Studies of Atrial Fibrillation in Patients

心房颤动患者的研究

• 批准号: 6675771
• 负责人: ALBERT L WALDO
• 金额: $ 34.43万
• 依托单位: CASE WESTERN RESERVE UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2003
• 资助国家: 美国
• 起止时间: 2003-07-15 至 2007-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/6675771
• 关键词: atrial fibrillation; cardiovascular disorder therapy; clinical research; electrocardiography; electrodes; electrophysiology; heart disorder diagnosis; heart rate; heart rhythm; heart surgery; human subject; mathematical model; patient oriented research; postoperative state

DESCRIPTION (provided by applicant): The two broad, long term objectives of this proposed research are to use electrophysiological techniques to improve our understanding of the mechanisms responsible for atrial fibrillation (AF) in patients and to develop an improved basis for its treatment. The specific aims of this research plan are to study patients 1) during open heart surgery a) to map the sequence of atrial activation simultaneously in both atria i) during spontaneous AF of various types (paroxysmal, persistent, or permanent) and duration (recent onset, weeks, months, or years); ii) during overdrive pacing or programmed atrial stimulation during AF from a site or sites close to or within an area of regular rhythm of very short cycle length; iii) following cardioversion of AF to sinus rhythm; iv) during atrial pacing from selected atrial sites during sinus rhythm in patients with or without a history of AF; b) during AF, to identify and characterize areas of very regular but very short cycle length, thought to drive the atria creating fibrillatory conduction; c) to characterize the atrial effective refractory period during sinus rhythm from selected sites in both atria in patients with various forms and durations of AF, and compare that with patients with normal atria and no history of AF; and d) to obtain Fast Fourier Transform (FFT) analysis of atrial electrograms recorded during intraoperative activation mapping to identify and help characterize the presence of a region with a regular rhythm of very short cycle length; and 2) in the postoperative period to use temporary atrial epicardial wire electrodes in patients with new onset AF a) to record atrial electrograms and obtain FFT analysis of these atrial electrograms to identify and help characterize the presence of a regular rhythm of very short cycle length; and b) to perform overdrive pacing from an area demonstrating a regular rhythm of very short cycle length to try to terminate the AF.

描述（由申请人提供）：这项拟议的研究的两个广泛的长期目标是使用电生理技术来提高我们对患者中房颤（AF）的机制的理解，并为其治疗提供改进的基础。 该研究计划的具体目的是研究患者1）在心脏外科手术期间a）在心房i）在自发性AF中同时绘制房屋激活的序列，以绘制各种类型（阵发性，持久性或永久性）和持续时间（最近的发作，几周，几周，几个月或年）； ii）在超速起搏或编程的期间，在AF期间从一个位点或位点附近或内部的位点或在常规节奏的周期长度很短的区域内进行了心房刺激； iii）在AF的心律转到鼻窦节奏之后； iv）在有或没有AF病史的患者的窦性心节律期间，从某些心律的心房起搏期间； b）在AF期间，要识别和表征非常规律但非常短的周期长度的区域，认为可以驱动心房产生纤颤传导； c）表征来自患有不同形式和AF的患者的心房中选定部位的窦性心节律期间的心房有效期，并将其与心房正常且没有AF病史的患者进行比较； d）要获得对术中激活映射期间记录的心房电图的快速傅立叶变换（FFT）分析，以识别和帮助表征具有非常短的循环长度的定期节奏的区域的存在； 2）在术后使用新发作AF a）记录心房电解的患者中使用临时心外膜电极电极，并获得对这些心房电解的FFT分析，以识别和帮助表征存在非常短的循环长度的常规节奏； b）从一个区域进行超速起搏，显示出非常短的循环长度的常规节奏，以试图终止AF。