up with Dr. Verma.

“Techniques for ablation are consistently changing and improving,” Dr. Verma says. “A decade ago, our success rate was 50 per cent. Now we are at about 70 per cent and are getting better and better all the time.”

Much of that consistent improvement is thanks to Dr. Verma’s research, which has focused on how to improve and refine these complex ablation procedures to get the best results and minimize risks. One of his first major studies while at Southlake, Substrate versus Trigger Ablation for Reduction of Atrial Fibrillation (STAR-AF), proved that there is a more effective way to treat patients with a severe arrhythmia than the current treatment methods.

The trial followed 108 patients at four Canadian hospitals, Southlake, Hamilton Health Sciences, Montreal Heart Institute and Royal Jubilee Hospital in Victoria, and four European cardiac centres in Norway, Spain and Italy, over a one-year period.

It compared three approaches to ablation and ultimately found the approach that yielded the best patient outcomes and likely saved the lives of countless people around the world. Dr. Verma is currently conducting a follow-up project, STAR-AF 2. With trials complete, the team is now in its analysis phase. Dr. Verma is also a co-principal investigator for an international research study referred to as RAFT-AF, which studies treatment methods for patients with heart failure and AF.

Dr. Verma is a key member of a group of arrhythmia specialists from across Canada who was recently awarded a major grant by the Canadian Institute of Health Research to study stroke prevention for patients with AF. As part of this $10-million, five-year study, Dr. Verma will co-lead the Optimal Anticoagulation for Enhanced Risk Patients Post-AF Ablation Trial, which will study whether eliminating AF in patients can prevent future strokes. For this research, 3,000 patients from Canada and Europe with successful AF ablation will have miniature loop recorders implanted under their skin and be followed for a minimum of three years.

Not stopping there, Dr. Verma is waiting to hear if a group proposal to the National Centre of Excellence will be accepted. Dr. Verma’s portion of the proposal is to study novel forms of health care delivery and knowledge translation—in other words, how we can take the data we get from science and translate it to patients.

“Long ago we realized AF increases the chance of stroke, so how do we make this real for patients,” he gives as an example. It is estimated that only half of patients who are known to benefit from blood thinners are on them—because they are not prescribed, they don’t understand the risks or they simply don’t want to take the medication.

“How do we get physicians to actively prescribe therapy to patients and make sure patients and physicians understand the risks?” Dr. Verma asks.

There is no doubt these are exciting times in the advancement of cardiac care, and Dr. Verma, thanks to a Southlake environment that encourages innovation, is in the driver’s seat for a lot of this progress. Understandably, Dr. Verma is thrilled he came to Southlake when he did. There really is no place like it.


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