Catalysing Change in Cardiac Arrhythmia Treatment: An Interdisciplinary Journey from Theory to Practice
Atrial tachycardia: case study
Atrial tachycardia: case study
Prof. Dr. Mattias Duytschaever
Atrial tachycardia: case study
Where I come from...
Studies Physics
PhD in Particle Physics
PhD in Particle Physics
PhD in Particle Physics
PhD in particle physics
Loes
Transition to cardiac arrhythmia...
Cardiac arrhythmia: 15-20% of all death
Cardiac arrhythmia: cause of death number 1
How does the heart work?
How does the heart work?
Physics of the heart
μs, nm
ms, μm
s, cm
s, m
Each part can be modeled
1D
2D
3D
3D
Basis of cardiac arrhythmia
Basis of cardiac arrhythmia
Treatment of cardiac arrhythmia
Ablation: scarring tissue to stop the wave
Behandeling van een hartritmestoornis
Ablation: removing the focal source by burning it
Basics of cardiac arrhythmia
How to treat an arrhythmia?
Basics of cardiac arrhythmia; types of arrhythmia
- Atrial tachycardia
- Atrial fibrillation
- Ventricular tachycardia
- Ventricular fibrillation
- Torsade de Pointes
- regular
- irregular
My first arrhythmia :)
Torsade de Pointes
Big question, what is causing it? Focal beats or reentry?
Simulations show both are possible
Visiting Utrecht...
Experiments on dogs
Novel idea!
Brain
Search algorithm
Novel idea!
Nieuw idee!
Novel idea!
Application to cardiac arrhythmia in humans...
Verschillende types hartritmestoornissen
- Atrial tachycardia
- Atrial fibrillation
- Ventricular tachycardia
- Ventricular fibrillation
- Torsade de Pointes
- regular
- irregular
Looking for clinical data...
2017...
Looking for clinical data....
2017...
Atrial tachycardia
Measurements give rise to a color map.
Needs to be interpreted manually: challenging and operator dependent.
Local activation time
DGM is born
The cycles are the mechanism of the arrhythmia!
DGM is born
DGM is born
DGM is born...
2019-2020!
BOF-ZAP :)
My team
Core team
Nele Vandersickel
Sander Hendrickx
Robin Van den Abeele
Arthur Bezerra
Bjorn Verstraeten
Arstanbek Okenov
Timur Nezlobinskii
Eike Wülfers
Sebastiaan Lootens
Klinische samenwerkingen
Mattias Duytschaever
Sebastiaan Knecht
Armin Luik
Annika Haas
Adding topology to the mix!
Anatomy of the left atrium
MV
LPV
RPV
Index theorem: loops come in pairs of 2
Index theorem (> 20 years old!)
- Each hole has an index: +1, -1 or 0
- Sum of the indexes has to be zero
Index = +1 or -1: critical boundary / Index = 0: non-critical boundary
CB
NCB
NCB
CB
CB
Index = -1
Index = +1
Index = 0
CB
Ablation
Ablation
Atrial tachycardia: case study
Atrial tachycardia: case study
Software package DGM
DGM can find any reentry circuit, so also applicable to any dataset involving
VT, VF, AF, TdP (simulation, experimental or clinical)
www.dgmapping.com