MEET OUR HEART MONTH AMBASSADOR
Dr. David Birnie, BSc (Hons), MBChB, MRCP(UK), MD Deputy Chief, Division of Cardiology Faculty of Medicine Tier 1 Clinical Research Chair in Cardiac Electrophysiology
David Birnie, MD, is staff cardiac electrophysiologist and Deputy Division Head of Cardiology at the University of Ottawa Heart Institute. He is also Full Professor in the Division of Cardiology, Department of Medicine, at the University of Ottawa. Dr. Birnie co-leads the Ottawa Region strategic research Innovation Cluster on Arrhythmias.
Dr. Birnie received his medical degree (MB ChB) from Glasgow University in 1990. After completion of Internal Medical training at Aberdeen University he gained his MRCP (UK) in 1993. He spent three years as a cardiology research fellow at Glasgow University studying the immunology of atherosclerosis and was awarded his PhD equivalent (MD) in 1996. Between 1996 and 2001 he undertook cardiology training at Glasgow University and received his Certificate of Completion of Specialist Cardiology Training in 2001. In addition, he spent a year in 1999-2000 as a Cardiac Electrophysiology Fellow at the University of Ottawa Heart Institute. Dr. Birnie was recruited to the University of Ottawa Heart Institute in 2002 as staff cardiac electrophysiologist and clinician investigator.
Dr. Birnie is a founding member and current chair of the Canadian Heart Rhythm Society Research Committee. He is chair of the first international guidelines for the diagnosis and management of cardiac sarcoidosis. He currently sits on both Canadian Institutes of Health Research (CIHR) and Heart and Stroke Foundation peer review panels.
Dr. Birnie, as principal investigator, has been funded by the British Heart Foundation, HSFC, CIHR and the JP Bickell Foundation. Dr. Birnie has current grant funding from HSFC and CIHR. He played a leading role as Co-Principal Investigator on the CIHR Canadian Atrial Fibrillation Stroke Prevention Network (2013-2019).
To date, he has been involved in over 500 peer-reviewed presentations, publications, and book chapters. In 2014, Dr. Birnie was awarded the University of Ottawa Heart Institute’s Clinical Science Investigator of the Year award and the Global Achievement Award in 2016. In 2018 he was awarded the prestigious University of Ottawa Department of Medicine Mentorship Award. Dr. Birnie has been an invited speaker at major international conferences including the American Heart Association, Heart Rhythm Society and the Canadian Cardiovascular Society meeting. He has managed to combine work with his major hobby, serving as cardiologist for the Medical Advisory Committee of the Canadian Soccer Association.
Research & Clinical Interests
Dr. Birnie is the Deputy Chief Division of Cardiology at UOHI. His clinical focus is on all aspects of cardiac electrophysiology including arrhythmia pharmacotherapy and radiofrequency ablation of simple and complex arrhythmias including atrial fibrillation. He also co-leads the cardiac sarcoidosis clinic and program. He also has a major clinical interest in all aspects of implantation and follow-up of device therapy for arrhythmias. This includes pacemakers, implantable cardioverter defibrillators (ICD) and cardiac resynchronization therapy (CRT).
Dr. Birnie’s major ongoing research interests are cardiac sarcoidosis, selection and optimization of CRT for heart failure patients, investigating optimal strategies for stroke reduction after AF ablation.
A Q&A with Dr. David Birnie, Heart Month 2022 Ambassador
What does it mean to you to be our 2022 Heart Month Ambassador?
It’s truly an honour and a privilege. Generally I‘m not someone who enjoys being in the limelight, but this is a wonderful opportunity to engage with our community. I’ve been with the Heart Institute for 20 years and our donors have been incredibly supportive. I look forward to sharing how excited I am about what’s happening here, hopefully providing even more insight and motivation to continue supporting us. It’s true that we are a world-renowned research centre, but our success is tied directly to our local story. Our donor community funds our ideas, our ingenuity, the first step after we realized there is a problem we don’t know how to fix. Donations provide us with the resources to get the pilot data, start small projects and put all the enabling platforms in place. Only then can we apply to multi million-dollar funding sources like the government to take the research to the next level. During Heart Month, not only are donations matched by local business, but they will be invested in research that could receive funding more than five times the amount of the donation!
What excites you about the research programs at UOHI?
