2018-2019

Annual Report

The Cardiac Arrhythmia Network of Canada (CANet) is made possible by the Networks of Centres of Excellence (NCE) – a program of the Federal Government of Canada to mobilize Canada’s best research, development, and entrepreneurial expertise. Along with our private, public and government partners, CANet gratefully acknowledges host support from Western University and the Schulich School of Medicine and Dentistry.

François Labonté

Chair Of The Board

I am pleased to report that the Network continues to move aggressively towards the achievement of the goals outlined in our Strategic Plan. The success of CANet is the direct result of many disciplines coming together to collaborate and learn from one another to help propel arrhythmia research in Canada and beyond.

The integration of patient-driven research initiatives and technologies highlighted within VIRTUES will improve the access, quality, and cost of healthcare for all Canadians with an arrhythmia condition. We have partnered with world-class researchers, full engaged patients, academic institutions and industry partners and their participation is a clear example of the confidence that Canadian companies and organizations have in CANet and the community that it has created.

We are committed to world-class patient-focused excellence in research; international collaborations; and solutions-driven outcomes that will impact the lives of the millions of Canadians suffering from Arrhythmia-related illnesses. We look forward to seeing the positive outcomes of the novel, interdisciplinary research that’s happening in our Network.

Dr. Anthony Tang

Scientific Director and CEO

The Network continues to demonstrate research excellence through the facilitation and funding of multi-disciplinary, multi-provincial, and multi-sectoral collaborative projects that help to position Canada at the forefront as a leader in arrhythmia research and patient engagement.

CANet is committed to empowering patients to manage their health through the development of VIRTUES (Virtual Integrated Reliable Transformative User-Driven E-Health System), a technology that will undoubtedly remodel the structure of care patients receive and allow for appropriate time and place care for arrhythmia patients. VIRTUES is a vital technological building block towards the realization of the transformation of care pathways in the management of arrhythmias.

At the core of the Network’s continued success are our growing connections with the best and brightest arrhythmia researchers in the world, our trainees, our fully engaged patients and our partners. Moving forward, CANet is committed to facilitating the continual invention and implementation of new technologies and strategic solutions.

21,250 Patients Active In Research Programs

VIRTUES

Virtual Integrated Reliable Transformative User-Driven E-Health System

Patient-Driven Care

VIRTUES provides personalized health care delivery, empowerment, and ownership for each patient to co-manage their health. Resources, including health education, are uniquely tailored to the individual.

VIRTUES is a leading-edge data platform designed by CANet that provides patients a cloud-based electronic health record that is owned by the patient and can be accessed by their healthcare providers. Combining mobile electrocardiographic monitoring, wearable/implantable technology, and digital smartphones and tablets,

VIRTUES will track a patient’s symptoms along with real-time data and medical information into a patient-specific, personalized clinical context for patients and medical professionals. It is constructed with the utmost in privacy and security safeguards.

VIRTUES

  • VIRTUES provides virtual care to patients.
  • VIRTUES delivers healthcare to patients at home, in their communities.
  • VIRTUES is designed by patients for patients.
  • VIRTUES improves quality and accessibility of care at reduced cost.
  • VIRTUES is an innovative Canadian solution to a global crisis.

The implementation of VIRTUES improves the access, quality, and cost of healthcare for all Canadians with an arrhythmia condition.

Achievements

  • VIRTUES has been assembled with collaboration from national and international partners
  • VIRTUES was demonstrated in real-time at the 2018 CANet’s Annual Scientific Conference

VIRTUES is the means to transform arrhythmia care to provide effective, efficient and accessible care to all Canadians and is the vehicle by which CANet’s research will be disseminated.

Achievements

Research Excellence

21,000
Patients Participating Across Canada


54 Impactful and Innovative
Patient-driven research programs

189 Network Investigators
Across Canada

27 Patients
Leading or co-leading projects

Networking & Partnerships

$45,590,876.00
Leveraged Funds Achieved


40 Private Sector
300% Growth (since application)

30 Post-Secondary Institutions
15% Growth (since application)

91 Community
225% Growth (since application)

HQP Development

38
New Careers Launched in Private and Public Sectors


304 HQP Active
In trainee Association

2040 HQP Trained

112 Courses and Workshops

Knowledge and Technology Exchange and Exploitation

338 / 1909
CANet Funded / Network Investigator (Publications)


7 Commercialized Technologies

3 Trademarks

5 Patents Filed

Socioeconomic Impacts

90th percentile Improvement in AED arrival

Canada’s first AED delivered by drone
  • Is a Canadian accomplishment in improving urban and rural delivery
  • Improve response time to cardiac arrest = lives saved
  • Successfully drone-delivered AED in Canada on May 17, 2019

