Transcatheter Aortic Valve Replacement (TAVR) is a minimally invasive procedure for high-risk patients with aortic stenosis that involves a high risk of developing cardiac arrhythmias and requires monitoring for 5-10 days post-surgery. Currently this monitoring is done using scares and expensive hospital telemetry beds.
A new mobile telemetry service (m-CARDS) will allow early discharge at 24 hours post-surgery, reducing pressure on hospital resources and improving patient experience.
Patients will receive pre- and post-TAVR monitoring via m-CARDS to examine the impact to cost-effectiveness, hospital readmissions, likelihood of hospital acquired infections and quality of life for patient and family.
Continuous home monitoring using the m-health solution is intended to detect intermittent conduction abnormalities, such as heart block and atrial fibrillation.
The primary objective of this study is to assess feasibility and patient and clinical team experience and to gather information useful for implementing a larger study for clinical outcomes including: length of stay post-TAVR; arrhythmia-related rehospitalizations; and cost-effectiveness.
Madhu Natarajan is an interventional cardiologist and Principal Investigator for the Coronary Interventional Health Delivery and Knowledge Translational and Implementation programs at PHRI. He is a Professor at McMaster University, Director of Catheterization Laboratories at Hamilton Health Sciences, and Site Director for Cardiology at Hamilton General Hospital.
He has published more than 85 articles, is Chair of the STEMI-EMS Committee, Cardiac Care Network of Ontario, member of the Royal College Cardiology National Examination Board, and program lead for Regional STEMI network in LHIN-4 Ontario.
Jeff Healey is a Senior Scientist in the Arrhythmia and Heart Failure research program at PHRI, an Associate Professor, Medicine, McMaster University, and Director of Arrhythmia Services at Hamilton Health Sciences. His research involves conducting RCTs and large registries in the fields of atrial fibrillation and cardiac devices. He was the lead author of the SIMPLE trial, published in the Lancet in 2015, which demonstrated that implantable defibrillators could be safely inserted without performing intra-operative defibrillation testing.
He was the lead author of the ASSERT trial, published in New England Journal of Medicine in 2012, demonstrating the increased stroke risk associated with sub-clinical atrial fibrillation detected by pacemakers. Thomson-Reuters recognized ASSERT as the 38th most-cited scientific publication in 2012 (#16 in Medicine).
He was principal investigator and chair of the Canadian Stroke Prevention Intervention Network (CSPIN), a ten-year network grant funded by the Canadian Institutes of Health Research, The Heart and Stroke Foundation of Canada and Industry. He is the past co-chair of the Canadian Cardiovascular Society’s Atrial Fibrillation Guidelines Committee. Jeff has published more than 185 manuscripts.
Associate Program Manager
Heather Beresh has worked at PHRI since May 2002, largely devoted to managing global, multi-centre clinical trials of antithrombotic therapies in patients with atrial fibrillation (AF). She started as research coordinator for the ACTIVE study evaluating dual antiplatelet therapy and angiotensin receptor blockers in patients with AF, then continued with oversight of the AVERROES open label extension trial evaluating a novel oral anticoagulant in the same population, and ARTESiA evaluating anticoagulant therapy in patients with subclinical AF.
In addition, she has coordinated trials of ablation procedures versus anti-arrhythmic medications and trials evaluating screening strategies for AF. Heather also manages network collaborations, including the Canadian Stroke Prevention Intervention Network (CSPIN). She has as a Master’s degree in Medical Sciences from McMaster University.
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