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Concurrent imaging of metabolic and electric signals in the heart
October 26, 2009
Cardiac rhythm disorders can result from disturbances in cardiac metabolism. These metabolic changes are tightly linked with specific cardiac electrophysiology (CEP) abnormalities, such as depressed excitability, impaired intra- and extracellular conductivities, wave propagation block, and alteration of conduction velocity, action potential amplitude, and duration. The altered electrophysiology eventually can lead to arrhythmias, fibrillation, and cardiac death; therefore, understanding the spatiotemporal complexity of the relationship between metabolism and electrophysiology is the challenge in developing new approaches for treatment of cardiac diseases. The optical system for simultaneous imaging electrical and metabolic quantities in the heart was developed by scientists at Vanderbilt University. The advantages of their imaging system over others include an optional software camera calibration routine that eliminates the need for precise camera alignment. The system allows for rapid setup, dichroic image separation, dual-rate imaging, and high spatial resolution, and it is generally applicable to any two-camera measurement. The authors provide a detailed description of a camera calibration algorithm along with multiple examples. They demonstrate the capabilities of this type of imaging system for recording not only the transmembrane potential and intracellular calcium, but other signals more directly related to myocardial metabolism, such as [K+]e, NADH, and reactive oxygen species, leading to the possibility of correlative multimodal cardiac imaging. The authors findings appear in the November issue of Experimental Biology and Medicine. "The challenge in understanding cardiac rhythm disorders is to discern the dynamic relationship between multiple cardiac variables," John Wikswo notes. "This dual camera system opens up a new window for correlating metabolic and electrophysiological events, usually studied independently."
Veniamin Sidorov expects that "the measurement of multiple cardiac parameters during cardiac ischemia or hyperkalemia may enable the screening of new drugs that can be used to adjust electrical and contractile activities of the heart more precisely than commonly used ion-channel blockers/activators."
In summary, the development of metabolic therapies for CEP abnormalities requires simultaneous observation of CEP and metabolism, and a mechanistic understanding of their relationship. The authors' analysis of the potential for dual camera systems and implementations advances the understanding of "electrometabolic" cardiac disorders and their clinical treatment, and their review of related efforts to extend the optical measurements of myocardial function suggests that this is a field worthy of expanded research.
Steven R. Goodman, Editor-in-Chief of Experimental Biology and Medicine said "This technological advance allows the simultaneous measurement of changes in the electrical properties and metabolic profile of the same region of the heart. The ability to measure these coupled phenomena will improve our mechanistic understanding of various cardiac abnormalities including heart failure, fatal arrhythmias, and rate-dependent cardiac remodeling."
Society for Experimental Biology and Medicine
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Cardiac Electrophysiology: From Cell to Bedside: Expert Consult - Online and Print
by Douglas P. Zipes MD (Author), Jose Jalife MD (Author)
Cardiac Electrophysiology: From Cell to Bedside defines the entire state of current scientific and clinical knowledge in this subspecialty. In response to the many major recent developments in the field, Drs. Zipes and Jalife have completely updated this modern classic, making the 5th Edition the most significant revision yet. From our latest understanding of ion channels, molecular genetics, and cardiac electrical activity through newly recognized syndromes, unique needs of special patient populations, and new diagnostic and therapeutic options, you'll find all the state-of-the-art guidance you need to make informed, effective clinical decisions. What's more, a significantly restructured organization, a new full-color layout, and full-text online access make reference easier than...
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Handbook of Cardiac Electrophysiology: A Practical Guide to Invasive EP Studies and Catheter Ablation
by Francis Murgatroyd (Author), Andrew D. Krahn (Author), Raymond Yee (Author), Allan Skanes (Author), George J. Klein (Contributor)
Outline: The Handbook of Cardiac Electrophysiology provides a comprehensive introductory-level guide to invasive cardiac EP studies. Its focus is to enable the reader to understand and interpret the recording and stimulation techniques used during an EP study. The primary emphasis is on tachyarrhythmia diagnosis, but the book also includes bradycardias, the principles of catheter ablation and new mapping techniques. The main concepts are explained diagrammatically in original color diagrams with clinical multichannel intracardiac recordings used to illustrate the concepts discussed. The book provides sufficient practical information to enable the reader to plan an EP study and interpret the intracardiac recordings of most common tachycardias.
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Practical Clinical Electrophysiology
by Peter J Zimetbaum (Editor), Mark E Josephson (Editor)
This book provides a comprehensive and clinically based approach to the diagnosis and management of arrhythmia disorders for the cardiology fellow and practicing general cardiologist. The clinical approach encompasses evidence-based medicine as well as practical pearls for the diagnosis and management of arrhythmia disorders. Chapters provide a comprehensive discussion of arrhythmia disorders, from noninvasive diagnostic strategies through pharmacologic and invasive therapeutic strategies. The level of sophistication ranges from the most basic to more sophisticated topics, and provides an excellent complement to Josephson's more advanced text.
