Working with families in the Inherited Cardiac Arrhythmia Program to define different aspects of inherited cardiac conditions is both an exciting challenge and incredible privilege. Each day brings new situations and different scenarios, but adopting a team approach to each different problem provides great satisfaction and will always be a unique and very humbling experience.

MEDIA

Caregiver Profile

Caregiver Profile

Meet Dr. Dominic J.R. Abrams

EDUCATION

Undergraduate Degree

  • St. Mary's Hospital and The Royal Postgraduate Medical Schools , 1991 , London , United Kingdom

Medical School

  • St. Mary's Hospital/Imperial College , 1994 , London , United Kingdom

Internship

  • St. Mary's Hospital , 1995 , London , Uited Kingdom

Residency

Pediatric
  • St. Mary’s, St. Thomas’, Northwick Park, Royal Brompton & Harefield Hospitals , 1999 , London , United Kingdom

Fellowship

Cardiac Electrophysiology
  • Royal Brompton & Harefield, St. Bartholomew’s and The Heart/University College Hospitals , 2007 , London , United Kingdom

Philosophy of Care

My job as a cardiac electrophysiologist provides an amazing contrast between the varied world of human cardiac genetics and the myriad of different cardiac arrhythmias managed interventionally in the cardiac electrophysiology laboratory.

From the early days of my medical training, I have been fascinated by the complex relationship between human genetics and the associated clinical conditions - how one simple molecular change can lead to such wide ranging and varied conditions, and how understanding human genetics has helped unlock different biological pathways involved in inherited heart disorders. Working with families in the Inherited Cardiac Arrhythmia Program to define different aspects of inherited cardiac conditions is both an exciting challenge and incredible privilege.  Each day brings new situations and different scenarios, but adopting a team approach to each different problem provides great satisfaction and will always be a unique and very humbling experience.

Equally challenging and satisfying, and yet requiring a complete different approach, is the interventional approach to arrhythmia management.  As a medical student watching a presentation of the treatment of a young patient with highly symptomatic Wolff-Parkinson-White syndrome, and seeing a picture of him on the summit of Mt. Kilimanjaro after a successful ablation was an inspirational and highly motivating experience.  To be able to eliminate symptoms in patients with arrhythmia allowing them to resume a normal quality of life remains as rewarding and satisfying today as performing my first ablation.

PROFESSIONAL HISTORY

I received my medical education and post-graduate training in the United Kingdom, specializing in cardiology and electrophysiology.  My fellowships were in both pediatric and adult cardiology, and in 2007 I was appointed as a Consultant Cardiologist and Electrophysiologist at St. Bartholomew’s Hospital, the largest adult electrophysiology center in the UK, and also continued to perform pediatric electrophysiology at Great Ormond Street Hospital.  This dual appointment allowed for detailed evaluation of all family members with varying inherited cardiac condition, including ion channel disorders and cardiomyopathies.  In Boston we have developed a rapid access Inherited Cardiac Arrhythmia Program for all patients with a confirmed or suspected inherited/genetic component to their condition, which runs between Boston Children’s and Brigham & Women’s Hospitals allowing for continued clinical care within the family irrespective of age.  Patients are comprehensively investigated, including clinical and genetic diagnosis and risk stratification, and appropriate management strategies implemented, including cascade screening across extensive families.  We are currently developing a major collaboration with colleagues across New England.  

As an adult and pediatric electrophysiologist I also have extensive experience in the management of arrhythmias in the adult congenital population and this has been a major area of clinical and research activity.