40% down to 5% Hospitalization reduction

Improved management strategy of AF patients in ED
  • Adopted into Canadian ED Best Practice
  • Will reduce hospitalization from 40% to 5%
  • Will improve the efficiency of care

$70,000,000 In healthcare savings

Canadian Syncope Risk Score saves healthcare costs
  • 71% of syncope patients were discharged from ED within 2 hours
  • Currently implemented in 16 sites across 4 provinces
  • Will save $70M per year in healthcare cost

45,000/yr Preventable Canadian SCD deaths

Groundbreaking SCD trial with global impact
  • Markers of Sudden Cardiac Death identified
  • Those with the markers die 9-fold more than those without
  • Implantable defibrillators should save the lives of those with the markers

200-300 Jobs created in Canada

Invention creates jobs
  • Early ablation to prevent AF from reoccurring = better quality of life and healthcare saving
  • Canadian invention of cryo-balloon ablation is widely used in Canada and in the world
  • More than 200-300 new Canadian jobs are created

36% Reduction in induced syncope

First drug that prevents vasovagal syncope
  • First effective drug to prevent vasovagal syncope
  • Reduced tilt-table induced syncope by 36%
  • Promising drug = improve quality of life and reduce healthcare spending

Research Excellence

Multidisciplinary Multi-sectoral and Innovative by Design

CANet’s innovative research program is designed to ensure excellence through iterative mentorship and growth. These core principles are the foundation upon which the Network’s funding programs and review processes are built.

All proposals considered for CANet-funding must be multidisciplinary (more than one, i.e. medicine, engineering, and social science); multi-centered (more than one institution, from more than one province); and multisectoral (more than one sector, i.e. academia, clinical, industry, government, not-for-profit, general public and patients). Our programs meet the expectations of a true pan-Canadian Network, utilizing the strengths across the country and encouraging the building of national research and development capacity.

Sudden Cardiac Death (SCD)

SCD is a sudden, unexpected death most commonly caused by a lethal arrhythmia.

A defibrillator shock is the only effective means to terminate the lethal arrhythmia. Currently, the only way to identify an individual at risk of SCD is to measure the heart function – left ventricular ejection fraction (LVEF). Although guidelines recommend LVEF measurement in patients after surviving a myocardial infarction (MI), it is rarely performed. As a result, many patients at-risk of SCD are not identified and are not treated appropriately to avoid SCD.

There are currently 13 national CANet-funded programs associated with SCD. CANet is on schedule to achieve a 10% drop of SCD in at-risk individuals and we continue development and implementation these programs.

Acute MI Quality Assurance and Know your Ejection Fraction - AMIQA and KYEF

Despite the recommendation that patients should have an LV function assessment 3-6 months post-MI, fewer than half of these patients have the assessment3. The goal of this research is to determine the reasons behind this failure and to develop, validate and implement patient-centered, innovative technologies to overcome the barriers to optimal clinical care; thereby reduce SCD in at-risk patients.

Achievements

  • Successful assessment of patient follow-up best practices after MI in 12 sites across Canada
  • A patient designed and tested virtual application to be used by MI survivors for effective management, treatment, and rehabilitation – being integrated with VIRTUES

Benefits to Canada (Socioeconomic Impacts)

  • Empower MI survivors to take ownership of post-MI care with virtual rehabilitation to improve access to guideline-directed management for SCD prevention; these patients contribute to 35% of the incidence of SCD, optimization of treatments in this population will reduce SCD by 34%.

A Large Clinical Trial to Reduce SCD – The World is Watching - REFINE-ICD

A large population of patients at risk of SCD post-MI are patients with intermediate degrees of impaired heart function (LVEF 36-50%)3. CANet investigators identified that if these patients have abnormal repolarization (T-wave alternans – TWA) and autonomic tone (heart rate turbulence – HRT) they are at high risk of SCD6-8. In one of the largest clinical trials in the world to address this issue, a multi-national study is underway using these novel methods to identify patients at risk of SCD and to determine if an implantable defibrillator can prevent their SCD.

Achievements

  • Results to date have demonstrated that individuals with BOTH abnormal TWA and impaired HRT have 9-fold higher death rate than do those patients without these abnormalities.

Benefits to Canada (Socioeconomic Impacts)

  • The results of this research will have a major impact on post-MI patient’s management. If the implantable defibrillator is shown to prevent SCD in these patients, their overall mortality will be reduced; these patients contribute to 7% of the incidence of SCD, optimization of treatments will reduce SCD by 15%.

