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2016: Rohan Wijesurendra

I studied pathology and medicine at Downing College, Cambridge, graduating with MA (Cantab) and MB BChir in 2006. My undergraduate training kindled an intellectual interest in scientific research, and I actively pursued experience of academic medicine during posts as an Academic Foundation Doctor in Cambridge, and then as an Academic Clinical Fellow in Oxford. 

During my early training in cardiology, I was struck by the prevalence of atrial fibrillation (AF), its association with significant cardiovascular complications including stroke and heart failure, and the limitations of current approaches to classification and management. I was immensely fortunate to be able to undertake a DPhil studying patients with AF, under the expert supervision of Prof Barbara Casadei, Prof Stefan Neubauer and Prof Vanessa Ferreira, and supported by a Clinical Research Training Fellowship from the British Heart Foundation Centre of Research Excellence in Oxford.

The main focus of my DPhil has been to explore the nature of the relationship between AF and left ventricular function using multiparametric cardiac magnetic resonance techniques. We found that left ventricular function and energetics are significantly impaired in patients with AF and no significant comorbidities compared to matched control subjects in sinus rhythm, and that these parameters do not normalise despite a substantial and sustained reduction in AF burden following ablation. An intriguing interpretation of these results is that apparently “lone” AF may actually be the consequence (rather than the cause) of an occult cardiomyopathy. Presentation of these novel findings in abstract form resulted in several awards (including the Young Investigator Award in Clinical Science at the European Society of Cardiology Congress held in Rome in August 2016), and the full manuscript has recently been published with an accompanying Editorial in Circulation.

I have also worked on adapting a widely used cardiac magnetic resonance sequence (ShMOLLI T1-mapping) for use in patients with AF. For the first time, we showed that acquisition in systole (rather than diastole) yields equivalent myocardial T1 values (a type of measurement in MRI scanning), improves data quality and is readily applicable in patients with tachyarrhythmia. This methodological groundwork has allowed me to use this technique to study ventricular tissue characteristics and myocardial perfusion in a cohort of patients with AF, despite the presence of a fast and irregular heart rhythm in some individuals.

I have now been appointed as a Clinical Lecturer in Cardiovascular Medicine, and will continue to pursue my clinical and research interests in arrhythmia, electrophysiology and cardiac magnetic resonance. I feel enormously privileged to have the opportunity to continue to work in such a multi-disciplinary and stimulating environment.

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