PUBLICATIONS

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  1. Lead age as a predictor for failure in pediatrics and congenital heart disease. Pacing Clin Electrophysiol. 2021 Jan 11. View abstract
  2. Causal Genetic Variants in Stillbirth. N Engl J Med. 2020 12 31; 383(27):2687. View abstract
  3. Cardiocutaneous Features of Autosomal Dominant Desmoplakin-Associated Arrhythmogenic Cardiomyopathy. Circ Genom Precis Med. 2020 Dec; 13(6):e003081. View abstract
  4. 2020 APHRS/HRS expert consensus statement on the investigation of decedents with sudden unexplained death and patients with sudden cardiac arrest, and of their families. Heart Rhythm. 2021 Jan; 18(1):e1-e50. View abstract
  5. Risk Factors for Early Recurrence Following Ablation for Accessory Pathways: The Role of Consolidation Lesions. Circ Arrhythm Electrophysiol. 2020 Nov; 13(11):e008848. View abstract
  6. Value of provocative electrophysiology testing in the management of pediatric patients after congenital heart surgery. Pacing Clin Electrophysiol. 2020 09; 43(9):901-907. View abstract
  7. An International Multicenter Evaluation of Inheritance Patterns, Arrhythmic Risks, and Underlying Mechanisms of CASQ2-Catecholaminergic Polymorphic Ventricular Tachycardia. Circulation. 2020 Sep 08; 142(10):932-947. View abstract
  8. Clinical and Genetic Findings in Children Presenting With Ventricular Fibrillation as the First Manifestation of Cardiovascular Disease. J Am Heart Assoc. 2020 05 18; 9(10):e016322. View abstract
  9. Predicting Heart Failure in Arrhythmogenic Right Ventricular Cardiomyopathy. J Am Heart Assoc. 2020 02 04; 9(3):e015702. View abstract
  10. Adverse event rate during inpatient sotalol initiation for the management of supraventricular and ventricular tachycardia in the pediatric and young adult population. Heart Rhythm. 2020 06; 17(6):984-990. View abstract
  11. An International Multicenter Evaluation of Type 5 Long QT Syndrome: A Low Penetrant Primary Arrhythmic Condition. Circulation. 2020 02 11; 141(6):429-439. View abstract
  12. Outcomes of catheter ablation of anteroseptal and midseptal accessory pathways in pediatric patients. Heart Rhythm. 2020 05; 17(5 Pt A):759-767. View abstract
  13. Arrhythmia Mechanisms and Outcomes of Ablation in Pediatric Patients With Congenital Heart Disease. Circ Arrhythm Electrophysiol. 2019 11; 12(11):e007663. View abstract
  14. 2019 HRS expert consensus statement on evaluation, risk stratification, and management of arrhythmogenic cardiomyopathy: Executive summary. Heart Rhythm. 2019 11; 16(11):e373-e407. View abstract
  15. Molecular mechanisms of arrhythmogenic cardiomyopathy. Nat Rev Cardiol. 2019 09; 16(9):519-537. View abstract
  16. Phenotypic Manifestations of Arrhythmogenic Cardiomyopathy in Children and Adolescents. J Am Coll Cardiol. 2019 07 23; 74(3):346-358. View abstract
  17. Insights Into the Pathogenesis of Catecholaminergic Polymorphic Ventricular Tachycardia From Engineered Human Heart Tissue. Circulation. 2019 07 30; 140(5):390-404. View abstract
  18. Gene Therapy for Catecholaminergic Polymorphic Ventricular Tachycardia by Inhibition of Ca2+/Calmodulin-Dependent Kinase II. Circulation. 2019 07 30; 140(5):405-419. View abstract
  19. 2019 HRS expert consensus statement on evaluation, risk stratification, and management of arrhythmogenic cardiomyopathy. Heart Rhythm. 2019 11; 16(11):e301-e372. View abstract
  20. Overlooked Leadership Potential: The Preference for Leadership Potential in Job Candidates Who Are Men vs. Women. Front Psychol. 2019; 10:755. View abstract
  21. Phenotypic Characterization of Individuals With Variants in Cardiovascular Genes in the Absence of a Primary Cardiovascular Indication for Testing. Circ Genom Precis Med. 2019 03; 12(3):e002463. View abstract
