Atrial fibrillation

Atrial fibrillation (AF or A-fib) is an abnormal heart rhythm (arrhythmia) characterized by rapid and irregular beating of the atrial chambers of the heart. It often begins as short periods of abnormal beating, which become longer or continuous over time. It may also start as other forms of arrhythmia such as atrial flutter that then transform into AF. Episodes can be asymptomatic. Symptomatic episodes may involve heart palpitations, fainting, lightheadedness, shortness of breath, or chest pain. Atrial fibrillation is associated with an increased risk of heart failure, dementia, and stroke. It is a type of supraventricular tachycardia. High blood pressure and valvular heart disease are the most common modifiable risk factors for AF. Other heart-related risk factors include heart failure, coronary artery disease, cardiomyopathy, and congenital heart disease. In low- and middle-income countries, valvular he

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Electr(on)ic palpitations: a visitors' pavilion for the Bieudron power plant, Switzerland

Michael Jakob

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2010

Cardiac ablation, How Contact Force influences lesion quality

Olivier Frémont

Cardiac ablation is a worldwide accepted minimally invasive procedure to treat Atrial Fibrillation (AF). It consists in creating lesions with a catheter in the cardiac tissue in order to cut off specific electrical pathways. During this project, based on preclinical studies, we investigated and modeled the lesion formation process. This led first to identify and quantify the different mechanisms which take place in the heating process. The model developed gave rise to a Lesion Depth Index to quantify the lesion depth based on clinical parameters used to treat patient: Force Power and Duration. Another part of this project was the analysis of the clinical study EFFICAS 1 focused on the local outcome of the Pulmonary Veins Isolation (PVI). Combining the lesion depth model with the clinical analysis permitted to upgrade the analysis and confirmed that the model developed was relevant for clinical analysis. Moreover, this clinical study, allowed us to discover that the smallest lesion performed in a given microscopic area is a key predictor for isolation defect in PVI. Therefore, we showed that performing transmural ablation at the first shot is essential for a good PVI.

2010

Intracardiac organization indices for the monitoring of atrial fibrillation

Sarah Volorio

Atrial fibrillation (AF) is the most common arrhythmia observed in clinical practice. It is responsible for about one third of hospitalizations related to problems of arrhythmia. AF is an important clinical entity due to the increased risk of morbidity and mortality. The consequences of AF most frequently found are hemodynamic function impairment (loss of atrial synchronized contraction, irregular and inadequately rapid ventricular rate), atriogenic thromboembolic events and tachycardia induced atrial and ventricular cardiomyopathy. With the present increase of life expectancy, AF prevalence is expected to double in the next fifty years, in particular in western countries. In collaboration with the Division of Cardiology of CHUV, a catheter ablative protocol mainly based on pulmonary vein isolation (PVI) and complex fractionated elctrograms ablations was defined in order to develop new strategies to decrease procedural time and ablation extent. More precisely, surface EGC as intracardiac electrogram (EGM) signals were recorded from different catheters at specific locations before ablation during and after PVI. The purpose of this project is to evaluate the ability of known (AF cycle length) and new intracardiac organization indices based on recorded surface ECGs and EGM signals to monitor AF organization during stepwise ablation of persistent AF.

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Heart

The heart is a muscular organ in most animals. This organ pumps blood through the blood vessels of the circulatory system. The pumped blood carries oxygen and nutrients to the body, while carrying me

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