The Division of Cardiology is based at the Children’s Hospital of Eastern Ontario (CHEO) which is the primary cardiac treatment provider for children in the Ottawa Region as well as Eastern Ontario, Western Quebec, Nunavut and parts of Northern Ontario.

The division offers a twice annual outreach clinic to Iqaluit, Nunavut.

We offer a full range of specialized services for infants, children and adolescents. All cardiologists on our team have a dedicated focus in specific areas of pediatric cardiology, including non-invasive imaging, electrophysiology, fetal cardiology and cardiac catheterization. Division members collaborate closely with our provincial partner, the Hospital for Sick Children in Toronto, including holding weekly case conference rounds. 

Our division currently consists of six cardiologists. Other members of the cardiology team are registered nurses, echosonographers and electrocardiography (ECG) technologists. The division is also supported by administrative assistants, patient services clerks (PSC) and a social worker.

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Clinical programs

Year 2013 to 2014 – Average patients per week

Number of inpatient consults: 394 per year – eight per week

All outpatient consults are seen in clinic as new patients as reflected below.

Number of new patients: 1,123 per year – 22 per week
Number of repeat patients: 3,001 per year – 58 per week

Inpatient care

Cardiac catheterization laboratory

Diagnostic catheterization – 11 per year for 2013 to 2014;
Interventional catheterization – 34 per year for 2013 to 2014

Cardiac catheterization is a non-surgical procedure in which specialized catheters are introduced into an artery or vein and directed into the heart for the purposes of diagnostic testing or intervention. Information not readily available via other testing can be obtained in this way, aiding in the diagnosis and treatment of congenital heart disease. Interventions can also be performed in this manner, including the closing of holes in the heart, expanding narrowed vessels and valves and opening new passages within the heart, which once would have required surgery.

Outpatient care

Clinical services provided by the division on site at CHEO include:

  • Consulting Pediatric Cardiology Clinic – provides full cardiology consultation and ongoing care for a wide range of pediatric cardiac conditions, including congenital and acquired heart disease. Clinical visits include cardiology testing such as ECG and echocardiography as required. Children requiring cardiac surgery are evaluated and followed pre- and post-operatively in this clinic as well. 
  • Arrhythmia Clinic – is a specialized clinic for children who have, or are at risk for, an abnormal heart rhythm. The clinic is directed by an electrophysiologist, a cardiologist with special expertise in this area. Specific cardiology testing including ECG, signal-averaged ECG, stress testing, Holter monitoring and telemetry may occur during these clinics. Since some cardiac rhythm disorders are inherited, there is also a cardiac genetic counsellor affiliated with the clinic.
  • Pacemaker Clinic – provides assessment and ongoing care of children with an implantable pacemaker, defibrillator or other monitoring device. The clinic is staffed by an electrophysiologist cardiologist and specialized nurses.
  • Neuromuscular Cardiac and Heart Function Clinic – provides specialized cardiac care for children at higher risk of heart muscle disease, including neuromuscular diseases such as muscular dystrophy, some chemotherapy recipients and children with a family or personal history of dilated cardiomyopathy.
  • Hypertrophic Cardiomyopathy Clinic – provides specialized care to children with a diagnosis of hypertrophic cardiomyopathy and/or a family history of this. A genetic counselor is affiliated with this clinic to provide assessment and counseling regarding available genetic testing. 
  • Fetal Cardiology Clinic – provides prenatal evaluation by echocardiography of fetuses with known cardiac conditions and screening of fetuses at risk of cardiac disease. A cardiologist, specialized echosonographers, a registered nurse and a social worker are affiliated with this clinic. 

As well as the above clinics within CHEO, the division conducts cardiology outreach clinics to Iqaluit, Nunavut twice a year. Children with suspected and known heart disease from the communities of Nunavut can receive full cardiac evaluations during these clinics, often saving them a trip to Ottawa. 

Clinical problems and diseases evaluated and followed

  • Congenital Heart Disease
  • Acquired Heart Disease
  • Arrhythmias
  • Fetal Heart Disease

Laboratory and diagnostic programs

Full cardiac diagnostic imaging and evaluation is provided by the division, including:

  • Echocardiography – transthoracic, transesophageal and fetal echocardiography

  • Electrocardiography (ECG) – including signal averaged ECG

  • Holter monitoring

  • Exercise stress testing, including cardiopulmonary testing

  • Telephone telemetry

  • Cardiac catheterization

  • Pacemaker interrogation

  • Cardiac MRI

Research

The division has a dedicated cardiologist, Dr. Robert Gow, who has a specific focus in developing and implementing research projects. In addition, the department has a close link with the CHEO Research Institute. Trainees in the division’s three-year subspecialty fellowship program in pediatric cardiology are exposed to both multi-centre and centre-specific research. Trainees in our program are expected to participate in clinical research as a mandatory part of their training. 

Current areas of study include: heritable arrhythmia, heart function and advanced echo imaging. Areas of research focus by faculty members include: 

  • Clinical research in the areas of inherited arrhythmias, the causes and prevention of sudden death in children and adolescents, as well as having an interest in the reliability of testing methods
  • Fetal cardiology, neuromuscular disorders and pediatric heart failure
  • Research projects associated with cardiac imaging and with the Healthy Active Living Research Unit at the CHEO Research Institute

Faculty

Training programs

Undergraduate training opportunities 

Medical students will have the opportunity to rotate through the Division of Pediatric Cardiology for a two-week observation period. Their learning objectives include developing an approach to cardiovascular history, physically recognizing common cardiac symptoms and gaining exposure to common procedures in pediatric cardiology. Students are expected to take part in rounds, clinic and on-site conferences.

Postgraduate training program

Subspecialty trainees have a rotational program as outlined in the course description on the uOttawa Faculty of Medicine website for the three-year Pediatric Cardiology Fellowship. The program has been configured to fulfill the requirements of the Royal College of Physicians and Surgeons of Canada. There is graduated responsibility for patient care and a well-coordinated balance of time for learning the clinical and technical skills necessary to practice as a pediatric cardiologist.

Conference funding is available for subspecialty residents to attend relevant conferences or present research papers. Residents will be encouraged to participate and/or develop an area of focus so that they may have a specific research interest.

The first two years of the program will be focused on the development of clinical and technical skills. The last year will be directed towards specific research interests and/or the enhancement of special skills such as advanced expertise in interventional cardiac catheterization and cardiac sonography.

Additional postgraduate training

Residents are accepted in cardiology for a four-week rotation. Residents are expected to participate in inpatient call and clinical duties (both inpatient and outpatient). They are also welcome to attend Cardiovascular Surgical Conferences and journal clubs. During their rotation, residents will be exposed to many modalities within the cardiology clinic including the catheterization lab, echosonography, electrophysiology and cardiac MRI.