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SUMMARY:Using multiscale in-silico models of the heart for optimisation of
  anti-arrhythmia therapies - Plank\, G (Medizinische Universitt Graz)
DTSTART:20090720T153000Z
DTEND:20090720T154500Z
UID:TALK19173@talks.cam.ac.uk
CONTACT:Mustapha Amrani
DESCRIPTION:Several multi-center clinical trials have provided consistent 
 evidence that implantable defibrillation therapy prolongs patient life. Th
 is convincing demonstration of efficacy has led to a nearly exponential gr
 owth\, over the last decade\, in the number of patients receiving implanta
 ble devices. Currently\, around 0.2 million implantable cardioverter defib
 rillators (ICDs) are implanted every year throughout the world. \n\nDespit
 e the importance and wide-spread use of this therapy\, understanding of me
 chanisms by which electric shocks halt life-threatening arrhythmias remain
 s incomplete. Further\, ICD therapy is clearly suboptimal: to reliably res
 tore sinus rhythm high shock strengths are required which are perceived as
  extremely painful by most patients\, leading to traumatization with a sig
 nificant impact on quality of life\; the high current densities close to t
 he electrode damage adjacent tissue\; ICDs sometimes deliver inadequate sh
 ocks which may even trigger lethal arrhythmias instead of preventing them.
  \n\nRecent experimental advances allow a better characterization of the s
 hock-tissue interaction which have led to new mechanistic insights. Noneth
 eless\, current experimental techniques cannot resolve\, with sufficient a
 ccuracy\, electrical events confined to the depth of the myocardial walls 
 which limits observations to the surfaces of the heart. In-silico computer
  models are a powerful complementary approach to bridge this gap by provid
 ing a mechanistic link between elecrical activity observed at endocardial 
 and epicardial surfaces. \n\nThe overall objective of this research is\, b
 y employing anatomically and functionally realistic in-silico computer sim
 ulations of the defibrillation process and the physics of experimental map
 ping techniques\, to shed light on basic mechanisms underlying shock-tissu
 e interactions and to test new hypotheses which may\, eventually\, pave th
 e road to reliable defibrillation at a fraction of the energy requirements
  of current ICDs.
LOCATION:Seminar Room 1\, Newton Institute
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