HomeScience and ResearchScientific ResearchAtrial Fibrillation Patients to Benefit from CNIC's Revolutionary Diagnostic Tool

Atrial Fibrillation Patients to Benefit from CNIC’s Revolutionary Diagnostic Tool

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New Hope for Atrial Fibrillation Patients

An innovative method promises enhanced diagnostic accuracy and a pathway towards personalized treatment for a widespread arrhythmia impacting over 10 million individuals across Europe.

The Centro Nacional de Investigaciones Cardiovasculares (CNIC), collaborating with researchers domestically and internationally, has introduced a novel diagnostic approach that enables concurrent evaluation of the electrical and contractile activities of the heart.

A comprehensive study orchestrated by the CNIC’s team of scientists showcases a groundbreaking technique to examine the structural and electrophysiological alterations, or atrial remodeling, in patients with atrial fibrillation – a prevalent type of cardiac arrhythmia.

This diagnostic approach hinges on the simultaneous evaluation of electrical and contractile activities in the heart’s atria during an atrial fibrillation episode. The research has been published in Nature Communications (DOI 10.1038/s41467-023-40196-y).

David Filgueiras, the study’s lead, pointed out that integrating both types of data for a more holistic evaluation has been “an unmet challenge” due to technological limitations and the technical difficulty of measuring the low-intensity contractions of the atria during fibrillation.

Atrial fibrillation, an irregular and often rapid heart rate, increases stroke, heart failure, and other complication risks due to potential blood clot formation in the heart. Approximately 10 million people in Europe and around 700,000 in Spain are affected by this condition.

Currently, atrial fibrillation is categorized based on how long a patient has been experiencing arrhythmia. However, Dr. Filgueiras, who heads the Advanced Development in Arrhythmia Mechanisms and Therapy group at CNIC and is a cardiologist at the Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), points out that this classification does not provide insights into the extent of a patient’s atrial remodeling.

The significance of “this new diagnostic method” lies in its ability to offer a personalized evaluation of an individual patient’s degree of atrial remodeling, regardless of their clinical classification, according to Dr. Filgueiras.

Daniel Enríquez Vázquez, one of the study’s first three authors from the Spanish cardiovascular research network (CIBERCV) and the Complejo Hospitalario Universitario in A Coruña, along with CNIC researchers Jorge G. Quintanilla and Alba García Escolano, stressed the clinical implications of the findings.

They noted that “on a clinical level, the results show that electromechanical dissociation in patients with atrial fibrillation is a solid indicator of disease progression and of the need to take urgent steps to return these patients to normal rhythm in an efficient and stable manner.”

Over the last decade, a team of local and international experts from various institutions, including the University of Connecticut, several Spanish universities and hospitals, and the CIBERCV, worked together to merge electrical and mechanical cardiac data, allowing personalized assessment of atrial fibrillation progression.

Through a multidisciplinary approach, the team initially devised an optimal strategy for merging electrical and mechanical data. They found that Doppler imaging, a non-invasive method providing information on atrial tissue movements, was effective for measuring mechanical activity, while surface electrocardiography was used for electrical activity.

In the subsequent phase, biology, biotechnology, biochemistry, and biomedical engineering experts collaborated with clinical cardiologists and the CNIC Proteomics Unit to align the newly derived data with the underlying pathological changes in atrial tissue. This collaboration led to the development of novel mapping techniques and computer simulations revealing the mechanisms of electrical and mechanical remodeling during atrial fibrillation progression.

A multicenter prospective study involving 83 early-stage atrial fibrillation patients concluded the project, establishing the prognostic value of simultaneous electrical and mechanical assessment in such patients.

The findings illustrated an early-stage imbalance between electrical and contractile activation in the atria, leading to atrial electromechanical dissociation, a phenomenon specific to each individual patient. The new method can identify this dissociation before the onset of overt clinical signs of structural atrial remodeling.

Dr. Filgueiras states that “The use of this new diagnostic approach allows early characterization of the underlying remodeling in patients with atrial fibrillation. The study shows that it is possible to integrate electrical and mechanical data from the atria of patients with atrial fibrillation to obtain personalized prognostic information about the clinical progression of the disease.”

Nicasio Pérez Castellano from IdISSC and David Calvo Cuervo, affiliated with both Hospital Central de Asturias and IdISSC, emphasize the non-invasive nature of this approach as its significant advantage, “will greatly ease the management of patients with atrial fibrillation.”

Julián Pérez Villacastín, a clinical collaborator on the study and current president of the Spanish Society of Cardiology, is hopeful that “its clinical implementation will allow an increasingly personalized management of patients with atrial fibrillation.”

Source: 10.1038/s41467-023-40196-y

Image Credit: Shutterstock

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