Prapa Kanagaratnam

Dr Prapa Kanagaratnam has been a consultant cardiologist at Imperial College Healthcare NHS Trust since 2005. He was educated at King Edward’s School, Birmingham and graduated with a medical degree from St Johns College, Cambridge, winning scholarships at both institutions. He joined Imperial College London in 1998 to undertake a PhD on a British Heart Foundation Junior Research Fellowship investigating the role of gap junctions in human atrial fibrillation. He was awarded the British Cardiac Society Young Investigator Prize for this work and obtained his PhD in 2002. He continued his research in the field of cardiac arrhythmias throughout his clinical cardiology training and secured further funding from the British Heart Foundation (BHF) and Wellcome Trust to supervise several PhDs.

Dr Kanagaratnam was appointed consultant cardiologist at St Mary’s Hospital (now part of Imperial College Healthcare) and honorary senior lecturer at Imperial College London in 2005. He has supervised several students to both successful completion of their PhDs and winning national and international prizes and awards.

His most important contribution to cardiac electrophysiology has been the development of Ripple Mapping, which is a novel method to visualise and understand cardiac activation in 3D. The technique was patented by Imperial Innovations and has been licensed by Biosense Webster Inc and incorporated within the CARTO3v4 system. It has been used in clinical studies to reveal novel arrhythmia mechanisms such as dual loop atrial tachycardias and slow ventricular scar channels. In addition to these mechanistic data the clinical benefits are being tested in multi-centre randomised studies.

Dr Kanagaratnam was one of the early users of robotic ablation technology and has published the benefits and limitations of these approaches. This culminated in setting up the ERASE-VT study. There has been much speculation on the role of the autonomic nervous system in triggering and maintaining arrhythmias but there has been limited data to support intervention on autonomic ganglia in human arrhythmogenesis. Dr Kanagaratnam established a program of research which characterised the role of the left atrial autonomic nervous system in human atrial fibrillation. This has led to the testing of a new method for targeting the ganglionated plexi that trigger atrial fibrillation. If this proves to be effective it will have a revolutionary effect on thinking around atrial fibrillation.

Dr Kanagaratnam’s latest innovation is a new method for understanding why electrical activation during atrial fibrillation can be transiently organised. He is also overseeing a research collaboration between clinicians and basic scientists using non-invasive mapping under autonomic strain to risk-stratify patients with inherited cardiac conditions. As clinical lead for cardiac electrophysiology, he has brought together a team of like-minded clinicians who recruit, follow research protocols and publish as a team. He has built relationships with Imperial Innovations and the protection of intellectual property has been the key to engaging the largest industry partners who have the resources to spread ideas globally. Working with the Imperial College Trials Unit has enabled him to validate that his clinical innovations translate into improved patient care. This has led to research partnerships with over 20 hospitals worldwide testing novel approaches to the treatment of arrhythmias.