The remarkable thing about the research initiatives at UOHI is how our teams are aligned to ensure we always have an opportunity to collaborate and talk to each other. As part of ORACLE (Ottawa Region for Advanced Cardiovascular Excellence,) which includes our partnership with the University of Ottawa, we have spent the past few years recruiting the very best scientists and research clinicians from around the world. Now we have a critical mass of dedicated researchers of all types. This is truly unique in the field of research and very exciting. Add to that the patient partner program. There are so many ways that patients and family members can get involved in research projects. Our research can start right at the patient’s bedside when we ask ourselves, how can we treat this patient for a better result? Better patient care?
How does the idea for a research study begin?
I’m primarily focused on patient-oriented clinical research of individuals with cardiac arrhythmias. It's really a three - step process. We start at the bedside with an issue faced by a single patient or a number of patients. We ask ourselves; How do we treat this? Can we treat this patient better, more efficiently? Can we give them a better quality of life? Can we help them live longer? We come up with the questions related to a specific disease. Step two is to do an international literature search and make sure that nobody else is already asking the question and further down the road with answers. There's no point in reinventing the wheel if somebody is already on it. Finally, step three is a review our resources, which includes the funding and the people with the right skills.
Can you give us an example?
My favorite example is a disease that I do a lot of research on, called cardiac sarcoidosis. It is a rare condition, but we still see plenty of patients with it. In 2004 I had been on staff for two years when a patient, a woman in her 50’s had been diagnosed with heart block, highly unusual for her age. The standard of care at the time was to insert a pacemaker. It was a puzzle to me, and we looked for answers. It turned out that what she had was cardiac sarcoidosis, a rare condition where patients have an abnormal immune reaction to something in the environment. It can cause a variety of issues including arrythmias and heart failure. At the time I couldn’t tell her why she had it, how to treat it or the prognosis. We pulled together the resources, rolled up our sleeves and in the past 17 years we have become internationally recognized leaders of this condition. It started with one patient, one bedside and one physician who didn’t know what to do. In 2004, that patient had a 50% chance of surviving 10 years with her disease. Here we are, 17 years later and she is still part of our patient research program. We now have the knowledge to help 90% of patients with this condition live another 10 years. This is a testament to the research environment at the institute. We have the tools, the enablers of success.
How are donations used to help advance research?
Advancing research always starts with the community. You can't just come up with an idea and receive a $2 million funding grant the next day. The local funding is required to get started. To buy the equipment needed for testing and analysis. It’s needed to hire the scientists to focus on the preliminary work and start the collaborations with other scientists. When we have this critical mass of expertise in our research teams, we want to keep them at the Heart Institute. Always reaching for the next innovation, solving new problems, bringing their ingenuity to clinical trials. To do that we need continuous funding from the community.
What breakthroughs do you see happening in the next decade?
The big breakthroughs in the last 10 years have been minimally invasive surgical procedures, the things that the surgeons do. For example, 15 years ago heart valve replacement was a major procedure for many patients. Now it's a much more minor procedure. Patients can go home in two or three days. In the next 10 years, you're going to see more and more of that happening. And because the procedures are less invasive, we can treat much older patients, and patients who are more frail because the recovery is much shorter. Recovery is a few days rather than a few weeks. That's number one. I think number two will be the breakthroughs that we've seen in the treatment of heart failure in the last few years. Heart failure used to be this dreadful prognosis. But that has been transformed in the past 10 years. And in my area of study, arrhythmias, you're going to see a lot of breakthroughs around the arrhythmia that's very common in Ottawa called atrial fibrillation. We are looking at the primary prevention of atrial fibrillation, getting to the disease before it becomes a disease.
And finally, I think we're going to see more and more breakthroughs in what are known as orphan diseases or rare diseases. Diseases like cardiac sarcoidosis that I mentioned earlier are relatively rare. You're going to see a lot more centralization of clinics studying it. Doctors in the community aren't just looking after one patient. There's going to be clinics built within institutions like ours to look after the whole region's patients with cardiac sarcoidosis. And there's other diseases like cardiac amyloidosis and many more examples I can give you.
What does it mean to you have to have our community supporting research at the Heart Institute?
A big part of our success at the institute is our culture and staff moral. The morale is very, very high. And it's high for many reasons, and one of the reasons is because the community supports us so well. The support is on multiple levels, there is the fundraising which is exceptional, and there are also the words, the cards and notes of appreciation, and the response from patients who want to participate and partner with our research. It all adds up. We are here because of the community and they make us better everyday.