Anne Gillis is a professor of Medicine at the University of Calgary, Calgary, Canada, and the medical director of Cardiac Pacing and Electrophysiology at Foothills Hospital, Calgary, Canada. She is also the current president of the Heart Rhythm Society (HRS). She talked to Cardiac Rhythm News about her career achievements and highlights, and her plans for the HRS.
Why did you decide to become a doctor and, in particular, why did you choose to specialise in electrophysiology?
I was always interested in science and research and pursued an undergraduate degree in chemistry. At university, I became aware of the varied research opportunities possible in the field of medicine. As a medical student, I became very interested in pharmacology and cardiology.
In my clerkship year, I did an elective in the coronary care unit that introduced me to arrhythmias and the emerging field of electrophysiology. That was in 1979, when the field of antiarrhythmic drug development was dominant and clinical electrophysiology was emerging as a subspecialty. In the early 80s, the first implantable cardioverter defibrillator (ICD) had just been implanted and catheter ablation was still an experimental concept.
I was fortunate to be able to pursue a clinical and research fellowship in electrophysiology at Stanford University from 1982 to 1985. My first week at Stanford, Roger Winkle supervised the first ICD to be implanted at that centre and hence my introduction to a tremendously exciting time of the evolution of device technology, which has saved and transformed so many people’s lives.
In terms of your career, who has been the great influence on you and why?
My career in medicine, in academic electrophysiology, as a clinician scientist, and now as president of the HRS has afforded me the opportunities to meet and work with some of the most brilliant minds in our field.
My career path has been influenced by many individuals. As a medical student, I had two important early mentors: Dr Brian Chandler, the head of the division of cardiology at Dalhousie University, and Dr Jean Gray, a clinical pharmacologist and outstanding teacher.
Both were incredibly supportive of my pursuit of an academic career in cardiac electrophysiology. Dr Eldon Smith and George Wyse recruited me to the University of Calgary and have been important role models throughout my career. In particular, George has had an enormous influence on my career development-mentoring me in my early years as a clinician scientist, facilitating my leadership development and has been an important collaborator in research. Additionally, my colleagues Brent Mitchell and Hank Duff have been important collaborators in the conduct of some of my research projects as well as providing valuable critiques of research grant applications and manuscripts. Working closely with George, Hank and Mitch during my early years as a clinician scientist helped me solidify my drive for the pursuit of excellence and innovation in research and clinical care.
I have to thank David Benditt for appointing me to my first HRS committee-the Scientific Program Committee, which introduced me to many leaders in our field. Nora Goldschlager, Sanjeev Saksena and Dwight Reynolds were all instrumental in encouraging me to pursue the leadership track of the HRS. Also, I have to acknowledge the entire electrophysiology group in Calgary who have been so supportive of my leadership role in HRS.
What do you think has been the most important development in the field of electrophysiology?
The field of electrophysiology is one of rapid evolution and constant change. Rarely in the field of medicine do we cure patients of illnesses, but in electrophysiology we have had the opportunity to cure many patients of their arrhythmias, improve the quality of their life, and transform their lives. The constant evolution of technology in our field is both exciting and challenging. As a clinician scientist, the opportunity to lead the development and investigation of new concepts to advance diagnostics and therapies for heart rhythm disorders has been very rewarding. There have been two extremely important developments in the field of electrophysiology-the ICD and catheter ablation. The ICD has saved millions of lives worldwide. Over 500,000 catheter ablation procedures are performed annually around the globe, curing patients of supraventricular tachycardia. We still have challenges to increase the successful outcomes of ablation for atrial fibrillation over the long term, which provides exciting opportunities for our field in the next decade.
One of your major research interests is in cardiac implantable electronic devices. What are the research priorities in this field?
I am eager to see the evolution of leadless pacing technology. I hope this will provide more affordable therapy options in developing nations. The success of this technology may also improve delivery of cardiac resynchronisation therapy (CRT) for heart failure patients in the future. I am an ardent proponent of remote programming of implantable electronic devices and would like to see accelerated activity in introducing this technology into clinical practice.
Improved risk stratification tools to identify those at greatest risk for sudden cardiac arrest who would benefit from an ICD remains important as our current clinical criteria are imperfect.
As someone who has been actively involved in research, which piece of research are you most proud of and why?
I am most proud of the research I did in collaboration with Andre Kleber and Vladimir Fast when I was on sabbatical leave in the Department of Physiology at the University of Bern in 1994–1995. Using what was, at the time, state-of-the-art optical mapping techniques at the cellular level, we studied the role of different types of discontinuities in tissue architecture and tissue geometry on the spatial distribution of the transmembrane potential during the application of defibrillation shocks. These three publications led to new insights into the mechanisms of defibrillation that challenged existing theoretical concepts at that time.
Of the research you have seen in the last year, which did you find the most interesting?
In the past year, the publications of the ARISTOTLE and ROCKET clinical trials have influenced guidelines for stroke prevention in the setting of atrial fibrillation worldwide. The superiority or equivalence of apixaban (Eliquis, Bristol-Myers Squibb, Pfizer) and rivaroxaban (Xarelto, Bayer) compared with warfarin for prevention of systemic thromboembolism with a significant reduction in the risk of major bleeding complications, especially intracranial haemorrhage, is clinically impactful. In addition, the publication of the PALLAS study reporting the increased risk of death associated with dronedarone (Multaq, Sanofi-aventis) in patients with significant cardiovascular risk factors and permanent atrial fibrillation is a sobering reminder of the risks of antiarrhythmic drugs.
