Faculty Profile

Richard Leonard Verrier, PhD

Associate Professor of Medicine, Harvard Medical School
Associate Professor, Department of Medicine, Beth Israel Deaconess Medical Center

Administrative Title(s)

Director, Cardiology Grand Rounds

See publications


Harvard Institutes of Medicine
77 Avenue Louis Pasteur, Room 223
Boston, MA 02115

Phone 617-667-0730
Phone 617-667-0733
Fax 617-975-5270

Email rverrier@bidmc.harvard.edu
Email sverrier@bidmc.harvard.edu

Society Memberships

American Heart Association
American College of Cardiology
Heart Rhythm Society
International Society of Holter and Noninvasive Electrocardiology

Research Unit(s)

Harvard Thorndike Electrophysiology Institute, Beth Israel Deaconess Medical Center

Research Interests

Our research is focused on neural, behavioral, and environmental triggers of sudden cardiac death and arrhythmias. The laboratory specializes in computerized analysis of electrocardiographic markers, especially T-wave alternans, a beat-to-beat fluctuation in the area and form of the T-wave of the ECG. We demonstrated that T-wave alternans provides an index of vulnerability to life-threatening cardiac arrhythmias as well as a means to identify individuals at risk and to measure the efficacy of pharmacologic therapy. Current investigations include neural triggers of sudden death during ischemia, anger, REM sleep, and exposure to environmental air particles. Our research has led to a novel technique for selective delivery of angiogenic and myogenic factors to the heart via the pericardial sac. This technology provides a natural interface between molecular and integrative biology


Bruce D. Nearing, PhD; Ward Casscells III, MD; Julie A. Kovach, MD; Peter R. Kowey, MD; Kapil Kumar, MD; Bruce T. Liang, MD; Federico Lombardi, MD;
Panos Papageorgiou, MD, PhD; Todd Pulerwitz, MD; Ernst A. Raeder, MD;
Gregory Wellenius, DSc; Susan X. Zhao, MD

Research Funding

Industrial grants


Harvard College Science B-23, Cardiovascular lectures

Selected Publications

Zanobetti A, Stone PH, Speizer FE, Schwartz JD, Coull BA, Suh HH, Nearing BD, Mittleman MA, Verrier RL, Gold DR. T-wave alternans, air pollution and traffic in high-risk subjects.
Am J Cardiol. 2009 Sep 1;104(5):665-70. Epub 2009 Jun 24. [PMID: 19699342]

De Ferrari GM, Verrier RL. Letter by De Ferrari and Verrier regarding article, "Role of microvolt T-wave alternans in assessment of arrhythmia vulnerability among patients with heart failure and systolic dysfunction: primary results from the T-wave alternans sudden cardiac death in heart failure trial substudy".
Circulation. 2009 Jul 21;120(3):e20; author reply e22. [PMID: 19620521]

Kumar K, Nearing BD, Carvas M, Nascimento BC, Acar M, Belardinelli L, Verrier RL. Ranolazine exerts potent effects on atrial electrical properties and abbreviates atrial fibrillation duration in the intact porcine heart.
J Cardiovasc Electrophysiol. 2009 Jul;20(7):796-802. Epub 2009 Feb 27. [PMID: 19298570]

Verrier RL, Kumar K, Nearing BD. Re: Time-domain T-wave alternans measured from Holter electrocardiograms predicts cardiac mortality in patients with left ventricular dysfunction: a prospective study.
Heart Rhythm. 2009 Apr;6(4):e1; author reply e1. Epub 2009 Jan 31. [PMID: 19324300]

Minkkinen M, Kähönen M, Viik J, Nikus K, Lehtimäki T, Lehtinen R, Kööbi T, Turjanmaa V, Kaiser W, Verrier RL, Nieminen T. Enhanced predictive power of quantitative TWA during routine exercise testing in the Finnish Cardiovascular Study.
J Cardiovasc Electrophysiol. 2009 Apr;20(4):408-15. Epub 2008 Oct 11. [PMID: 19175840]

Bartoli CR, Wellenius GA, Diaz EA, Lawrence J, Coull BA, Akiyama I, Lee LM, Okabe K, Verrier RL, Godleski JJ. Mechanisms of inhaled fine particulate air pollution-induced arterial blood pressure changes.
Environ Health Perspect. 2009 Mar;117(3):361-6. Epub 2008 Oct 6. [PMID: 19337509]

Bartoli CR, Wellenius GA, Coull BA, Akiyama I, Diaz EA, Lawrence J, Okabe K, Verrier RL, Godleski JJ. Concentrated ambient particles alter myocardial blood flow during acute ischemia in conscious canines.
Environ Health Perspect. 2009 Mar;117(3):333-7. Epub 2008 Sep 10. [PMID: 19337504]

Minkkinen M, Nieminen T, Verrier RL, Leino J, Lehtimäki T, Viik J, Lehtinen R, Nikus K, Kööbi T, Turjanmaa V, Kähönen M. Impaired exercise capacity predicts sudden cardiac death in a low-risk population: enhanced specificity with heightened T-wave alternans.
Ann Med. 2009;41(5):380-9. [PMID: 19301163]

