CDISE Seminar: Vadim V. Fedorov

Wednesday, 15 June 2016

11:00 – 12:00 in Room 407
Prof. Vadim V. Fedorov, Ohio State University

Targeting patient-specific 3D functional microanatomy of the human heart: new therapeutic strategy for cardiac arrhythmias

Atrial fibrillation (AF) is the most common sustained arrhythmia and is associated with increased cardiovascular morbidity and mortality. Clinical studies currently lack reliable mapping approaches necessary to resolve the detailed course of fast electrical activity during AF in patients as a result of the highly complex 3D structure of the human atria. Consequently, there remains a significant debate around the mechanism driving AF, the cause of these drivers, and how best to locate and treat these patient-specific drivers in patients with cardiac diseases. For this purpose, we developed a novel approach to simultaneously map sub-endocardial and sub-epicardial activation patterns and integrate these data with ex vivo 3D gadolinium-enhanced MRI images of the atrial microanatomic architecture, including fibrosis, in order to elucidate patient-specific mechanisms of AF in diseased human hearts. We found that a limited number of sustained intramural re-entry circuits anchored to patient-specific 3D microanatomic tracks are responsible for the maintenance of AF. This translational research is a critical step toward the development of new patient-specific therapies, whereby AF drivers can be accurately defined, targeted, and successfully treated to cure the most common arrhythmia in Russia and the United States.