Heart Failure
Professor Martin Cowie
Lead academic
+44 (0)20 7351 8856

Arrhythmia and Electrophysiology
Professor Nick Peters
Lead academic
+44 (0)20 7594 1880

Study with NHLI

What we do

Our research advances knowledge in heart failure and arrhythmia: we focus on assessing new technologies (such as drug therapies, devices, diagnostics, and new ways of working), looking at the impact of these innovations on the delivery of healthcare for people living with heart failure.   

Why it is important

More than 500 000 people live with heart failure in the UK alone. This condition shortens their life and can reduce their quality of life substantially, if they do not receive the best treatment. The prognosis for patients with heart failure is worse than some common cancers, such as breast and colorectal cancer, but is steadily improving.  1-2% of the NHS budget is spent on heart failure, largely on the cost of hospitalisation when the heart failure syndrome worsens. We help assess the clinical and economic value of new technologies that can improve care and the experience of care for people living with this condition.  

How it can benefit patients

Our section carries out research to improve and develop new treatment and diagnostic options for patients.  An important part of our work centres around the patient's perspective on their care. Patients are involved throughout the research process in our group, from study design to study completion, and their feedback is actively encouraged and drawn upon at each stage. Previous projects by the group have helped establish the evidence base for diagnostic and treatment guidelines (including national NICE guidelines), and the exciting part of our team's work is that we can see the impact of our research in clinical practice rapidly at the end of our studies.

Summary of current research

  • The electrophysiology of heart failure and the consequences of treatment on the contractile and electrical properties of the heart:

Particular interest is in the mechanisms of myocardial regeneration following mechanical devices or stem and gene therapy, and the cellular and molecular mechanisms of arrhythmias (Terraciano).

  • Measurement of contraction, rhythm and calcium dynamics of cardiomyocytes simultaneously using a high resolution microscopic technique for studying living cells:

Scanning Ion Conductance Microscopy (SICM) coupled with Fluorescence Resonance Energy Transfer (FRET), allowing the study arrhythmias and heart failure in cultured heart cells at subcellular resolution (Gorelik).

  • Digital health: Investigation into remote monitoring technologies:  

A collaboration between The British Heart Foundation, St Jude Medical, Boston Scientific and Medtronic looking at remote monitoring of heart failure patients with implantable devices (biventricular devices and internal defibrillators) called REM-HF.  1650 patients at 9 English hospitals were randomised into this study, and followed up for an average of almost 3 years. We did not demonstrate any improvement in mortality or hospitalisation, although patients did like the fact they were being monitored more closely than is usual.

A collaboration with St Jude Medical to establish the clinical impact of their "butterfly monitor" - a miniature wireless sensor that measures the pressure of blood in the pulmonary artery, the main blood vessel that carries blood from the heart to the lungs - in improving the outcome for patients with more severe heart failure. This work includes health economics, and a UK-based study at 10 hospitals.

  • Examining the efficacy of new drugs in heart failure:

Working with Merck, Sharp and Dohme (MSD) we are investigating the value of vericiguat in the treatment of heart failure, leading the UK centres involved in the VICTORIA Study.

Working with Amgen, we are also investigating the value of omecamtiv, a novel inotropic agent, in the treatment of a particular type of heart failure.

  • Sleep disordered breathing

We have a long track record in studying the prevalence and impact of sleep disordered breathing (sleep apnoea) in cardiovascular disease, and have looked at different diagnostic approaches, the impact on prognosis, and how treatment with mask therapy affects outcome. In collaboration with ResMEd we lead the world's largest randomised trial of ASV therapy for central sleep apnea (SERVE-HF) and have now moved on to looking at the effect of such therapies in a type of heart failure called HFpEF (preserved ejection fraction).

In collaboration with Boston Scientific, we have been validating an algorithm in a pacemaker, to see if it can pick up sleep apnoea without the need for the patient to have a screening study.

  •  Patient perspective

We have a track record of looking in detail at the patient perspective in heart failure, including quality of life from patient-reported outcome measures, and also illness belief and health cognition. Currently, in collaboration with St Jude Medical, we are looking at quality of life in patients attending clinic with heart failure.

  • Heart failure management programmes

In addition to leading the Breathlessness Theme of the North West London Collaboration for Leadership in Applied Health Research and Care (CLAHRC), the group are helping to lead a global disease management quality improvement programme (OPTIMIZE-HF), in collaboration with Servier, with hospital protocols, patient check lists, and a patient passport and smart phone App.

Read more about our research in detail


For patients

If you are interested in finding out more about our work and research please email Rebecca Lucas (r.lucas@rbht.nhs.uk) or call +44 (0) 207 349 7716.

Our researchers

Mr Winston A S Banya

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Mr Winston A S Banya
Honorary Research Officer

Dr Ali Vazir

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Dr Ali Vazir
Honorary Clinical Senior Lecturer