Surviving Ventricular Arrhythmias - Guidelines Adopted in the USA – VANISH

A Canadian-led clinical trial has demonstrated that catheter ablation is a better treatment option for recurrent ventricular tachycardia (VT) than is augmenting therapy to more potent antiarrhythmic drugs9. The multi-center, multi-national study has been published in the New England Journal of Medicine (NEJM) and currently has over 112,000 hits placing it in the top 5-6% of NEJM articles of all time.

Achievements

  • Through CANet’s Implementation strategy, the results of this study are being incorporated into international guidelines (AHA, ACC, HRS).

Benefits to Canada (Socioeconomic Impacts)

  • The results of this research will have a major impact on patients who suffer from repeated defibrillator shocks for VT. The occurrence of VT in this population is 20-30% over 5 years, the reduction in VT occurrence is 47%.

Remote Patient Monitoring–Eliminating the Differences Between Urban and Rural Healthcare (RPM-CIED)

Currently, 120,000 Canadians with a pacemaker or implantable defibrillator (ICD) have regular device checks in hospitals10. Technology is available to allow remote monitoring of these devices, which has shown to have clinical benefits, be cost-effective, and have high patient satisfaction11. The RPM-CIED program uses remote monitoring technology that integrates with VIRTUES to provide virtual holistic devices and patient care without the need for patients to travel out of their local communities.

Achievements

  • The remote monitoring technologies have been integrated with VIRTUES with privacy and security clearance.

Benefits to Canada (Socioeconomic Impacts)

  • Equal access and quality of care for rural regions and urban regions.
  • Substantial cost-savings in Canadian healthcare for patients by completely removing the need for patients to travel outside of their local community for treatment, an advantage that is especially important in rural Canada.

Drone-Delivered Automated External Defibrillators (AED)

Survival after a cardiac arrest is determined by the rapidity with which a shock can be applied to terminate the lethal arrhythmia12. EMS response times in urban areas are on average 5 minutes, but in rural regions, EMS response times are >10 minutes resulting in fatalities13. AEDs delivered by drones in these rural areas can potentially save lives14.

Achievements

  • Preliminary work has begun in two municipalities in Ontario – Peel Region and Renfrew County
  • Required clearance and regulatory approvals by Transport Canada and NAV Canada have been obtained and test flights were completed in May 2019.

Benefits to Canada (Socioeconomic Impacts)

  • Drone technology, when applied across Canada, will reduce SCD by 15%.
  • Improved response time in rural regions of Canada, saving lives and providing equal quality of care.

Atrial Fibrillation (AF)

AF is the most common heart rhythm disorder and has become an epidemic in the developed and developing world.

AF will affect 1 in 4 Canadians. AF increasing prevalence is due to the aging population, improved detection, and increased risk factors. It leads to impaired quality of life, lost productivity, a 5-fold increase in the risk of disabling stroke, and a doubling in the risk of death.

There are currently 12 CANet-funded AF programs. We are ahead of schedule in achieving a 20% drop of AF hospitalization and ED visits. The (AAF-ED) program has demonstrated >20% reduction of hospitalization in a few centres that have implemented the strategy. Implementing this strategy nationally will result in achieving our clinical goal of 20% reduction in AF related hospitalization.

In addition, the EARLY AF program, the life-style modification program, and the Virtual AF Care program will provide better AF care, thus preventing long-term consequence of AF and reducing ED visits.

New Canadian Guidelines for AF Treatment in the ED - AAF-ED

Patients with acute atrial fibrillation (AAF) <48 hours since onset represent 66% of all patients presenting to ED, and many of these patients are admitted to the hospital16, 17. Appropriate ED management can avoid many hospitalizations. Achievements

  • CANet developed a strategy that improved ED care of patients with AAF while reducing unnecessary hospitalizations.
  • Piloted implementation of these guidelines has reduced hospitalization from 40% to 3.5%18.
  • These practice guidelines have been adopted into Canadian ED Best Practice Guidelines.

Benefits to Canada (Socioeconomic Impacts)

  • Implementation of appropriate management of AAF in the ED and virtual AF care upon discharged from the ED will decrease hospital admissions across Canada.
  • Working with provincial representatives to adopt these guidelines across Canada (> 1000 sites) will reduce in AF-related ED visits and hospitalizations nationally by 30%.

