Patient-Directed Computational Analysis of Atrial Fibrillation

患者导向的心房颤动计算分析

基本信息

批准号：
10398887
负责人：
WOUTER-JAN RAPPEL
金额：
$ 57.12万
依托单位：
UNIVERSITY OF CALIFORNIA, SAN DIEGO
依托单位国家：
美国
项目类别：
财政年份：
2015
资助国家：
美国
起止时间：
2015-01-12 至 2024-03-31
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/10398887
关键词：
3-Dimensional Ablation Acute Address Affect Algorithms American Arrhythmia Atrial Fibrillation Automobile Driving Blinded Caring Characteristics Chronic Clinical Clinical Trials Complex Computational Technique Computer Analysis Computer Models Computer Simulation Data Development Digital Computers Electrophysiology (science)Extinction (Psychology)Freedom Frequencies Funding Geometry Goals Health Heart Atrium Heart failure Hour Left Maintenance Maps Mediating Meta-Analysis Modeling Morbidity - disease rate Observational Study Outcome Patients Pattern Persons Pharmacotherapy Phase Physics Procedures Public Health Pulmonary veins Registries Reporting Rotation Source Stroke Techniques Testing Therapeutic Time Tissues Translating Work base effective therapy improved indexing individual patient interest mortality novel novel therapeutics open source patient registry prospective test randomized trial simulation source localization spatiotemporal success therapy development

项目摘要

Patient-Directed Computational Analysis of Atrial Fibrillation Project Summary Atrial fibrillation (AF) is the most common arrhythmia and is a rapidly-growing public health problem that currently affects over 30 million people world-wide and more than 5 million people in the US. If left untreated, AF leads to an increase in stroke, heart failure and mortality. Unfortunately, the mechanisms that maintain AF remain poorly understood, hindering further improvement of current therapy strategies. Recent studies, however, have revealed that AF may be driven by rotational or focal sources and that targeting these sources using localized ablation can result in promising long-term outcomes. Due to our incomplete understanding of AF, however, this targeted ablation approach is not always successful. This project will test the novel hypothesis that AF is sustained by localized rotational and focal sources with different size and temporal stability and that, after these sources are removed, termination is not immediate but is maintained by non-local mechanisms. We will address this hypothesis using a combined computational/clinical approach that employs advanced multiscale computational techniques and state-of-the-art clinical mapping. The project will 1) quantify AF organization using patient-specific geometries; 2) determine whether some rotational or focal sources are more important than others; 3) test possible causes of AF maintenance and termination using patient-specific digital computer models. We will use data from our unique and large patient registry, currently totaling >500 patients. This project is significant because it will establish a deeper understanding of AF and might reveal novel mechanisms of AF maintenance. Our results can be translated directly to practice and may enable the development of better treatment options.

患者导向的心房颤动计算分析项目概要心房颤动（AF）是最常见的心律失常，并且是一种快速增长的疾病目前影响全球超过3000万人的公共卫生问题美国有超过 500 万人。如果不及时治疗，房颤会导致中风、心力衰竭和死亡率增加。不幸的是，这些机制维持 AF 仍然知之甚少，阻碍了当前的进一步改进治疗策略。然而，最近的研究表明 AF 可能是由旋转或焦点源驱动，并使用这些源来瞄准局部消融可以带来有希望的长期结果。由于我们的对 AF 的了解还不完全，然而，这种有针对性的消融方法并不适用总是成功的。该项目将测试新的假设，即房颤是由局部区域维持的具有不同尺寸和时间稳定性的旋转源和焦点源，并且，删除这些来源后，不会立即终止，但会维持终止状态通过非本地机制。我们将使用组合来解决这个假设采用先进的多尺度计算的计算/临床方法技术和最先进的临床绘图。该项目将 1) 量化 AF 使用患者特定的几何形状进行组织； 2）判断是否有一些旋转源或焦点源比其他源更重要； 3) 可以进行测试使用患者专用数字计算机维持和终止 AF 的原因模型。我们将使用来自我们独特的大型患者登记处的数据，目前总计>500名患者。这个项目意义重大，因为它将加深对 AF 的理解并可能揭示房颤维持的新机制。我们的结果可以是直接转化为实践并可能促进更好的发展治疗方案。