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Clinical Cardiac Electrophysiology: Techniques and Interpretations (Solution (Lippincott Williams & Wilkins))
by Mark E Josephson (Author)
Fully revised and updated for its Fourth Edition, Dr. Josephson's classic text provides a thorough understanding of the mechanisms of cardiac arrhythmias and the therapeutic interventions used to treat arrhythmias. The book details the electrophysiologic methodology required to define the mechanism and site of origin of arrhythmias so that safe and effective therapy can be chosen. Close attention is given to the mechanisms, clinical implications, and limitations of current therapeutic interventions, including drugs, implantable devices, and catheter and surgical ablation. More than 1,100 illustrations clarify the concepts and techniques presented in the text. This edition has a new full-color design. A companion Website offers the fully searchable text with all illustrations...
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Understanding Cardiac Arrhythmias: Current and Emerging Treatments
Episodes of dizziness and loss of consciousness are unsettling and potentially life-threatening. But as our population ages, these problems become more common. Often, they stem from heart rhythm irregularities: cardiac arrhythmias. So how do we treat them? This program looks at different kinds of cardiac arrhythmias, as well as the variety of new and emerging treatments used to control them. Paul Wang, MD, is a Professor of Medicine in the Department of Cardiology at the Stanford University School of Medicine. His specialty is cardiology, with subspecialties in arrhythmias, atrial fibrillation, and syncope. His research interests include atrial fibrillation, pacemakers and defibrillators, catheter ablation, and hypertrophic cardiomyopathy. Dr. Wang was educated at the...
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Clinical Cardiac Electrophysiology Techniques And Interpretations
by Lippincott Williams & Wilkins
Clinical Cardiac Electrophysiology Techniques and Interpretations : Clinical Cardiac Electrophysiology Techniques and Interpretations Pub Date: June 2008 Product Type: Print Author/s: Mark E Josephson MD Fully revised and updated for its Fourth Edition, Dr. Josephson's classic text provides a thorough understanding of the mechanisms of cardiac arrhythmias and the therapeutic interventions used to treat arrhythmias. The book details the electrophysiologic methodology required to define the mechanism and site of origin of arrhythmias so that safe and effective therapy can be chosen. Close attention is given to the mechanisms, clinical implications, and limitations of current therapeutic interventions, including drugs, implantable devices, and catheter and surgical...
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Essential Cardiac Electrophysiology: With Self-Assessment (Blackwell's Essentials)
by Zainul Abedin (Author), Robert Conner (Author)
This concise collection of electrophysiological facts prepares you to face the clinical questions surrounding arrhythmia and conduction disorders with confidence. Clear and direct, the book offers:
succinct factual information supported by illustrations, tables, and references self-assessment questions for each chapter, to test your knowledge of the area
Essential Cardiac Electrophysiology summarizes the fundamental information that forms the basis of the modern approach to cardiac arrhythmias, from an explanation of the electrophysiologic effects of cardiac ion channel activity to the latest information on available implantable defibrillators. All members of the cardiac care team will benefit from keeping this valuable guide close at...
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Basic Cardiac Electrophysiology for the Clinician
by Jose Jalife (Author), Mario Delmar (Author), Justus Anumonwo (Author), Omer Berenfeld (Author), Jerome Kalifa (Author)
This book translates fundamental knowledge in basic cardiac electrophysiology from the bench to the bedside. Revised and updated for its second edition, the text offers new coverage of the molecular mechanisms of ion channel behavior and its regulation, complex arrhythmias, and the broadening roles of devices and ablation. Clear, straightforward explanations are illustrated by plentiful diagrams to make the material accessible to the non-specialist.
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Clinical Arrhythmology and Electrophysiology: A Companion to Braunwald's Heart Disease: Expert Consult: Online and Print (Expert Consult Title: Online + Print)
by Ziad Issa MD (Author), John M. Miller MD (Author), Douglas P. Zipes MD (Author)
Another timely companion to Braunwald's Heart Disease, this unique volume focuses on the clinical aspects of all types of cardiac arrhythmias and offers the most up-to-date guidelines for diagnosis and treatment. You'll get expert coverage of hot topics such as mechanisms of arrhythmias, electrophysiologic testing, mapping and navigation modalities, ablation energy sources, sinus node dysfunction, conduction disturbances, atrial tachyarrhythmias, preexcitation syndromes and all types of ventricular and supraventricular tachycardias. Expert Consult functionality allows you to access the entire contents of the book online, from any Internet connection.
Offers unique perspectives from a three-author team whose members are affiliated with the Indiana University School of Medicine, one...
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Handbook of Cardiac Electrophysiology
by Andrea Natale (Author)
The first practical, user-friendly guide to the theory and practice of a routinely used technique, this new manual provides the specialist in training with a thorough grounding in the equipment, procedures, and clinical findings with which clinicians need to be familiar.
Conceived as an alternative to the large and expensive texts aimed at specialists, the handbook is divided into two sections, which present:
a review of the main kinds of arrhythmia, with illustrations of typical ECG findings supported where appropriate by correlative imaging the principal diagnostic and therapeutic procedures, including implantation of pacemakers, resynchronization therapy, use and placement of catheters and ablation techniques
Providing practical guidance on clinical...
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