Abolishing AF Early to Prevent Subsequent Adverse Outcomes - EARLY-AF

This is a national clinical trial to determine whether first-line treatment with ablation, using a Canadian invention and manufactured cryo-balloon technology for ablation, instead of initially treating with mediation will eradicate AF early in its course, and thereby be more cost-effective.

Achievements

  • Since the inception and conduct of this study, the Canadian manufactured cryo-balloon ablation procedure has been adopted widely in Canada and internationally. There has been incremental employment of over 200 highly skilled and professional individuals in CryoCath facility, Pointe-Claire, Quebec.
  • This study also incorporates another Canadian invention, RF transseptal technology (Baylis Medical). This study will showcase this technology to the world.

Benefits to Canada (Socioeconomic Impacts)

  • Early ablation could stop AF from reoccurring, thus preventing long-term consequences of AF, improving quality of life, and saving healthcare direct and indirect costs. This study targets 10% of patients with AF. This study is projected to reduce symptomatic AF by 30%.

Virtual AF Care

In-person AF clinics utilizing an interdisciplinary approach have been shown to be effective in providing specialized care with very good clinical outcomes19, 20. However, in-person AF clinics can only provide excellent care to a limited number of patients in an urban region, often an academic center. CANet has developed and begun to implement virtual AF care using the VIRTUES platform (see Section 3: Strategic Plan). CANet plans to establish virtual AF care in several health regions, including the Nunavut Territory, to provide specialized AF care in the patient’s home in their own community.

Achievements

  • The VIRTUES platform has been adapted to incorporate virtual AF care.
  • Privacy and security concerns from institutions/hospitals have been overcome allowing virtual AF care to be initiated.
  • Educational material has been developed and tested by AF patients for adoption.

Benefits to Canada (Socioeconomic Impacts)

  • Greatly improve access to care for Canadians across geographic barrier.
  • Improve care and potentially reduce cost.

Syncope

Syncope affects ~50% of Canadian, causes 1-3% of ED admissions overall with 43% being due to vasovagal syncope (VVS).

These individuals are at very low risk of adverse events. The challenge is to differentiate those with VVS from patients with causes of syncope at high risk of adverse events.

There are currently 8 CANet-funded national programs associated with syncope propelling CANet ahead of schedule in achieving a 30% drop of syncope-related hospitalization and ED visits. When the Canadian Syncope Risk Score (CSRS) in conjugation with emergency medical services (CASMER) were applied to several ED and regions, hospital admissions were reduced by 16% and ER visits were reduced by 34%.

With the implementation of these programs nationally coupling with the application of Virtual Syncope Care, and the promise of a drug that may greatly reduce VVS, we are confident that syncope related ED visits and hospitalization will be reduced.

Canada-Wide Implementation of the Canadian Syncope Risk Score – CSRS

The Canadian Syncope Risk Score (CSRS) optimizes the management of syncope patients by providing accurate ED risk-stratification for early disposition of the very-low to low-risk patients. Using this CSRS tool, clinicians can determine the patient’s risk and chart the best course of action for individual patients.

Achievements

  • The CSRS tool enhances identification of low-risk syncope patients for early discharge and reduces unnecessary hospital admissions and healthcare costs.
  • The CSRS has being implemented in 16 clinical practice sites across 4 provinces.
  • The CSRS tool can be accessed on the MDCalc website and app that is currently used in 196 countries with 1 million monthly users. It is also accessible on the Calculate by QxMD app, a similar platform that has over 400 medical decision support tools encompassing all specialties.
  • Benefits to Canada (Socioeconomic Impacts)

    • Through CANet’s KT platform, national implementation has begun. The CSRS tool will result in 71% of all syncope patients being discharged quickly from the ED (within 2 hours) and is projected to save the Canadian healthcare system approximately $70M per year.
    • 21% of patients can be discharged home with cardiac monitoring devices, with a follow-up plan.
    • This study affects all patients with syncope presenting to the ED, it has already demonstrated a 40% reduction in hospitalizations and repeat ED Visits.

    First Promising Pharmaceutical Drug for Syncope Treatment Found – POST6

    To date, there have been no effective treatments for VVS, which causes a heavy economic impact on our healthcare system (418,000 visits yearly to family physicians and 100,000 visits yearly to the ED). This study is investigating the efficacy and safety of a drug, atomoxetine to prevent vasovagal syncope.

    Achievements

    • This pilot study demonstrated that atomoxetine reduced VVS by 36%.
    • A bigger randomized controlled trial is now planned.

    Benefits to Canada (Socioeconomic Impacts)

    • This drug may be unique in its ability to prevent syncope.
    • This will improve patient’s quality of life and reduce absenteeism.
    • This will be of great benefit to Canadian manufacture of the drug.

