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The Hearts in Rhythm Organization: A Canadian National Cardiogenetics Network. CJC Open 2020; 2:652-662. [PMID: 33305225 PMCID: PMC7710951 DOI: 10.1016/j.cjco.2020.05.006] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2020] [Accepted: 05/23/2020] [Indexed: 12/21/2022] Open
Abstract
Background The Hearts in Rhythm Organization (HiRO) is a team of Canadian inherited heart rhythm and cardiomyopathy experts, genetic counsellors, nurses, researchers, patients, and families dedicated to the detection of inherited arrhythmias and cardiomyopathies, provision of best therapies, and protection from the tragedy of sudden cardiac arrest. Methods Recently, existing disease-specific registries were merged into the expanded National HiRO Registry, creating a single common data set for patients and families with inherited conditions that put them at risk for sudden death in Canada. Eligible patients are invited to participate in the registry and optional biobank from 20 specialized cardiogenetics clinics across Canada. Results Currently, there are 4700 participants enrolled in the National HiRO Registry, with an average of 593 participants enrolled annually over the past 5 years. The capacity to enable knowledge translation of research findings is built into HiRO’s organizational infrastructure, with 3 additional working groups (HiRO Clinical Care Committee, HiRO Active Communities Committee, and HiRO Annual Symposium Committee), supporting the organization’s current goals and priorities as set alongside patient partners. Conclusion The National HiRO Registry aims to be an integrated research platform to which researchers can pose novel research questions leading to a better understanding, detection, and clinical care of those living with inherited heart rhythm and cardiomyopathy conditions and ultimately to prevent sudden cardiac death.
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Roston TM, Dewar L, Franciosi S, Hathaway J, Bartels K, Cunningham T, Gibbs KA, Sheps S, Laksman ZWM, Sanatani S, Krahn AD. The accessibility and utilization of genetic testing for inherited heart rhythm disorders: a Canadian cross-sectional survey study. J Community Genet 2017; 9:257-262. [PMID: 29170972 DOI: 10.1007/s12687-017-0348-y] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2017] [Accepted: 11/08/2017] [Indexed: 01/01/2023] Open
Abstract
The genetic basis of many sudden death-related conditions has been elucidated. These include inherited arrhythmias and arrhythmogenic cardiomyopathies, termed inherited heart rhythm disorders (IHRD). Advising on and interpreting genetic testing is challenging for the general cardiologist. This has led to the development of interdisciplinary clinics for IHRD in varying stages of establishment in Canada. We sought the viewpoints and patterns of practice of Canadian IHRD experts, and assessed their ability to access genetic testing for IHRD using a national cross-sectional survey. Of 56 participants, most were physicians (68%) or genetic counselors (19%). Despite working collaboratively, most genetic counselors (59%) were either not satisfied or only somewhat satisfied with their relationships with physicians. Ninety percent of participants were involved in offering genetic evaluation, including 80% who felt that testing was usually/always accessible. Most offered genetic testing to confirm clinical diagnosis and/or direct family screening. Post-mortem genetic analysis was sought by 69% of respondents; however, a lack of retained tissue and/or poor tissue preparation hindered this process. Family screening was usually recommended in the setting of a pathogenic/likely pathogenic variant. The most commonly perceived barrier to genetic testing was cost to the healthcare system. More than a quarter of patients waited ≥ 6 months for funding. An ability to engage at-risk relatives was rated as limited/poor by 34% of participants. Despite the establishment of several interdisciplinary clinics, timely access to affordable testing, supported by strong team communication, continues to be a barrier to genetic testing in Canada.
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Affiliation(s)
- Thomas M Roston
- BC Inherited Arrhythmia Program, Vancouver, BC, Canada.,Heart Rhythm Vancouver, Division of Cardiology, University of British Columbia, Vancouver, BC, Canada.,University of Alberta, Edmonton, AB, Canada
| | - Laura Dewar
- Simon Fraser University, Burnaby, BC, Canada
| | - Sonia Franciosi
- Children's Heart Centre, BC Children's Hospital, Vancouver, BC, Canada
| | | | | | - Taylor Cunningham
- Children's Heart Centre, BC Children's Hospital, Vancouver, BC, Canada
| | - Karen A Gibbs
- BC Inherited Arrhythmia Program, Vancouver, BC, Canada
| | - Sam Sheps
- University of British Columbia, Vancouver, BC, Canada
| | - Zachary W M Laksman
- BC Inherited Arrhythmia Program, Vancouver, BC, Canada.,Heart Rhythm Vancouver, Division of Cardiology, University of British Columbia, Vancouver, BC, Canada
| | - Shubhayan Sanatani
- BC Inherited Arrhythmia Program, Vancouver, BC, Canada.,Heart Rhythm Vancouver, Division of Cardiology, University of British Columbia, Vancouver, BC, Canada.,Children's Heart Centre, BC Children's Hospital, Vancouver, BC, Canada
| | - Andrew D Krahn
- BC Inherited Arrhythmia Program, Vancouver, BC, Canada. .,Heart Rhythm Vancouver, Division of Cardiology, University of British Columbia, Vancouver, BC, Canada. .,Heart Rhythm Vancouver, 211-1033 Davie St, Vancouver, BC, V6E 1M7, Canada.
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Care M, Chauhan V, Spears D. Genetic Testing in Inherited Heart Diseases: Practical Considerations for Clinicians. Curr Cardiol Rep 2017; 19:88. [PMID: 28812208 DOI: 10.1007/s11886-017-0885-3] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
PURPOSE OF REVIEW Genetic testing has become an important element in the care of patients with inherited cardiac conditions (ICCs). The purpose of this review is to provide clinicians with insights into the utility of genetic testing as well as challenges associated with interpreting results. RECENT FINDINGS Genetic testing may be indicated for individuals who are affected with or who have family histories of various ICCs. Various testing options are available and determining the most appropriate test for any given clinical scenario is key when interpreting results. Newly published guidelines as well as various publicly accessible tools are available to clinicians to help with interpretation of genetic findings; however the subjectivity with respect to variant classification can make accurate assessment challenging. Genetic information can provide highly useful and relevant information for patients, their family members, and their healthcare providers. Given the potential ramifications of variant misclassification, expertise in both clinical phenotyping and molecular genetics is imperative in order to provide accurate diagnosis, management recommendations, and family risk assessment for this patient population.
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Affiliation(s)
- Melanie Care
- Division of Cardiology, Department of Medicine, Peter Munk Cardiac Centre, Toronto General Hospital, University Health Network, 200 Elizabeth St., Toronto, ON, M5G 2C4, Canada.,Department of Molecular Genetics, University of Toronto, Toronto, ON, Canada
| | - Vijay Chauhan
- Division of Cardiology, Department of Medicine, Peter Munk Cardiac Centre, Toronto General Hospital, University Health Network, 200 Elizabeth St., Toronto, ON, M5G 2C4, Canada.,Department of Medicine, University of Toronto, Toronto, ON, Canada
| | - Danna Spears
- Division of Cardiology, Department of Medicine, Peter Munk Cardiac Centre, Toronto General Hospital, University Health Network, 200 Elizabeth St., Toronto, ON, M5G 2C4, Canada. .,Department of Medicine, University of Toronto, Toronto, ON, Canada.
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