Kumar K, Nearing BD, Bartoli CR, Kwaku KF, Belardinelli L, Verrier RL. Effect of ranolazine on ventricular vulnerability and defibrillation threshold in the intact porcine heart.
J Cardiovasc Electrophysiol. 2008 Oct;19(10):1073-9. Epub 2008 May 9. [PMID: 18479333]

Verrier RL, Kumar K, Wellenius GA. Predicting cardiac resynchronization therapy response based on endothelial dysfunction: causal link or fellow traveler?
Heart Rhythm. 2008 Sep;5(9):1236-7. Epub 2008 Jul 3. [PMID: 18774095]

Verrier RL, Nearing BD, Kumar K. Computer-aided visualization of microvolt T-wave alternans: "seeing is believing".
J Cardiovasc Electrophysiol. 2008 Sep;19(9):E51-2. Epub 2008 Jul 25. [PMID: 18662178]

Kumar K, Kwaku KF, Verrier RL. Treatment options for patients with coronary artery disease identified as high risk by T-wave alternans testing.
Curr Treat Options Cardiovasc Med. 2008 Feb;10(1):39-48. [PMID: 18325306]

Verrier RL, Kumar K, Josephson ME. The frustrating search for arrhythmia risk stratifiers in heart failure due to nonischemic cardiomyopathy: does T-wave alternans testing help?
J Am Coll Cardiol. 2007 Nov 6;50(19):1905-6. Epub 2007 Oct 22. [PMID: 17980259]

Nieminen T, Lehtimäki T, Viik J, Lehtinen R, Nikus K, Kööbi T, Niemelä K, Turjanmaa V, Kaiser W, Huhtala H, Verrier RL, Huikuri H, Kähönen M. T-wave alternans predicts mortality in a population undergoing a clinically indicated exercise test.
Eur Heart J. 2007 Oct;28(19):2332-7. Epub 2007 Jul 25. [PMID: 17652105]

Bartoli CR, Akiyama I, Godleski JJ, Verrier RL. Long-term pericardial catheterization is associated with minimum foreign-body response.
Catheter Cardiovasc Interv. 2007 Aug 1;70(2):221-7. [PMID: 17632787]

Kwaku KF, Verrier RL. The atrial neural network: Ablation minefield or strategic target?
Heart Rhythm. 2007 Jan;4(1):64-5. Epub 2006 Oct 13. [PMID: 17198992]

Bartoli CR, Okabe K, Akiyama I, Verrier RL, Godleski JJ. Technique for implantation of chronic indwelling aortic access catheters.
J Invest Surg. 2006 Nov-Dec;19(6):397-405. [PMID: 17101609]

Chen JC, Stone PH, Verrier RL, Nearing BD, MacCallum G, Kim JY, Herrick RF, You J, Zhou H, Christiani DC. Personal coronary risk profiles modify autonomic nervous system responses to air pollution.
J Occup Environ Med. 2006 Nov;48(11):1133-42. [PMID: 17099449]

Zhao SX, Lee LM, Nearing BD, Busso VO, Kwaku KF, Verrier RL. Suppression of calcium-induced repolarization heterogeneity as a mechanism of nitroglycerin's antiarrhythmic action.
J Cardiovasc Pharmacol. 2006 Aug;48(2):22-9. [PMID: 16954817]

Verrier RL. Beta3-adrenoceptor: friend or foe?
Heart Rhythm. 2005 Dec;2(12):1356-8. [PMID: 16360090]

Gold DR, Litonjua AA, Zanobetti A, Coull BA, Schwartz J, MacCallum G, Verrier RL, Nearing BD, Canner MJ, Suh H, Stone PH. Air pollution and ST-segment depression in elderly subjects.
Environ Health Perspect. 2005 Jul;113(7):883-7. [PMID: 16002377]

Dockery DW, Luttmann-Gibson H, Rich DQ, Link MS, Mittleman MA, Gold DR, Koutrakis P, Schwartz JD, Verrier RL. Association of air pollution with increased incidence of ventricular tachyarrhythmias recorded by implanted cardioverter defibrillators.
Environ Health Perspect. 2005 Jun;113(6):670-4. [PMID: 15929887]

Verrier RL, Kwaku KF, Nearing BD, Josephson ME. T-wave alternans: does size matter.
J Cardiovasc Electrophysiol. 2005 Jun;16(6):625-8. [PMID: 15946362]

Kop WJ, Krantz DS, Nearing BD, Gottdiener JS, Quigley JF, O'Callahan M, DelNegro AA, Friehling TD, Karasik P, Suchday S, Levine J, Verrier RL. Effects of acute mental stress and exercise on T-wave alternans in patients with implantable cardioverter defibrillators and controls.
Circulation. 2004 Apr 20;109(15):1864-9. Epub 2004 Mar 22. [PMID: 15037524]