    Integration of Syncope Education and Training Implemented in Alberta for EMS and Patients - CASMER

    About 65% of syncope patients seen in ED arrive by ambulance and 10‐40% are admitted23. This study has adapted the Canadian Syncope Risk Score (CSRS) guidelines (see above) to develop checklists for paramedics that will help them decide whether syncope patients are low-risk. If so, the patients can be treated and released immediately.

    Achievements

    • Extensive training modules have been created and, as a pilot trial in the province of Alberta, EMS are currently being trained on the checklists for actual use in the field.

    Benefits to Canada (Socioeconomic Impacts)

    • The training modules will be expanded to include pilot studies in other provinces (Ontario, Nova Scotia) and then will be expanded to national implementation.
    • The benefits of this syncope “Treat & Release protocol” includes decreased operational burden on the ED, a reduction in healthcare costs, and increased patient satisfaction with their healthcare experience.

    Our Trainees

    Highly Qualified Personnel (HQP)

    Evolution of Career Development

    To maintain the same multidisciplinary and multi-sectoral approach inherent in the Network’s research excellence, CANet’s education and career development program, known as CHAT (CANet Highly Qualified Personnel Association of Trainees) is collaborative by design. In addition to directed training programs, CHAT facilitates programs designed to bring members of different fields together, promoting cross-disciplinary and cross-sector collaboration. As CANet’s CHAT program matures, the program has come to a stage where the Network has formed the first CHAT Alumni Association for trainees that have graduated. The alumni will play a prominent role in the Network’s training as mentors and facilitators as part of CHAT’s Legacy Program.

    Enhancing HQP Capacity in Relation to the Needs of the Trainees

    The CANet HQP program is constantly shaped by the evolving needs of its trainees, Network members, and partners. A yearly needs assessment is conducted with all other public and private stakeholders in our Network. CANet continually adapts and tailors its educational offerings to address any gaps in qualifications/skillsets of the HQPs. Feedback received assures that our graduating HQP possess the necessary knowledge to be successful in obtaining employment or advancing their education.

    At its core, the Network continues to emphasize the importance of nation-wide research collaboration with colleagues, partners, and patients early in HQP development to ensure that this concept is implemented into their future professional careers. Nation-wide collaboration is crucial for the growth of national teams and is in alignment with Canada’s evolving funding environment focusing on multi-disciplinary and multi-sectoral, rather than siloed research.

    The Network has 304 HQP trainees enrolled in the CANet HQP association. CANet has committed $6,779,991 in HQP initiatives (salaries, training initiatives and grants) since 2014.

    HQP include: 38 undergraduates, 50 graduates, 27 medical residents, 39 PDF/clinical fellows and 135 allied health research professionals.

    In addition, CANet supports 15 early career/junior investigators. Out of 304 members, 154 are students (54, 35% have graduated and are HQP Alumni). Upon completing the CANet HQP programs, 38 (70%) have obtained full time positions.

    Goals Achieved

    • 300 active members in CHAT
    • 34 new careers launched in public and private sector
    • 112 courses and workshops held
    • 2040 HQP trained

    Knowledge Mobilization: Implementation Research

    CANet’s integrated KT strategy was developed at its inception, which has served well for the initiation of many research programs. The integrated KT strategy has been enhanced to embrace implementation strategies, including the development of the KT milestone tracking. This process ensures that CANet’s integrated KT strategy supports the ongoing translation activities of the research projects.

    Currently, several programs/projects are completing knowledge generation activities and have progressed to knowledge mobilization with implementation research.

    Four research projects are currently initiating regional and provincial implementation activities.

    Canadian Syncope Risk Score (CSRS)

    The Canadian Syncope Risk Score (CSRS) was developed and is being implemented in 16 sites across 4 provinces. The CSRS is being adopted in clinical practice sites in the United States and is receiving strong support for world-wide implementation. The CSRS project was chosen as 1 of only 4 plenary lectures presented at the 2018 Society of Academic Emergency Medicine Conference.

    VANISH

    Ventricular tachycardia/fibrillation (VT/VF) are the lethal arrhythmias leading to SCD. A Canadian-led clinical trial VANISH has demonstrated that catheter ablation is superior than additional antiarrhythmic drug (AAD) therapy to prevent recurrent VT. The results of this study are being incorporated into guidelines of the American Heart Association (AHA), American College of Cardiology (ACC), and the Heart Rhythm Society (HRS). CANet’s implementation strategy was instrumental in developing educational materials resulting in practice change.

