Experimental study on analyzing the presence of arrhythmogenic substrates during ventricular circulatory support

• Grant number: 14/26066-0
• Support Opportunities: Scholarships in Brazil - Post-Doctoral
• Start date: April 01, 2015
• End date: May 31, 2015
• Field of knowledge: Engineering - Biomedical Engineering - Bioengineering
• Agreement: Coordination of Improvement of Higher Education Personnel (CAPES)
• Principal Investigator: Idágene Aparecida Cestari
• Grantee: João Loures Salinet Júnior
• Host Institution: Instituto do Coração Professor Euryclides de Jesus Zerbini (INCOR). Hospital das Clínicas da Faculdade de Medicina da USP (HCFMUSP). Secretaria da Saúde (São Paulo - Estado). São Paulo , SP, Brazil
• Associated research grant: 12/50283-6 - Circulatory support in pediatric patients: ventricular assist device and extracorporeal membrane oxygenation, AP.TEM

Abstract

The heart of sudden cardiac death patients is characterized by its deficiency in pump blood effectively. As the patients' hemodynamic conditions is deteriorate, the use of ventricular assistance device (VAD) is sometimes the only possibility of survive while patients are waiting a transplant. Although these devices have been shown of importance, clinical complications are commonly seen during and after the clinical VAD implant procedure. Moreover, ventricular arrhythmias have been observed in patients with DAV assistance on the left ventricle (LA). Two are the possible hypotheses: (1) electrical remodelling and ionic currents as consequence of mechanical myocardium strength, and (2) presence of arrhythmic episodes due to modification of the excitation-contraction coupling at the cells located surrounding the DAV's blood cannula introduced surgically at the heart's apex. The primary aim of this research project is to investigate the electrical patterns from the heart's epicardium as a trigger to generate and maintenance the arrhythmic episodes. The experiments will be conducted at isolated animals' heart perfused through Langendorff preparation. The electrical activity from the epicardium data will be acquired using a net with high-density unipolar electrodes placed around the animals' heart. The off-line analyses will be performed using Matlab R2014b (Mathworks, Inc.) toolboxes. 2D maps will be generated after the electograms' depolarization segmentation. Analysis consists in creation of 2D maps using time domain (isopotential and phase maps), frequency domain and nonlinear methods to identify patterns of activation and its wavefront propagation. The methodological approach consisting of invasive animals procedure, signals acquisition and processing may identify possible arrhythmic behaviour. As the project's next step, patients undergoing VAD implant will be evaluated. Understanding the substrates' mechanism during VAD assistance might contribute without precedents to an improve clinical procedures and patients' quality life. (AU)

Scientific publications

(References retrieved automatically from Web of Science and SciELO through information on FAPESP grants and their corresponding numbers as mentioned in the publications by the authors)

SALINET, JOAO; SCHLINDWEIN, FERNANDO S.; STAFFORD, PETER; ALMEIDA, TIAGO P.; LI, XIN; VANHEUSDEN, FREDERIQUE J.; GUILLEM, MARIA S.; ANDRE NG, G.. Propagation of meandering rotors surrounded by areas of high dominant frequency in persistent atrial fibrillation. HEART RHYTHM, v. 14, n. 9, p. 1269-1278, SEP 2017. (14/26066-0)

ALMEIDA, TIAGO P.; CHU, GAVIN S.; BELL, MICHAEL J.; LI, XIN; SALINET, JOAO L.; DASTAGIR, NAWSHIN; TUAN, JIUN H.; STAFFORD, PETER J.; NG, G. ANDRE; SCHLINDWEIN, FERNANDO S.. The temporal behavior and consistency of bipolar atrial electrograms in human persistent atrial fibrillation. MEDICAL & BIOLOGICAL ENGINEERING & COMPUTING, v. 56, n. 1, p. 71-83, JAN 2018. (14/26066-0)