  22. International Triadin Knockout Syndrome Registry. Circ Genom Precis Med. 2019 02; 12(2):e002419. View abstract
  23. The Real-World Utility of the LINQ Implantable Loop Recorder in Pediatric and Adult Congenital Heart Patients. JACC Clin Electrophysiol. 2019 02; 5(2):245-251. View abstract
  24. Genetic Testing for Inherited Cardiac Arrhythmias: Current State-of-the-Art and Future Avenues. J Innov Card Rhythm Manag. 2018 Nov; 9(11):3406-3416. View abstract
  25. Arrhythmias in congenital heart disease: a position paper of the European Heart Rhythm Association (EHRA), Association for European Paediatric and Congenital Cardiology (AEPC), and the European Society of Cardiology (ESC) Working Group on Grown-up Congenital heart disease, endorsed by HRS, PACES, APHRS, and SOLAECE. Europace. 2018 11 01; 20(11):1719-1753. View abstract
  26. Channelopathies That Lead to Sudden Cardiac Death: Clinical and Genetic Aspects. Heart Lung Circ. 2019 Jan; 28(1):22-30. View abstract
  27. SCN5A mutations in 442 neonates and children: genotype-phenotype correlation and identification of higher-risk subgroups. Eur Heart J. 2018 08 14; 39(31):2879-2887. View abstract
  28. Utility of incomplete right bundle branch block as an isolated ECG finding in children undergoing initial cardiac evaluation. Congenit Heart Dis. 2018 May; 13(3):419-427. View abstract
  29. Postmortem Genetic Testing for Cardiac Ion Channelopathies in Stillbirths. Circ Genom Precis Med. 2018 01; 11(1):e001817. View abstract
  30. Cardiac Conduction System in Congenitally Corrected Transposition of the Great Arteries and Its Clinical Relevance. J Am Heart Assoc. 2017 12 21; 6(12). View abstract
  31. Genotype-phenotype-guided medical and surgical intervention in long QT syndrome. HeartRhythm Case Rep. 2018 Jan; 4(1):14-17. View abstract
  32. Dynamic QT Interval Changes from Supine to Standing in Healthy Children. Can J Cardiol. 2018 01; 34(1):66-72. View abstract
  33. Role of Genetic Testing in Inherited Cardiovascular Disease: A Review. JAMA Cardiol. 2017 10 01; 2(10):1153-1160. View abstract
  34. Cardiac Events During Competitive, Recreational, and Daily Activities in Children and Adolescents With Long QT Syndrome. J Am Heart Assoc. 2017 Sep 21; 6(9). View abstract
  35. Circadian Variation of Ventricular Arrhythmias in Catecholaminergic Polymorphic Ventricular Tachycardia. JACC Clin Electrophysiol. 2017 11; 3(11):1308-1317. View abstract
  36. Ebstein Anomaly. Card Electrophysiol Clin. 2017 06; 9(2):245-254. View abstract
  37. How to develop a clinic for sudden cardiac arrest survivors and families of non-survivors. Cardiol Young. 2017 Jan; 27(S1):S3-S9. View abstract
  38. Relation of Left Atrial Size to Atrial Fibrillation in Patients Aged =22 Years. Am J Cardiol. 2017 Jan 01; 119(1):52-56. View abstract
  39. Whole-Exome Molecular Autopsy After Exertional Sudden Cardiac Death: Not a Panacea but a Step in the Right Direction. Circ Cardiovasc Genet. 2016 06; 9(3):210-2. View abstract
  40. Radiofrequency ablation of atrial tachyarrhythmias in adults with tetralogy of Fallot - predictors of success and outcome. Cardiol Young. 2017 Mar; 27(2):284-293. View abstract
  41. PACES/HRS expert consensus statement on the use of catheter ablation in children and patients with congenital heart disease: Developed in partnership with the Pediatric and Congenital Electrophysiology Society (PACES) and the Heart Rhythm Society (HRS). Endorsed by the governing bodies of PACES, HRS, the American Academy of Pediatrics (AAP), the American Heart Association (AHA), and the Association for European Pediatric and Congenital Cardiology (AEPC). Heart Rhythm. 2016 06; 13(6):e251-89. View abstract
