The Maintenance of Human Atrial Fibrillation

人类心房颤动的维持

• 批准号: 9752645
• 负责人: Sanjiv M Narayan
• 金额: $ 18.33万
• 依托单位: STANFORD UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2010
• 资助国家: 美国
• 起止时间: 2010-09-01 至 2020-07-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9752645
• 关键词: Ablation; Address; Affect; American; Animals; Arrhythmia; Atrial Fibrillation; Atrial Tachycardia; Biomedical Engineering; Cardiac; Cardiovascular system; Cauterize; Cessation of life; Clinical; Clinical Research; Clinical Trials; Complex; Computing Methodologies; Data; Disease; Dizziness; Ectopic beats; Electrophysiology (science); Exhibits; Faculty; Fibrosis; Freedom; Funding; Future; Gadolinium; Geometry; Glossary; Heart; Heart Atrium; Heart failure; Hospitalization; Human; Image; Individual; Institute of Medicine (U.S.); Lead; Magnetic Resonance Imaging; Maintenance; Maps; Mentors; Mentorship; Methods; Modeling; Multicenter Studies; Outcomes Research; Paper; Patients; Phenotype; Physicians; Procedures; Process; Progress Reports; Public Health; Pulmonary veins; Reporting; Research; Research Proposals; Risk; Science; Scientist; Sinus; Site; Source; Stroke; Structural defect; Structure; Tachycardia; Testing; Time; Tissues; Training; Translating; career development; clinically relevant; computer studies; drug development; effective therapy; gene therapy; heart rhythm; improved; interest; novel; novel therapeutics; patient oriented research; prevent; programs; public health relevance; randomized trial; source localization; standard of care; success; therapy design; voltage

 DESCRIPTION (provided by applicant): The Maintenance of Human Atrial Fibrillation Project Summary. Atrial fibrillation (AF) is the most common heart rhythm disorder, affecting 2-5 million Americans in whom it may cause skipped heart beats, dizziness, stroke and even death. Unfortunately, therapy for AF is limited. One of the major drawbacks in developing better therapy for AF is that our understanding of what causes AF (its `mechanisms') is not clear. This renewal outlines a program of career development for the applicant, of Mentored training for young clinician-scientists, and of mechanistic patient-oriented research in atrial fibrillation The Research Plan builds upon discoveries in the last cycle, that human AF is often not random, but instead maintained (driven) by a small number of `sources' in the form of rotors (akin to electrical spinning tops) or focal beats, that are stable over time. Sources may lie in regions of the heart (the atria, or top chambers) that are different in each patient, often away from where physicians currently apply cautery therapy (ablation). In this project, we will study 1) how much additional benefit is achieved by ablating at trigger sites (at the pulmonary veins) over and above these rotor source; 2) how rotors actually cause disorganized rhythms, and not just simple organized circuits; 3) whether this process is altered by structural abnormalities in the atria. We will pursue these aims in a clinical trial, by making detailed recordings of AF, usin bioengineering methods and by integrating imaging. These patient-specific analyses will be among the most detailed and clinically-relevant in the field, and will form a platform for future hypothesis testing and clinical trials. This project is significant because it tests the success of novel therapy at recently discovered AF rotors against current standard-of-care, because it studies the fundamental mechanisms that cause cardiac fibrillation in humans, and because it also tests novel imaging strategies. This project will be performed in patients with AF and a limited number of patients without AF, during electrophysiologic study, so that its results can be translated directly to practice. This approach may also allow a more rational general approach to drug development and gene therapy.



项目成果

What tissue does circumferential PV Isolation actually modulate?

圆周 PV 隔离实际上调节哪些组织？

• DOI: 10.1111/jce.12310
• 发表时间: 2014
• 期刊: Journal of cardiovascular electrophysiology
• 影响因子: 2.7
• 作者: McGarry,ThomasJ;Narayan,SanjivM
• 通讯作者: Narayan,SanjivM

Microvolt T-wave alternans physiological basis, methods of measurement, and clinical utility--consensus guideline by International Society for Holter and Noninvasive Electrocardiology.

• DOI: 10.1016/j.jacc.2011.06.029
• 发表时间: 2011-09-20
• 期刊: JOURNAL OF THE AMERICAN COLLEGE OF CARDIOLOGY
• 影响因子: 24
• 作者: Verrier, Richard L.;Klingenheben, Thomas;Malik, Marek;El-Sherif, Nabil;Exner, Derek V.;Hohnloser, Stefan H.;Ikeda, Takanori;Pablo Martinez, Juan;Narayan, Sanjiv M.;Nieminen, Tuomo;Rosenbaum, David S.
• 通讯作者: Rosenbaum, David S.

Novel three-dimensional imaging approach for cryoballoon navigation and confirmation of pulmonary vein occlusion.

• DOI: 10.1111/pace.13858
• 发表时间: 2020-03
• 期刊: Pacing and clinical electrophysiology : PACE
• 作者: Kowalewski CAB;Rodrigo M;Brodt C;Haddad F;Wang PJ;Narayan SM
• 通讯作者: Narayan SM

Percutaneous stellate ganglion block suppressing VT and VF in a patient refractory to VT ablation.

• DOI: 10.1111/jce.12138
• 发表时间: 2013-08
• 期刊: Journal of cardiovascular electrophysiology
• 影响因子: 2.7
• 作者: Hayase J;Patel J;Narayan SM;Krummen DE
• 通讯作者: Krummen DE

HRS policy statement: clinical cardiac electrophysiology fellowship curriculum: update 2011.

HRS 政策声明：临床心脏电生理学研究金课程：2011 年更新。

• DOI: 10.1016/j.hrthm.2011.06.008
• 发表时间: 2011
• 期刊: Heart rhythm
• 影响因子: 5.5
• 作者: Link,MarkS;Exner,DerekV;Anderson,Mark;Ackerman,Michael;Al-Ahmad,Amin;Knight,BradleyP;Markowitz,StevenM;Kaufman,ElizabethS;Haines,David;Asirvatham,SamuelJ;Callans,DavidJ;Mounsey,JPaul;Bogun,Frank;Narayan,SanjivM;Krahn,
• 通讯作者: Krahn,