The Maintenance of Human Atrial Fibrillation

人类心房颤动的维持

基本信息

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
项目类别：
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

项目摘要

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.

描述（由申请人提供）：人类心房颤动的维持项目摘要心房颤动 (AF) 是最常见的心律失常，影响着 2-500 万美国人，可能会导致心跳加快、头晕、中风甚至死亡。不幸的是，房颤的治疗方法是有限的，开发更好的房颤治疗方法的主要缺点之一是我们对房颤的病因（其“机制”）的了解尚不清楚。此次更新概述了申请人的职业发展计划、年轻临床医生科学家的指导培训以及以患者为中心的心房颤动机械研究。研究计划建立在上一个周期的发现之上，即人类房颤通常不是随机的，而是由少数以转子（类似于电动陀螺）或焦点节拍形式的“源”维持（驱动），这些源可能随着时间的推移而稳定在心脏区域。（心房或顶部心室）在每个患者中都是不同的，通常远离医生目前应用烧灼疗法（消融）的位置。在这个项目中，我们将研究 1)。通过在这些转子源上方和上方的触发部位（肺静脉处）进行消融可以获得多少额外的好处；2）转子实际上如何导致紊乱的节律，而不仅仅是简单的组织电路；3）这个过程是否是由结构异常引起的；我们将在临床试验中通过使用生物工程方法详细记录 AF 并通过整合成像来实现这些目标，这些针对患者的分析将是最详细且与临床相关的分析之一。领域，并将形成未来假设检验和临床试验的平台。该项目意义重大，因为它根据当前的护理标准测试了最近发现的 AF 转子的新型疗法是否成功，因为它研究了导致人类心脏颤动的基本机制，还因为它还测试了新的成像策略。在电生理研究期间，对 AF 患者和有限数量的非 AF 患者进行研究，以便其结果可以直接转化为实践。还可能为药物开发和基因治疗提供更合理的通用方法。

项目成果

期刊论文数量（8）

专著数量（0）

科研奖励数量（0）

会议论文数量（0）

专利数量（0）

What tissue does circumferential PV Isolation actually modulate?

圆周 PV 隔离实际上调节哪些组织？

DOI：
发表时间：
2014-02
期刊：
影响因子：
2.7
作者：
McGarry, Thomas J;Narayan, Sanjiv M
通讯作者：
Narayan, Sanjiv M

CrossTalk proposal: Rotors have been demonstrated to drive human atrial fibrillation.

CrossTalk 提案：转子已被证明可以驱动人类心房颤动。

DOI：
发表时间：
2014-08-01
期刊：
影响因子：
0
作者：
Narayan, Sanjiv M;Jalife, José
通讯作者：
Jalife, José

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：
发表时间：
2011-08
期刊：
影响因子：
5.5
作者：
Link, Mark S;Exner, Derek V;Anderson, Mark;Ackerman, Michael;Al;Knight, Bradley P;Markowitz, Steven M;Kaufman, Elizabeth S;Haines, David;Asirvatham, Samuel J;Callans, David J;Mounsey, J Paul;Bogun, Frank;Narayan, Sanjiv M;Krahn
通讯作者：
Krahn

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

微伏T波交替的生理基础、测量方法和临床实用性——国际动态心电图和无创心电学会共识指南。

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.

Mechanisms linking electrical alternans and clinical ventricular arrhythmia in human heart failure.

人类心力衰竭中电交替与临床室性心律失常的联系机制。