  42. Response to Letters Regarding Article, "Clinical Management of Catecholaminergic Polymorphic Ventricular Tachycardia: The Role of Left Cardiac Sympathetic Denervation". Circulation. 2016 Jan 26; 133(4):e366-7. View abstract
  43. Evolution of Electrocardiographic and Structural Features Over 3 Decades in Arrhythmogenic Cardiomyopathy. Circulation. 2015 Jun 23; 131(25):2233-5. View abstract
  44. Clinical Management of Catecholaminergic Polymorphic Ventricular Tachycardia: The Role of Left Cardiac Sympathetic Denervation. Circulation. 2015 Jun 23; 131(25):2185-93. View abstract
  45. Mechanism and ablation of arrhythmia following total cavopulmonary connection. Circ Arrhythm Electrophysiol. 2015 Apr; 8(2):318-25. View abstract
  46. Time dependence of risks and benefits in pediatric primary prevention implantable cardioverter-defibrillator therapy. Circ Arrhythm Electrophysiol. 2014 Dec; 7(6):1057-63. View abstract
  47. Implantable cardioverter-defibrillators in children. Arch Dis Child. 2015 Mar; 100(3):265-70. View abstract
  48. Sudden arrhythmic death syndrome: diagnostic yield of comprehensive clinical evaluation of pediatric first-degree relatives. Pacing Clin Electrophysiol. 2014 Dec; 37(12):1681-5. View abstract
  49. Long QT syndrome. Circulation. 2014 Apr 08; 129(14):1524-9. View abstract
  50. Feasibility and outcomes of ajmaline provocation testing for Brugada syndrome in children in a specialist paediatric inherited cardiovascular diseases centre. Open Heart. 2014; 1(1):e000023. View abstract
  51. Transbaffle mapping and ablation for atrial tachycardias after mustard, senning, or Fontan operations. J Am Heart Assoc. 2013 Sep 19; 2(5):e000325. View abstract
  52. The use of an integrated electroanatomic mapping system and intracardiac echocardiography to reduce radiation exposure in children and young adults undergoing ablation of supraventricular tachycardia. Europace. 2014 Feb; 16(2):277-83. View abstract
  53. The role of cardiac resynchronization therapy for arterial switch operations complicated by complete heart block. Ann Thorac Surg. 2013 Sep; 96(3):904-9. View abstract
  54. Pharmacological and non-pharmacological therapy for arrhythmias in the pediatric population: EHRA and AEPC-Arrhythmia Working Group joint consensus statement. Europace. 2013 Sep; 15(9):1337-82. View abstract
  55. The electrophysiological characteristics of accessory pathways in pediatric patients with intermittent preexcitation. Pacing Clin Electrophysiol. 2013 Sep; 36(9):1117-22. View abstract
  56. Current genomics in cardiovascular medicine. Curr Genomics. 2012 Sep; 13(6):446-62. View abstract
  57. Chest pain and ST elevation. BMJ. 2012 Jun 27; 344:e4323. View abstract
  58. Variable QRS morphologies in Ebstein's anomaly: what is the mechanism? Heart Rhythm. 2013 Jun; 10(6):933-7. View abstract
  59. The DSPII splice variant is crucial for desmosome-mediated adhesion in HaCaT keratinocytes. J Cell Sci. 2012 Jun 15; 125(Pt 12):2853-61. View abstract
  60. Inflammatory skin and bowel disease linked to ADAM17 deletion. N Engl J Med. 2011 Oct 20; 365(16):1502-8. View abstract
  61. Accuracy of algorithms to predict accessory pathway location in children with Wolff-Parkinson-White syndrome. Heart. 2012 Feb; 98(3):202-6. View abstract
  62. Wherein lies children's intergroup bias? Egocentrism, social understanding, and social projection. Child Dev. 2011 Sep-Oct; 82(5):1579-93. View abstract
  63. Does ventricular dyssynchrony on echocardiography predict response to cardiac resynchronisation therapy? A randomised controlled study. Heart. 2011 Sep; 97(17):1410-6. View abstract
  64. Catheter ablation for atrial fibrillation on uninterrupted warfarin: can it be done without echo guidance? J Cardiovasc Electrophysiol. 2011 Mar; 22(3):265-70. View abstract
