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Arrhythmias, also known as cardiac arrhythmias, heart arrhythmias, or dysrhythmias, are irregularities in the heartbeat, including when it is too fast or too slow. A resting heart rate that is too fast – above 100 beats per minute in adults – is called tachycardia, and a resting heart rate that is too slow – below 60 beats per minute – is called bradycardia. Some types of arrhythmias have no symptoms. Symptoms, when present, may include palpitations or feeling a pause between heartbeats. In more serious cases, there may be lightheadedness, passing out, shortness of breath or chest pain. While most cases of arrhythmia are not serious, some predispose a person to complications such as stroke or heart failure. Others may result in sudden death. Arrhythmias are often categorized into four groups: extra beats, supraventricular tachycardias, ventr

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This course introduces the student to the fudamentals of pharmacology, pharmacokinetics and drug-receptor interactions. It discusses also pharmacogenetics and chronopharmacology, to exemplify the challenges of personalized medicine.

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Reduced order models for the simulation of pathological heart valves

Lidia Stepanova

Numerical modeling of the human cardiovascular system (CVS) represents an active branch of research which allows the medical specialists to advance in understanding of underlined processes of blood circulation and the heart work at any scale, moreover, it helps to analyze the potential problems which can arise in the CVS by modifying the parameters inside the mathematical models. Due to inability to capture in details the pressure and flow parameters without invasion into heart chambers, the process of diagnosing heart diseases can become very complicated, the limited data on atrial pressure and cardiogram results can give only overall representation of the heart condition and the exactness of the diagnosis is based mainly on experience of the doctor. Nevertheless, the development of numerical models of CVS helps to get better understanding on processes which can cause particular disease (reverse flow leakage in heart chambers, improper contraction of heart muscles due to infarction of tissue). Mathematical model allows the analysis of all physical values of the system during the heart beat as well as possibility to adjust individual parameters specific to each patient. Therefore, it becomes an efficient tool for doctors to diagnose properly the heart disease, to assign the necessary treatment and surgery, and to predict the effect of implanting cardiac-assist devices.

2013

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.

2011

Phenomenological and physiological approaches in the study of cardiac alternans: Theoretical background, mathematical modeling and numerical simulations

Marie Dupraz

This project presents the theoretical background in electrophysiology that is used as a basis in the development of numerical methods for the simulation of heart’s electrical activity. We discuss the mathematical models currently used in cardiac electrophysiology research to simulate the propagation of an action potential wave, and then focus on the description of the ionic currents. This study allows us to anticipate the numerical model sensitivity with regard to the discretization, with the aim of recovering the physiological behaviors of the tissue (i.e. conduction velocity, electrical restitution, etc). Thereafter, we introduce the pseudo-ECG signal reconstruction method from the action potential map. This leads us to examine the approximation of such a signal using the finite element basis coming from the discretization of the monodomain equations. We discuss then a particular cardiac rhythm disorder: action potential alternans. In a second step, we perform an extended simulation study in order to validate the previous numerical methods. We carefully check the convergence of the conduction velocity with respect to the mesh size, and we bring out the advantage of phenomenological approach in terms of electrical restitutions and computational cost. We reproduce typical rhythm disorders and show that the pseudo-ECG signal is able to detect them. Finally, we discuss the influence of anisotropy in cardiac wave propagation and alternans development, characterizing the effect of fibers direction and pacing site in the resulting spatio-temporal distribution.

2013

Electrocardiography

Electrocardiography is the process of producing an electrocardiogram (ECG or EKG ), a recording of the heart's electrical activity through repeated cardiac cycles. It is an electrogram of the heart

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 abnorm

Cardiology

Cardiology () is the study of the heart. Cardiology is a branch of medicine that deals with disorders of the heart and the cardiovascular system. The field includes medical diagnosis and treatment of