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Additional info for Atrial Fibrillation - A Medical Dictionary, Bibliography, and Annotated Research Guide to Internet References
We will also test the hypothesis generated by our preliminary data that a Kv eta subunit can function as an AKAP. Finally, our initial results indicate that chronic rapid stimulation of atrial cells in culture leads to electrical remodeling, and this system will be used to test the hypothesis that the molecular events that trigger remodeling resemble those of cardiac hypertrophy, with activation of specific intracellular signaling cascades. The knowledge gained from these studies will improve our understanding of the molecular components of atrial electrophysiology, and should lead to the development of novel targets to treat atrial fibrillation.
During phase 1 and 2, arterial pressure, central venous pressure and muscle sympathetic nerve activity using microneurography will be recorded during sinus rhythm, atrial pacing (in patients with a QRS greater than 150msw) and atrialventricular pacing (RV, LV or BV). Pacing will be performed at a rate 10 beats faster than sinus rhythm. During phase 3 and 4, we will assess the effect of BV pacing on the inducibility of ventricular arrhythmias and the associated electrophysiologic changes. The outcome of this study will have a great impact on our management of patients with congestive heart failure.
From these results, a clinical prediction rule will be formulated. Validation of the prediction rule will then take place in a prospective cohort study using a different group of patients from which the rule was derived. This will allow for the assessment of both validity and generalizability. The candidate has committed himself to a career as an independent investigator, with an interest in the application of rigorous epidemiologic techniques to questions of importance in cardiac electrophysiology, his area of clinical expertise.