Combining a non-invasive multimodal imaging approach with provocative manoeuvres to improve risk prediction for sudden cardiac death in ischemic cardiomyopathy.

Sudden cardiac death (SCD) by cardiac rhythm disturbances is an important cause of death in our

society. Coronary artery disease is the most common cause of SCD. The triggers for these lethal

arrhythmias are poorly understood and current risk prediction for SCD is unsatisfactory. We

hypothesize that including assessment of triggers together with a combination of

electrocardiographic and imaging studies can improve identification of patients at risk for SCD. We

hypothesize that a sudden rise in myocardial load can trigger ventricular premature beats that can

degenerate in ventricular tachycardia or ventricular fibrillation (VT/VF) in a diseased heart. We

hypothesize that remodeling of the infarcted muscle region forms the substrate for VT/VF and

specifically that fibro-fatty reorganization of the infarct border-zone induced by inflammation and

the autonomic nervous system is important in this process. We will study animal models of

myocardial infarction with multimodal imaging techniques in vivo and perform histological analysis

after sacrifice to provide evidence for these hypotheses. The imaging techniques used in the large

animal model will be translated in patients receiving an implantable cardioverter defibrillator for

ischemic cardiomyopathy. We will correlate our animal findings with the occurrence of ventricular

arrhythmias in patients. The ultimate goal of our project is a better selection of patients at risk for

SCD after myocardial infarction.

RESEARCH

Main host institution KU Leuven

- 1