
Andrew Flett
Cardiology
Dr Andrew Flett is a Consultant Cardiologist at University Hospital Southampton and holder of a Research Leaders Programme (RLP) award.
His research focuses on cardiac devices for patients with heart failure.
Preventing a cardiac arrest
Non-ischaemic cardiomyopathy (NICM) is a common cause of heart failure, accounting for around a third of cases. The pumping of the heart is reduced, but the blood supply to the heart is normal.
People with this condition are more at risk of developing dangerous, very fast heartbeats that can cause the heart to suddenly stop pumping. This is called a cardiac arrest.
An implantable cardioverter defibrillator (ICD) can detect these abnormal rhythms, and treat a cardiac arrest by delivering an electric shock to the heart. This resets the heart’s normal rhythm.
Identifying who will benefit
There is evidence showing that not all patients with this type of heart failure benefit from an ICD.
Andrew is Chief Investigator for the BRITISH trial. This is a national study that aims to identify which patients with NICM would benefit from having an ICD fitted under the skin in their chest.
Researchers in 35 UK hospitals aim to recruit over 2,500 patients. They will all have NICM and scarring in the heart, detected using a magnetic resonance imaging (MRI) scan. They are also collecting blood samples, to see if a blood test could be developed to use instead of MRI.
Patients will be randomly allocated to either have an ICD or a monitoring device (which cannot deliver a shock) implanted. The trial will monitor their heart health over three years, to see which group has better outcomes.
The aim is to see whether ICDs are beneficial for this high-risk group, with scarring in the heart. The results could inform national guidelines to support decisions around who should have an ICD.
Achieving a better balance
Andrew applied to the RLP in order to secure enough time for him to run this study and others alongside his clinical work.
“I was keen to achieve a better balance,” he says, “where I had dedicated time for research, so that I could spend proper time thinking about it, rather than just trying to squeeze it in.”
He is also keen to grow his team and become a better leader. He currently supervises a number of research fellows’ Doctor of Medicine (MD) degrees. He is now looking to expand the team to include research nurses and allied health professionals (AHPs).
During his RLP award, he will work closely with Dr Peter Cowburn, another cardiology RLP awardee. They hope their two different approaches, with one focused on academic research and the other on commercial research, will prove complimentary.
“The RLP is a really good initiative,” he says. “It’s a fantastic opportunity for clinicians who have an interest in research to actually get some dedicated time, so they can realise their potential as researchers.”