    AAF (Acute AF)-ED

    The AAF (acute AF)-ED study has developed a management strategy that was demonstrated to improve patient care in the ED and decrease hospitalization. As of March 2018, this management strategy has been adapted into the ED Best Practice Guidelines. The implementation of this strategy into practice in Canada is expected to improve the management of patients in the ED and decrease the need for admission to the hospital.

    CASMER

    The CASMER study has adapted the Canadian Syncope Risk Score (CSRS) guidelines to develop a simple checklist for paramedics to determine whether the syncope patient is at low-risk. A training module has been created and is being used by the paramedics in Alberta. This “Treat & Release protocol” will decrease the clinical burden on ED, reduce healthcare costs. The project has progressed to the implementation research phase.

    Goals Achieved
    • 338 CANet funded publications
    • 7 commercialized technologies
    • 5 patents filed
    • 3 trademarks
    • 2 start-up companies created
    • 25,146 unique website users, 1,400 social media followers
    • 1,600 total attendees to public forums and annual conferences

    Commercialization

    42 Health Inc. – A Transcutaneous Physiologic Sensor for Home and Clinical Use  (2 patents filed)

    42 Health Inc (CANet funded start-up) is developing a small wearable transcutaneous blood pressure (BP) monitor device that weighs a fraction of an ounce. The device measures the BP of every heartbeat, measures blood oxygen levels, can detect when one falls, stores episodes of arrhythmias, and does this wirelessly. The digital data is transmitted to other devices, such as a smart phone. The company has filed 2 patent applications and is currently being incubated at the University of Calgary.

    An Accurate Simple Blood Test for Arrhythmogenic Cardiomyopathy (1 patent filed)

    Arrhythmogenic right ventricular cardiomyopathy (ARVC) is an inherited heart rhythm disorder which is responsible for 11% of sudden death in adults, 22% in athletes, and 25% in children. ARVC is difficult to diagnose with current clinical or genetic testing. A novel biomarker has been identified and simple, accurate blood test for ARVC has been created. The biomarker is currently undergoing large scale specificity and sensitivity testing.

    Aufero Medical Technologies – Catheter Contact-Force Controller for Cardiac Ablation Therapy (1 patent filed)

    Aufero Medical (CANet funded start-up) has developed a Catheter Contact-Force Controller (CFC) device that can be used in conjunction with standard catheters to instantaneously adjust the catheter position and control contact force. This technology will greatly improve the ablation procedure for atrial fibrillation and will reduce AF recurrence after ablation. The technology is ready for human use. The company is actively fundraising to advance the device to clinical trials.

    Conavi Medical – Catheter-based Imaging Tools for Characterization of Myocardial Ablation Lesions (1 patent filed)

    By coupling ablations with state-of-the-art imaging methods, such as high-resolution ultrasound, physicians are able to visualize the site of the catheter ablation in the heart in real-time to improve the outcomes of the procedure by more effectively destroying the abnormal tissue that is causing the heart rhythm problem. The prototype is ready for clinical testing.

    Drone-Delivered Automated External Defibrillator (AED)

    Drone-delivered AED and drug therapy to improve survival of cardiac arrest victims can save lives. This technology has been developed in collaboration with Drone Delivery Canada. Pilot study for drone-delivered AED to cardiac arrest site is ongoing.

    EARLY-AF – Cryo-balloon Technology for Ablation

    This CANet research project has enhanced the adoption of two Canadian invention and manufactured tools. The use of cryo-balloon for AF ablation procedure and the utilization of transseptal radiofrequency puncture tool have increased substantially in Canada and internationally, resulting is new manufacturing and marketing jobs created in Canada (~200 new jobs created at Baylis Medical, and > 200 new jobs at CryoCath-Medtronic in Quebec).

    Partnerships

    CANet has achieved and exceeded our matching fund goal of $40M within the first 4 years of the Network. CANet has brought in $45,540,876 of cash and in-kind funds from our industry and institutional partners:  an overall research leverage of 3.30 (partner matching dollars) to 1 (NCE/CANet research dollar). CANet is proud to bring together provincial partnerships including nine provinces and one territory. CANet has grown exponentially in private sector and community (medical institutions, clinics, government, public sector) partnerships. Since the original application for NCE funding, private sector involvement has grown 300% and community involvement (hospitals, government, public sector) has grown 225%.

    Through the Network’s investigators and their research accomplishment, there is international awareness, engagement, and collaboration. Our Network reach includes international investigators from USA, Brazil, Columbia, Argentina, Germany, France, Italy, Belgium, Netherlands, Norway, Finland, Sweden, UK, Poland, Spain, Saudi Arabia, India, China, Hong Kong, Australia, New Zealand, Malaysia, Singapore, and Japan.

