The Beat Interviews Dr. F. Daniel Ramirez

Dr. F. Daniel Ramirez is a cardiac electrophysiologist and clinician-scientist in the Division of Cardiology at the University of Ottawa Heart Institute (UOHI). He bounced around between Kingston and Ottawa while completing his early medical training, and later studied in Bordeaux, France, before returning to the UOHI.

The Beat caught up with Dr. Ramirez to learn more about his journey to becoming a doctor and his passion for electrophysiology and cardiovascular research.

What follows is a short summary of our conversation.

The Beat: Do you recall what sparked your interest in cardiovascular medicine?
Dr. Daniel Ramirez: I realized I wanted to pursue clinical medicine and research when I was an undergraduate student in Ottawa. I joined Dr. Ed O’Brien’s vascular biology laboratory as an honours student in biochemistry in 2006. Dr. O’Brien is both an interventional cardiologist and basic science researcher. That was my first exposure to biomedical research, and specifically to cardiovascular research, but also to medicine and cardiology. Dr. O’Brien’s team at that time included several people who are well known today: Dr. Benjamin Hibbert, Katey Rayner, PhD, Dr. Trevor Simard, the list goes on. I credit Dr. O’Brien and his team for sparking my interest in both medicine and cardiovascular research. I am fortunate to have had him as a mentor.

Can you tell us about your educational background – where did you study?
I moved from Kingston, Ontario to Ottawa to complete my undergraduate degree in biochemistry at the University of Ottawa in 2007. After that, I returned to Kingston to complete medical school at Queen’s University in 2011. Then I relocated back to Ottawa to complete residency training in internal medicine and cardiology. In internal medicine, I spent a year as chief resident. I earned my Royal College certifications in internal medicine in 2014 and in cardiology in 2018. I extended my cardiology residency by one year to complete a master’s in epidemiology at the University of Ottawa, defending my thesis and earning the best thesis award in 2019. I also completed clinical and research fellowship training in cardiac electrophysiology in Ottawa in 2019. I was then awarded a Canadian Institutes of Health Research Banting Postdoctoral Fellowship, which allowed me to undertake additional cardiac electrophysiology training at the Hôpital Cardiologique du Haut-Lévêque and L’Institut de Rythmologie et Modélisation Cardiaque (LIRYC) in Bordeaux, France. I completed that in 2020. And now I am back here!

What are your clinical interests and why do these subjects interest you?
I am interested in virtually all aspects of electrophysiology, but my main interests are atrial tachyarrhythmias–rhythm disorders that include atrial fibrillation and atrial tachycardia. One in four people will develop atrial fibrillation at some point in their life. Despite it being so common, there is still so much we have yet to understand about the condition. We have come a long way in the last few decades, but there are still fundamental questions about these arrhythmias that we must answer. I wanted to study in Bordeaux, France because the group there pioneered the ablation techniques used for atrial fibrillation. I wanted to learn firsthand their approach to ablation of this and related arrhythmias. My experience in Bordeaux gave me an appreciation for the complexities and the nuances of these ablative procedures as well as of the unanswered questions that we still need to tackle. It is great to see that our arrhythmia team here at the Heart Institute is working to answer many of these same questions through our clinical research. As we continue to refine our understanding of these arrhythmias and discover innovative ways to treat them, we expect to have a big impact on a large portion of our patients.

How does working at the University of Ottawa Heart Institute position you to be successful?
The Heart Institute is truly a unique place. I did not fully appreciate the value of having a whole dedicated institute for cardiovascular medicine until I started visiting other centres and working elsewhere. It is rare to find this concentration of cardiovascular knowledge and skill, clinically, but also in research. Working at a place like this keeps me on my toes–in a good way. As a clinician and researcher, it is a privilege to work here. You get the opportunity to do innovative procedures and interventions for patients, to care for patients with complex medical conditions, to train future cardiologists, and to perform impactful research. Along with that comes a sense of duty and responsibility. You want to make sure you make the most out of it as possible and that you do it well because there are very few places that can offer what the Heart Institute offers.

What do you hope to achieve through your work at the Heart Institute?
We have a very strong group of electrophysiologists here at the Heart Institute. They are highly skilled, highly knowledgeable, and our centre has one of the highest electrophysiology procedural volumes in Canada. The group also has a track record of conducting impactful research. I very much want to contribute to that, to be a part of the recipe. I want to help advance the great work my colleagues are doing, and at the same time, I hope to find complementary questions that I can answer, especially questions focused on atrial arrhythmias. The top priority for the whole group is of course patient care, but it goes hand-in-hand with the research work the group does and I hope to do.

What is one thing you wish you could tell every patient – one thing you think every patient should know?
That is a tough question because every patient is unique and experiences their cardiac condition differently. What matters to one patient might not be the same as what is important to another. Accordingly, as a clinician, how you can make an impact varies with each patient. A common thread though is that patients are at the heart of what we do. It sounds corny, but all of us dwell on patients well after we have left the hospital, we all get excited when a patient does well, and tough cases stay with us for years. Similarly, from a research perspective, what we all consider the most important research is that which helps us provide better care for our patients. Our patients truly are our motivation. They are at the heart of why we are here, the reason for everything we do. I think for most patients, knowing that their physician truly cares about them, that they are their physician’s priority, is important. It is what I would want as a patient, what I believe my loved ones would want. Surely, it is what I want for my patients: for them to know that their well-being is my number one priority.