Electrogram and MRI-guided Identification of Dynamic and Fixed Substrate for Atrial Fibrillation

Project Abstract: Atrial fibrillation (AF) is the commonest rhythm disturbance of the heart, and is a major cause of stroke and congestive heart failure. The last few years have seen the development of new radiofrequency ablation (and related surgical) procedures to treat AF. Although ablation is being used to treat several thousand patients with AF each year, the efficacy of AF ablation is not optimal, in part because current ablation procedures do not target the specific mechanisms underlying AF. This project proposes to develop a new diagnostic strategy that combines novel signal processing and imaging techniques to better detect the specific mechanisms underlying AF e.g. build up fibrous tissue in the heart, increased nerve signaling, altered calcium activity. Specifically, we will use a combination of electrical recordings from the heart and magnetic resonance imaging (MRI) to detect the aforementioned key mechanisms underlying AF. An improved ability to detect the mechanisms underlying AF in a given patient would be expected to better tailor current ablation and surgical techniques (to a given patient), and thereby increase efficacy of these procedures. The proposed approach may therefore have considerable therapeutic potential in the management of AF, especially in patients who are resistant to current ablation procedures.