    Goals Achieved 
    • Over $45M in leveraged partner funds received
    • 189 Network Investigators (78% growth)
    • 34 private sector partners (240% growth)
    • 30 post-secondary institutions (15%growth)
    • 72 community partners (157% growth)

    Patient

    Driven by the Network vision of a transformed, patient-driven arrhythmia care, CANet embraces patients as partners. While healthcare professions are experts at treating disease, patients are experts at living with their diseases. Combining the expertise from both healthcare professionals and patients is the key to the impactful and imaginative use of healthcare resources and research funding. The voices and involvement of patients are critical to the success of CANet. In CANet, patients are not just consulted but are active partners in every aspect of the Network.

    Patients are co-PIs of each research team: All research in CANet must have a patient co-lead to develop protocols, set milestones, and engage other patients. Patients facilitate the direction of research such that the research is relevant and important to them.
    Patients are involved in the governance and management of CANet: Patient partners are members on all CANet committees. Patients are an integral part of the review process for CANet funding initiatives as active reviewers with their own separate review and ranking procedure that they have designed.

    Patient partnership is at the core of CANet’s strategic plan: CANet created the Patient Engagement and Empowerment (PE2) strategy, facilitated by the Patient Advisory Committee (PAC). The PAC is composed entirely of patients with AF, syncope, or are at risk of SCD. CANet has been approached by other healthcare organizations such as the Ontario Ministry of Health and Long-Term Care to integrate our patient engagement strategy into the Ontario provincial implantable cardiac defibrillator and cardioverter resynchronization therapy procurement process.

    In partnership with patients and in accordance with CANet’s vision, the Network has created a patient-driven healthcare model – VIRTUES (Virtual Integrated Reliable Transformative User‐Driven E‐Health System) (see Section 3C for more details).

    Government

    Provincial Government Partners – Provincial government leaders from seven provinces (BC, AB, SK, MB, ON, QC, NS) were consulted at the inception of CANet. Provincial representatives are continually informed of all the R&D of the Network through a bi-annual provincial round table forum. The key outcomes have been the identification of implementation strategies necessary for the translation of CANet research into practice and the development of terms of reference to guide the implementation of best practices. These sessions also facilitate communication across provinces through the identification of connections between provincial mandates. CANet is proud to report that this provincial partner involvement has now expanded to nine provinces (NB, NL) and one territory (NU).

    Industry

    The traditional approach to industry partnerships is either “industry-initiated” research in which researchers agree to participate and include their patients, or “investigator-initiated” research projects that industry would agree to fund. CANet set out to replace this traditional approach with a more collaborative R&D environment. At CANet, industry partners are engaged in the early stages of research conception and are integral to the development of proposals. R&D is co-developed with our partners. This approach facilitates not only achieving CANet strategic goals, but also in expanding the R&D goals of Small and Medium Enterprises (SME’s). An example is the expansion of Baylis Medical, a Canadian SME to open a state-of-the-art Medical Innovation Centre. The new facility will allow Baylis Medical to advance its R&D efforts and significantly expand its product line and workforce. Through our partnership, Baylis Medical has hired over 180 new employees. By promoting a collaborative research environment, traditional industry competitors have become industry collaborators in the medical device field. Through the networking support of CANet, Abbott, Boston Scientific, Medtronic, and Baylis Medical share resources and work collectively on several CANet research projects.

    Annual Scientific Conference

    It was another successful Annual Scientific Conference held in Ottawa, Ontario, September 2018, documenting a growing turnout of attendees including patient, industry and provincial partners, network investigators, trainees and members of our board.

    Hosted by Adrian Harewood (CBC News, Ottawa), our Public Forum featured a very impactful armchair discussion which included panelists Emile Therien and Stephen Blais describing how arrhythmia has personally touched their lives. New this year, the forum was live streamed allowing online viewing and participation. Members of the community joined us on site for the interactive session which was a significant lead into conference day one.

    André Picard, the award-winning national-health writer for the Globe & Mail, was the opening keynote speaker of the ASC and provided a compelling perspective on Canadian healthcare. Our panel discussion informed attendees of unmet challenges of cardiac implantable electrical devices. Conference host, Dr. Calum Redpath (Cardiologist, University of Ottawa Heart Institute) was joined by patients partners to provide a demonstration of VIRTUES displaying the interaction between mobile devices and the cloud-based platform. Dr. Phillip Cuculich (Cardiologist, Washington University) captured the attention of the audience with his in-depth presentation on arrhythmia-related innovation. Cuculich presented some of the research and findings he developed collaboratively with radiation oncologists that resulted in a noninvasive method to map and treat heart rhythm disorders using technology typically used for treating certain forms of cancer.