Verrier RL, Nearing BD, La Rovere MT, Pinna GD, Mittleman MA, Bigger JT Jr, Schwartz PJ; ATRAMI Investigators. Ambulatory electrocardiogram-based tracking of T wave alternans in postmyocardial infarction patients to assess risk of cardiac arrest or arrhythmic death.
J Cardiovasc Electrophysiol. 2003 Jul;14(7):705-11. [PMID: 12930249]

Kumar K, Nguyen K, Waxman S, Nearing BD, Wellenius GA, Zhao SX, Verrier RL. Potent antifibrillatory effects of intrapericardial nitroglycerin in the ischemic porcine heart.
J Am Coll Cardiol. 2003 May 21;41(10):1831-7. [PMID: 12767672]

Wellenius GA, Coull BA, Godleski JJ, Koutrakis P, Okabe K, Savage ST, Lawrence JE, Murthy GG, Verrier RL. Inhalation of concentrated ambient air particles exacerbates myocardial ischemia in conscious dogs.
Environ Health Perspect. 2003 Apr;111(4):402-8. [PMID: 12676590]

Nearing BD, Verrier RL. Progressive increases in complexity of T-wave oscillations herald ischemia-induced ventricular fibrillation.
Circ Res. 2002 Oct 18;91(8):727-32. [PMID: 12386150]

Nearing BD, Verrier RL. Modified moving average analysis of T-wave alternans to predict ventricular fibrillation with high accuracy.
J Appl Physiol. 2002 Feb;92(2):541-9. [PMID: 11796662]

Kovach JA, Nearing BD, Verrier RL. Angerlike behavioral state potentiates myocardial ischemia-induced T-wave alternans in canines.
J Am Coll Cardiol. 2001 May;37(6):1719-25. [PMID: 11345390]

Gold DR, Litonjua A, Schwartz J, Lovett E, Larson A, Nearing B, Allen G, Verrier M, Cherry R, Verrier R. Ambient pollution and heart rate variability.
Circulation. 2000 Mar 21;101(11):1267-73. [PMID: 10725286]

Rowe K, Moreno R, Lau TR, Wallooppillai U, Nearing BD, Kocsis B, Quattrochi J, Hobson JA, Verrier RL. Heart rate surges during REM sleep are associated with theta rhythm and PGO activity in cats.
Am J Physiol. 1999 Sep;277(3 Pt 2):R843-9. [PMID: 10484502]

Verrier RL, Waxman S, Lovett EG, Moreno R. Transatrial access to the normal pericardial space: a novel approach for diagnostic sampling, pericardiocentesis, and therapeutic interventions.
Circulation. 1998 Nov 24;98(21):2331-3. [PMID: 9826322]

Verrier RL, Lau TR, Wallooppillai U, Quattrochi J, Nearing BD, Moreno R, Hobson JA. Primary vagally mediated decelerations in heart rate during tonic rapid eye movement sleep in cats.
Am J Physiol. 1998 Apr;274(4 Pt 2):R1136-41. [PMID: 9575980]

Kovach JA, Gottdiener JS, Verrier RL. Vagal modulation of epicardial coronary artery size in dogs. A two-dimensional intravascular ultrasound study.
Circulation. 1995 Oct 15;92(8):2291-8. [PMID: 7554214]

Dickerson LW, Huang AH, Thurnher MM, Nearing BD, Verrier RL. Relationship between coronary hemodynamic changes and the phasic events of rapid eye movement
Sleep. 1993 Sep;16(6):550-7. [PMID: 8235240]

Dickerson LW, Huang AH, Nearing BD, Verrier RL. Primary coronary vasodilation associated with pauses in heart rhythm during sleep.
Am J Physiol. 1993 Jan;264(1 Pt 2):R186-96. [PMID: 8430878]

Nearing BD, Huang AH, Verrier RL. Dynamic tracking of cardiac vulnerability by complex demodulation of the T wave.
Science. 1991 Apr 19;252(5004):437-40. [PMID: 2017682]


Verrier RL, Josephson ME. Impact of sleep on arrhythmogenesis.
Circ Arrhythm Electrophysiol. 2009 Aug;2(4):450-9. Review. [PMID: 19808502]

Verrier RL, Kumar K, Nearing BD. Basis for sudden cardiac death prediction by T-wave alternans from an integrative physiology perspective.
Heart Rhythm. 2009 Mar;6(3):416-22. Epub 2008 Nov 27. Review. [PMID: 19251221]

Verrier RL, Nearing BD, Kwaku KF. Noninvasive sudden death risk stratification by ambulatory ECG-based T-wave alternans analysis: evidence and methodological guidelines.
Ann Noninvasive Electrocardiol. 2005 Jan;10(1):110-20. Review. [PMID: 15649246]

Verrier RL, Antzelevitch C. Autonomic aspects of arrhythmogenesis: the enduring and the new.
Curr Opin Cardiol. 2004 Jan;19(1):2-11. Review. [PMID: 14688627]

Lavery CE, Mittleman MA, Cohen MC, Muller JE, Verrier RL. Nonuniform nighttime distribution of acute cardiac events: a possible effect of sleep states.
Circulation. 1997 Nov 18;96(10):3321-7. Review. [PMID: 9396423]

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