  65. [Long QT syndrome]. Praxis (Bern 1994). 2010 Jul 07; 99(14):854-8. View abstract
  66. Identification and characterization of DSPIa, a novel isoform of human desmoplakin. Cell Tissue Res. 2010 Jul; 341(1):121-9. View abstract
  67. Resolution of dyssynchronous left ventricular failure via cardiac resynchronization and subsequent radiofrequency ablation in an infant with pre-excitation. Pediatr Cardiol. 2010 Aug; 31(6):897-900. View abstract
  68. Long QT syndrome. BMJ. 2010 Jan 08; 340:b4815. View abstract
  69. Cryoablation versus radiofrequency ablation for treatment of atrioventricular nodal reentrant tachycardia: cryoablation with 6-mm-tip catheters is still less effective than radiofrequency ablation. Heart Rhythm. 2010 Mar; 7(3):340-3. View abstract
  70. Validation of a classification system to grade fractionation in atrial fibrillation and correlation with automated detection systems. Europace. 2009 Dec; 11(12):1587-96. View abstract
  71. Uninterrupted warfarin for periprocedural anticoagulation in catheter ablation of typical atrial flutter: a safe and cost-effective strategy. J Cardiovasc Electrophysiol. 2010 Feb; 21(2):150-4. View abstract
  72. Electrophysiologic and anatomic characterization of sites resistant to electrical isolation during circumferential pulmonary vein ablation for atrial fibrillation: a prospective study. J Cardiovasc Electrophysiol. 2007 Dec; 18(12):1282-8. View abstract
  73. Comparison of noncontact and electroanatomic mapping to identify scar and arrhythmia late after the Fontan procedure. Circulation. 2007 Apr 03; 115(13):1738-46. View abstract
  74. Invasive electrophysiology in paediatric and congenital heart disease. Heart. 2007 Mar; 93(3):383-91. View abstract
  75. The impact of CT image integration into an electroanatomic mapping system on clinical outcomes of catheter ablation of atrial fibrillation. J Cardiovasc Electrophysiol. 2006 Oct; 17(10):1093-101. View abstract
  76. Successful ablation of atrioventricular nodal reentry tachycardia following the atriopulmonary Fontan procedure. Europace. 2006 Oct; 8(10):907-10. View abstract
  77. Validation of the noncontact mapping system in the left atrium during permanent atrial fibrillation and sinus rhythm. J Am Coll Cardiol. 2006 Aug 01; 48(3):485-91. View abstract
  78. Radiofrequency ablation of arrhythmias guided by non-fluoroscopic catheter location: a prospective randomized trial. Eur Heart J. 2006 May; 27(10):1223-9. View abstract
  79. Validation of three-dimensional cardiac image integration: use of integrated CT image into electroanatomic mapping system to perform catheter ablation of atrial fibrillation. J Cardiovasc Electrophysiol. 2006 Apr; 17(4):341-8. View abstract
  80. Transhepatic pulmonary artery stenting via a short intravascular sheath following neonatal repair of truncus arteriosus. Catheter Cardiovasc Interv. 2005 Oct; 66(2):277-80. View abstract
  81. Mechanism and mapping of atrial arrhythmia in the modified Fontan circulation. Heart Rhythm. 2005 Oct; 2(10):1138-44. View abstract
  82. Catheter ablation of permanent atrial fibrillation: medium term results. Heart. 2006 Feb; 92(2):233-8. View abstract
  83. Prolapse of the antero-superior leaflet of the tricuspid valve secondary to congenital anomalies of the valvar and sub-valvar apparatus: a rare cause of severe tricuspid regurgitation. Cardiol Young. 2005 Aug; 15(4):417-21. View abstract
  84. Images in cardiovascular medicine. Membranous pulmonary atresia treated by radiofrequency-assisted balloon pulmonary valvotomy. Circulation. 2003 Apr 22; 107(15):e98-9. View abstract
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