    Financials

    Statement of Operations and Changes in Net Assets

    For the year ended March 31, 2019, with comparative information for 2018

     Networks of Centres of Excellence (NCE)Non-funding Agencies20192018

    Revenue

    NCE grants 5,406,554 - 5,406,554 7,112,698
    In-kind contributions - 725,257 725,257 925,928
    Partner contributions - 200,000 200,000 200,000
    Amortization of deferred capital contributions - 148,630 148,630 148,630
    Other revenue - 172,672 172,672 116,728
    5,406,554 1,246,559 6,653,113 8,503,984

    Expenses

    Research grants and awards 2,756,686 - 2,756,686 5,044,912
    In-kind expenses- 725,257 725,257 925,928
    Salaries and benefits 864,036 - 864,036 832,573
    HQP training and awards 420,988 2,200 423,188 452,167
    Other services 591,504 173,789 765,293 413,733
    Travel, networking and workshop 525,303 14,790 540,094 227,635
    Annual scientific conference 156,073 - 156,073 155,687
    Amortization expense 1,896 148,630 150,526 150,526
    Audit and professional fees 37,788 8,226 46,014 47,355
    Supplies and other 19,075 7,208 26,283 24,767
    Communications 33,205 - 33,205 23,807
    Sponsorship - 5,500 5,500 -
    5,406,554 1,085,600 6,492,155 8,299,090
    Excess of revenue over expenses - 160,959 160,959 204,894
    Net assets, beginning of year - 577,348 577,348 372,454
    Excess of revenue over expenses - 160,959 160,959 204,894
    Net assets, end of year - 738,306 738,306 577,348

    Board of Directors

    Dr. Pierre Boyle (C)
    Chair, Board of Directors
    BROSSARD, QC

    Ms. Krista Connell
    CEO, Nova Scotia Health Research Foundation
    HALIFAX, NS

    Dr. John Capone
    Vice President, Research, Western University
    LONDON, ON

    Dr. Shurjeel Choudhri
    Senior Vice President, Bayer Canada
    TORONTO, ON

    Mr. Vincent Dumez
    PAC Chair, Co-Director, Office of Collaboration and Patient Partnership, Universite de Montreal
    MONTRÉAL, QC

    Mr. Neil Fraser
    President and CEO,
    Medtronic Canada Ltd.

    BRAMPTON, ON

    Dr. Paul Morley
    Founder & Chief Science Officer,
    Zelos Therapeutics
    OTTAWA, ON

    Dr. François Philippon
    Institut Univérsitaire de Cardiologie et de Pneumologie de Québec
    STE-FOY, QC

    Mr. Michael Gilbert
    President and CEO, Synergiq Solutions
    TORONTO, ON

    Dr. Katherine Allan (OBS)
    Post-Doctoral Fellow
    HAMILTON, ON

    Dr. Anthony Tang
    Scientific Director and CEO
    LONDON, ON

    Dr. George Wells (OBS)
    Associate Scientific Director
    OTTAWA, ON

    Dr. Bryce Pickard (OBS)
    Managing Director and COO
    LONDON, ON

    Our Network

    Dr. Anthony Tang
    Scientific Director and CEO

    Dr. George Wells
    Associate Scientific Director

    Dr. Bryce Pickard
    Managing Director and COO

    Dr. Kevin O’Neil
    Director of Research and Training

    Dr. Natalie Szudy
    Director of Partnerships and Knowledge Mobilization

    Fabian A. Folias
    Director of Digital Marketing and Communications

    David Brazier
    Director of Finance

    Dr. Dimitri Popolov
    Research Data and Systems Manager

    Courtney Gingrich
    Project Coordinator

    Lori Sutherland
    Privacy Officer

    Collaborators
    (click to view)

    Network Investigators
    (click to view)

    The Cardiac Arrhythmia Network of Canada (CANet) is a not-for-profit organization dedicated to transforming Canada’s arrhythmia health care system through integrated trans-disciplinary research and development. The network’s strategy is to invent, prove, and implement innovative solutions to enable patients to take ownership and co-manage their arrhythmia health.

    CANet is funded by the federal government’s Networks of Centres of Excellence (NCE), Canada’s flagship science and technology program and housed at the Schulich School of Medicine & Dentistry at Western University.

    GDPR