Analysing The Paced QRS To Refine Arrhythmic Risk Stratification V1.4

  • Research type

    Research Study

  • Full title

    An Investigation Of The Spatiotemporal Characteristics Of Paced Ventricular Depolarisation In Relation To Myocardial Scar Identified By Three Dimensional Voltage Mapping And Contrast Enhanced Cardiac Magnetic Resonance Imaging

  • IRAS ID

    118097

  • Contact name

    Hanney Gonna

  • Contact email

    hanney@doctors.org.uk

  • Sponsor organisation

    St. George’s Hospital NHS Trust

  • Research summary

    Over half of deaths related to heart attacks are caused by cardiac rhythm disturbances. The majority of these rhythm disorders are due to abnormal circuits of electrical activity around areas of scar tissue caused by the heart attack. These circuits cause very rapid heart rates and subsequent cardiac arrest. Current methods used to predict who is at risk of cardiac arrest are suboptimal, as little is known about the effects of scar tissue on electrical flow within the heart. Additionally the shape and size of scar tissue vary between patients. It is important to identify patients at high risk of cardiac arrest, as effective treatments exist.

    Our research will examine the effects of scar tissue on electrical flow within the heart. We will identify scar tissue from imaging scans of patients with previous heart attacks.

    Patients already undergoing a medically needed cardiac electrical procedure will have a slightly more detailed examination, performed predominantly during the routine waiting period observed during such procedures, with additional points of electrical stimulation within the heart. We will measure the time taken for that stimulus to travel within the heart from different points and compare that with distribution of their scar tissue. Combined with the imaging scans, the information gained about electrical conduction within the heart will be used to generate personalised computer models of electrical flow through the heart.

    Our primary goal is to understand the electrical effects of scar tissue and develop a method of assessment to identify people at high risk of cardiac arrest and would therefore require specialised therapy.

  • REC name

    London - City & East Research Ethics Committee

  • REC reference

    13/LO/0568

  • Date of REC Opinion

    15 Aug 2013

  • REC opinion

    Further Information Favourable Opinion