Projects / Programmes
The influence of Cardiac Autonomic regulation and Systemic Humoral activation on Arrhythmia incidence, initiation, and therapy by heart surgery
| Code |
Science |
Field |
Subfield |
| 3.06.00 |
Medical sciences |
Cardiovascular system |
|
| Code |
Science |
Field |
| B530 |
Biomedical sciences |
Cardiovascular system |
surgical treatment, hert rhythm disturbances, atrial fibrillation, heart rate variability
Researchers (6)
Organisations (2)
Abstract
Substantial proportion of the present population worldwide is threatened by cardiac arrhythmias. Despite improved recognition and diagnostic tools, better knowledge of the underlying mechanisms, identification of risk factors and more efficient medical treatment it still contributes significantly to overall morbidity and mortality. Recent progress in understanding of underlying electrophysiology with concomitant development of newer technologies and techniques enables us to target cardiac arrhythmias by causal approach. Consequently, the role of surgical ablative treatment of atrial fibrillation accompanying structural heart disease is gaining importance. There has been a profound advancement achieved in the cardiac surgery field over the past years resulting in new and less invasive treatment modalities. Anticipating every surgical procedure poses a certain risk to the patient it is mandatory to define and recognize every possible preoperative factor and mechanism that might affect the postoperative course or even result in suboptimal and undesired outcome. Additionally, the expected outcome of treatment assessing single patients” individual risk factors should be known preoperatively, preferrably by identification of specific and sensitive predictors in a minimally invasive, ideally non-invasive manner. Such optimised approaches and individually tailored recognition and assessment of risk factors secures safe way to improved outcomes. The aim of the present study is to assess and quantify the indices of autonomic modulation of the heart, humoral adrenergic response and systemic inflammatory reaction first, by heart procedures with concomitant ablation in patients with preoperative paroxysmal, persistent or permanent atrial fibrillation and second, in beating – and arrhested heart revascularization procedures with special emphasis on the recognition of perioperative arrhythmias. The collected data will help us to better understand the underlying mechanisms, recognze the subgroups that will on one hand benefit from the surgery most and on the other hand others, that already preoperatively carry the highest risk of failure, what will hopefully improve our current cure rates and.
Significance for science
Many interesting options are now available for surgical RF ablation of atrial fibrillation. Widely used is the concomitant ablation during cardiac surgery, where bipolar devices, sometimes with the combination of the monopolar, can offer the patients good chances for the sinus rhythm restoration and better postoperative outcome. Also available is the minimally invasive technique, either in combination with minimally invasive cardiac surgery or as a standalone procedure. To standardize and to document the outcomes after this unique surgical treatment, it is necessary to test the conduction blocks after the ablation actually to demonstrate entry and exit conduction blocks. Thorough evaluation of postoperative rhythm is mandatory if we want to wean the patients from anti arrhythmic drugs and anticoagulant treatment.
Significance for the country
Totally endoscopic transdiaphragmatic unipolar RF ablation of long standing persistent atrial fibrillation in combination with endocardial unipolar RF ablation used by electrophysiologists is a new method, currently used routinely in just three center around the world: Ljubljana, Slovenia, Pinehurst, NC, USA and Austin, TX, USA.
Most important scientific results
Annual report
2008,
final report,
complete report on dLib.si
Most important socioeconomically and culturally relevant results
Annual report
2008,
final report,
complete report on dLib.si