You have won several awards, which one are you most proud of and why?
Becoming a medical scientist of the Alberta Heritage Foundation for Medical Research was a significant career award as I was the first investigator of the Foundation who was recruited initially as a clinical investigator to advance to scholar, senior scholar and then scientist. Of course, I am very proud to have been elected to become the 34th president of the HRS.
What are your main goals for the HRS during your year as president?
I am extremely honoured to serve as the second international president of the HRS. The society has many exciting opportunities this year, including the expansion of our Sudden Cardiac Arrest and Atrial Fibrillation Awareness Campaigns through our global partners, and the introduction of a new awareness campaign focused on device disparities in USA minority populations.
We will continue to advance the care of patients with heart rhythm disorders through advocacy, research and education. In addition, I will be working to help develop programmes that will put future electrophysiology leaders in a position to succeed. By equipping physicians and educating patients and the general public, the HRS will be one step closer to achieving its goal of eliminating death and suffering due to heart rhythm disorders.
You have been a member of the society since 1991; how has it evolved during that time?
Over the last two decades, the HRS has grown in size and maturity. In 2001, we undertook major governance restructuring, including a rebranding from the North American Society of Pacing and Electrophysiology (NAPSE) to the HRS reflecting, in part, the growing international stature of the society. I have also witnessed the annual scientific sessions grow in size and become the pre-eminent meeting for our field, including both clinicians and basic scientists. In addition, the HRS continues to promote and guide high standards of care worldwide through our various consensus documents. I am very pleased that although the society has evolved into a global premier organisation over time, we have continued to maintain a patient-centred approach in all of our efforts in advocacy, education and research.
What, in your view, are the benefits of becoming a member of a society such as the HRS?
Our members include professionals in cardiac pacing and electrophysiology in over 70 countries that help to further our mission to improve the care of patients by promoting research, education and optimal health care policies and standards. The benefits for our members are numerous. HRS offers online and print subscriptions to HeartRhythm, one of the premier subspecialty journals in cardiology, updates on the latest consensus statements, and discounts on educational programmes, including the society’s annual scientific sessions, board review courses and online educational offerings. In addition, the ability to network with other colleagues in the field is one of the highest identified benefits of membership. Readers can learn more about our services at HRSonline.org.
What has been your most memorable case and why?
Calgary is the training centre for a number of national sports teams, including men and women’s ice hockey and Nordic events. I have performed catheter ablation procedures on a number of Olympic athletes and subsequently seeing them achieve their personal bests in international competition is memorable.
Many of the leading figures in electrophysiology are male. What can be done to encourage women into electrophysiology and how can they be encouraged to be leaders in their field?
Given that females comprise over 50% of enrolment in medical schools in North America, it is imperative that the HRS increase awareness of the field of electrophysiology early in the medical training curriculum. We need to create a culture of healthy work life balance in our field to make it a more attractive subspecialty for women. The society is in a great position to encourage women to begin careers in electrophysiology through our Women’s Leadership Initiative (WLI). Through the WLI, we strive to diversify the field of electrophysiology by creating a vibrant community of interest for female electrophysiologists. We also aim to increase the number of women in the field of electrophysiology, strengthen their non-medical professional skills, provide opportunities to enhance their professional standing, and enable them to assume leadership positions in the field. This is achieved in part by linking WLI participants with a female mentor in the field who can help guide their professional steps. We believe that our efforts will strengthen the field overall and positively impact research, education and patient care.
Outside of medicine, what are your hobbies and interests?
I very much enjoy golfing and I am an avid skier. I particularly enjoy these activities with my sister, brother-in-law, and nephews. I also enjoy hiking in the mountains and alpine photography. In addition, I have a very eclectic taste in books from history to fiction. I love mysteries and thrillers (especially on long plane flights) but also enjoy general fiction and non-fiction.
1996–present Professor of Medicine, Department of Cardiology, Faculty of Medicine, University of Calgary, Libin Cardiovascular Institute of Alberta, Calgary, Canada
1991–1996 Associate professor of Medicine, Department of Cardiology, Faculty of Medicine, University of Calgary, Libin Cardiovascular Institute of Alberta, Calgary, Canada
1986–1991 Assistant professor of Medicine, Department of Cardiology, Faculty of Medicine, University of Calgary, Libin Cardiovascular Institute of Alberta, Calgary, Canada
1986–present Clinical electrophysiologist, Foothills Medical Centre, Calgary, Canada
1979 MD with Distinction, Dalhousie University, Halifax, Canada
1975 BSc with Distinction (Chemistry), Dalhousie University, Halifax, Canada
Awards and distinctions (selected)
2006 Department of Medicine, ARP 2005 Merit Award
2003–2009 Medical Scientist of the Alberta Heritage Foundation for Medical Research
1998–2003 Senior Scholar of the Alberta Heritage Foundation for Medical Research
- Heart Rhythm Society (president)
- American Heart Association
- Basic Science Council/Clinical Council, Canadian Cardiovascular Society
- Cardiac Electrophysiology Society
- Canadian Medical Association
- Royal College of Physicians and Surgeons of Canada
- European Heart Rhythm Association