Research

Area 2

Arrhythmias, resynchronization and cardiac imaging

Team leader

Strategic objectives

The aims for the coming year are fundamentally to continue developing the five main research lines of the group: genetic cardiovascular diseases, atrial fibrillation, cardiac resynchronization, ventricular tachycardias, and experimental models of etiological factors in atrial fibrillation. A new research line may be added in sports cardiology, taking advantage of our previous experience in arrhythmias and cardiac imaging, and in the previous development of a murine experimental model of chronic training. Another strategic aim of the group is to consolidate the Cardiac Imaging Subgroup, which collaborates with all the group research lines, applying cardiac imaging techniques to the study of the physiopathology of arrhythmias and their mechanics. Furthermore, we wish to continue promoting prospective multicenter projects allowing the obtainment of transcendental clinical results, without abandoning practical clinical research, with a view to improving patient care.

Main lines of research

  1. Cardiovascular genetic diseases:
    • This year patients continue to be included in the multicenter study ‘Sudden cardiac death: Translating basic science into clinical care’, in collaboration with Dr. Ramon Brugada of the Cardiovascular Genetics Center UdG-IDIBGI, in Girona.
  2. Experimental models for the study of etiological factors in atrial fibrillation:
    • We wish to continue analyzing the mechanisms conditioning the appearance of atrial and ventricular fibrosis in the rat model of resistance exercise.
    • We are continuing collaboration with the Pneumology Sleep Unit and the Department of Physical Medicine of the Faculty of Medicine of Barcelona University, with the purpose of studying the repercussions of obstructive apnea upon the heart, using an experimental model in rats.
  3. Atrial fibrillation (AF):
    • On one hand we are continuing the study of etiological factors in primary atrial fibrillation, specifically with the FUTURE study, which analyzes the role of undetected hypertension and physical exercise.
    • Recruitment is continuing in the SARA study (Spanish Atrial Fibrillation vs Antiarrhythmic Drugs). Comparative multicenter study of the efficacy of ablation versus drug treatment.
    • Recruitment has been completed in two randomized, prospective studies designed to compare different ablation techniques.
  4. Ventricular tachycardia (VT):
    • Multicenter study of antiarrhythmic drugs versus ablation in ischemic patients with automated implantable defibrillators.
    • A prospective study evaluating the ejection fraction following ventricular extrasystolia ablation in patients with ventricular extrasystoles and structural heart disease.
    • Different prospective studies are being conducted, evaluating the clinical usefulness of epicardial ablation in different substrates.
    • Software has been developed to delimit the slow conduction zones within myocardial scars by means of magnetic resonance studies and their fusion with images obtained from three-dimensional navigation sysems.
    • Siemens has has sponsored a prospective study to evaluate remodelling and sudden death risk predictive capacity with MRI and biomarker levels in patients with structural heart disease.
  5. Sports cardiology:
    • We are continuing work on the murine experimental model of cardiac adaptation to chronic training, developed for the study of atrial fibrillation physiopathology, focusing research mainly on right ventricle adaptation.
    • We have incorporated the human clinical model thanks to collaboration of the group with elite sports entities (FC Barcelona and the Consell Català de la Salut), performing cardiac imaging studies of all the athletes, and again focusing on cardiac adaptation to chronic training.

Grups

Cardiac resynchronization (Associated)

MONT, LLUIS

(ICT)

Our group focuses its research on the applications and results of cardiac resynchronization techniques. At present we are carrying out a number of studies:

  • We are continuing recruitment in two studies to evaluate the effect of optimization in the success of cardiac resynchronization. BEST study.
  • Inclusion is continuing in the ECHO-CRT study on the efficacy of cardiac resynchronization therapy (CRT) in patients with narrow QRS waves.
  • Inclusion has ended in the multicenter SEPTAL-CRT trial, designed to evaluate the efficacy of septal versus right ventricle apical stimulation.
  • We have started the CRT CAT project, which is a multicenter prospective study in Catalonia, designed to evaluate the efficacy, cost and complications of cardiac resynchronization in our setting.
  • We have started the multicenter SPARE III study, designed to evaluate the efficacy of CRT in atrial fibrillation.
  • The cvREMOD study is ongoing, financed by the CENIT (CDTI). This project has allowed us to develop a porcine experimental model of mechanical dyssynchrony, with the purpose of producing the tools necessary for further exploring the mechanisms of action of CRT.