Daniel Keene is a Clinical Senior Lecturer in Cardiac Electrophysiology and Devices based within the world-renowned National Heart and Lung Institute (NHLI) at Imperial College London. He is also a Consultant Cardiologist treating patients at both Imperial College Healthcare NHS Trust and the Royal Free London Foundation NHS Trust.
He is involved in all clinical aspects of inpatient and outpatient general cardiology but his clinical focus is in cardiac electrophysiology and complex devices. He has a diverse research portfolio spanning much of the cardiac implantable device landscape.
Dr Keene graduated from the University of Manchester in 2009 having received commendations for all his Special Study Modules. In 2013, after completing his Foundation Years training and Core Medical Training he was appointed a prestigious NIHR Academic Clinical Fellow Cardiology fellowship based at Imperial College London.
During this time, whilst completing his clinical cardiology training, he prepared and was then awarded in 2015 a highly competitive British Heart Foundation Clinical Research Fellowship Training Fellowship to support dedicated research time to address novel issues in implantable cardiac devices leading to award of his PhD under the excellent supervision and mentorship of Dr Zachary Whinnett and Professor Darrel Francis. His PhD explored the role of His Bundle pacing and also mechanistically unpicked why Ventricular Tachycardia can be haemodynamically harmful. Following the award of his PhD, he completed his general cardiology training and was also appointed as an Advanced Clinical Training Fellow in Electrophysiology and Devices. This training opportunity led to the development of advanced skills and accreditation in both simple and complex cardiac device implantation, as well as their troubleshooting and follow-up.
He has developed highly specialised skills in the implantation of the subcutaneous ICD (including use of nerve block for analgesia), been trained in the use of interventional CRT techniques for complex trans-venous device implant procedures and has vast experience in all aspects of Conduction system pacing (His bundle Pacing and Left Bundle Area Pacing) for which he is highly regarded internationally for being a high volume implanter, proctor, researcher and educator in this field. He also has built up a considerable experience in cardiac device lead management including lead extraction when necessary.
He is competent in performing and interpreting electrophysiological studies and the ablation of AVNRT, AVRT, Atrial Flutter, Ventricular Ectopy and Atrial Fibrillation.
From 2019 until his current appointment in 2021 whilst being the Lead SPR at Imperial NHS he was also privileged to be appointed as an NIHR Academic Clinical Lecturer further developing his research portfolio and building a catalogue of potential clinical trials designed to explore the role of conduction system pacing.
Dr Keene’s research program includes evaluating novel pacing approaches and device technologies.
These encompass pacing strategies for heart failure and bradycardia with a focus on optimising and evaluating the role of conduction system pacing. He has led international registries and multi-centre RCTs and has a number of future large-scale studies under review.
He co-owns Intellectual Property for an approach to incorporate real-time haemodynamic sensors into cardiac devices with the aim of reducing unnecessary ICD shocks. He has developed an implantable loop recorder which now allows him to perform chronic in-vivo testing of this approach.
He is particularly interested in service design, improvement and implementation and has recently improved the utilisation, integration and optimisation of Device Remote Monitoring for patients with implantable cardiac devices aiming to improve care delivery and patient outcomes.
He hopes in addition to the above to develop research interests in novel approaches for treating cardiac syncope.
Dr Keene has extensive experience teaching, proctoring and tutoring colleagues.
He is a tutor, lecturer and project supervisor for Imperial College London both on their MBBS program as well as their CardioVascular BSc program.
He is highly involved supporting and organising educational days at the Royal Society of Medicine.
He is frequently invited to teach, lecture and deliver webinars for the European Society of Cardiology, the European Heart Rhythm Society and industry partners. He runs and organises international educational events for hundreds of participants on Conduction System Pacing and is also part of a small faculty delivering regular training to small groups of international consultant colleagues on how best to deliver conduction system pacing, this training uses a number of techniques including didactic lectures, small group discussions and hands-on simulator training.
Method and an apparatus for determining haemodynamic status.
Dr Keene’s patent describes a method for interpreting light based haemodynamic signals in a manner that is robust to noise, artefact and biological variability by employing an electro-mechanical coupling approach. This means only haemodynamic signal oscillations that occur at the frequency of the heartbeat are included for analysis increasing sensitivity and specificity of signal interpretation when compared to conventional running mean or isolated oscillatory height analytical approaches.
It is hoped that this method will refine syncope diagnostic pathways by allowing haemodynamic sensors to be reliably incorporated into future loop recorders and even more excitingly potentially reduce ICD therapies by delivering therapies only when they’re absolutely needed, where haemodynamic harm is detected.
Academic Grants Awarded:
- Wellcome Trust, Hamlyn Accelerator for Surgical Innovation, Awarded April 2021 “Implantable Electro-Mechanical Coupling Loop Recorder: In-vivo human testing”
- NHSx Artificial Intelligence (AI Award 2020 Phase 3), Awarded September 2020 “Point of Care Heart Failure Diagnosis for GP use: implementation and Evaluation of a simple AI-tool into the Folio of Care Pathways Serviced by Imperial’s Connected Care National GP network”
- British Heart Foundation Pump Priming Grant. CI (RE/18/4/34215) Awarded May 2020 “Development of the Imperial Implantable Electro-Mechanical Coupling Loop Recorder”
- The Academic Health Science Networks (AHSNs) and Pfizer Independent Grants for Learning and Change (IGLC) Awarded April 2017: “Pivotal Impact of the Connected Care Bureau (CONN-CARE) at Imperial NHS Trust: Enhanced detection of AF in a cost-effective pathway for diagnosing unexplained palpitations using real and full time heart rhythm monitoring”
- British Heart Foundation Clinical Research Training Fellowship (no. FS/15/53/31615) Awarded April 2016; “Investigation of the physiological mechanisms through which Ventricular Tachycardia (VT) impairs cardiac function and exploration of potential clinical applicable therapy to improve cardiac output during VT”
- Imperial College Healthcare Charity Research Fellowship Awarded October 2015; “Assessment of Laser Doppler as a method for monitoring haemodynamic status during ventricular arrhythmias”
Sau A, 2023, Artificial intelligence-enabled electrocardiogram to distinguish atrioventricular re-entrant tachycardia from atrioventricular nodal re-entrant tachycardia, Cardiovascular Digital Health Journal, Vol:4, ISSN:2666-6936, Pages:60-67
et al., 2023, Conduction system pacing, a European survey: insights from clinical practice, Europace, ISSN:1099-5129
et al., 2023, Feasibility of mapping and ablating ectopy-triggering ganglionated plexus reproducibly in persistent atrial fibrillation, Journal of Interventional Cardiac Electrophysiology, ISSN:1383-875X
et al., 2023, Comparison of methods for delivering cardiac resynchronization therapy: an acute electrical and haemodynamic within-patient comparison of left bundle branch area, His bundle, and biventricular pacing, Ep Europace, Vol:25, ISSN:1099-5129, Pages:1060-1067
et al., 2023, Effects of haemodynamically atrio-ventricular optimized His bundle pacing on heart failure symptoms and exercise capacity: the His Optimized Pacing Evaluated for Heart Failure (HOPE-HF) randomized, double-blind, cross-over trial, European Journal of Heart Failure, Vol:25, ISSN:1388-9842, Pages:274-283