11 September 2017

CVON Earlier Recognition project "VIGILANCE" granted

The CVON Earlier Recognition project "VIGILANCE" of Prof. Paul Volders (CARIM Dept. of Cardiology) was granted.

Out-of-hospital cardiac arrest by ventricular fibrillation can occur in the absence of significant coronary artery disease, infarction or overt structural heart disease. Upon careful screening, an inherited arrhythmia syndrome or subclinical cardiomyopathy may be diagnosed, and an arrhythmogenic influence inferred, but despite all information provided by electrical phenotyping and genetic profiling it remains virtually impossible to identify in advance those individuals who will die suddenly by ventricular fibrillation. The VIGILANCE project focuses on establishing a Dutch national registry of patients with idiopathic ventricular fibrillation, i.e., individuals in whom no obvious diagnosis to explain the lethal arrhythmia can (yet) be made. In addition, the VIGILANCE investigators, with world-leading experts in the fields of cardiac electrophysiology, arrhythmogenesis, cardiogenetics, cardiovascular radiology and sudden cardiac arrest, will apply an advanced diagnostic flowchart combined with noninvasive electrocardiographic imaging (ECGI) to significantly improve the detection of arrhythmogenic substrates in patients with idiopathic VF. ECGI is a noninvasive technique that employs mathematical formulations to reconstruct the electrical activity directly at the level of the heart muscle, based on extensive body-surface electrocardiograms and a digital, patient-specific body and heart geometry. Among other applications, this technology will facilitate the characterization and imaging of electrical gradients under basal and provoked conditions to localize the origins of idiopathic VF, and to determine the substrate complexity underlying this arrhythmia. It is of utmost importance to early recognize the electropathologic substrate and triggers that cause VF in surviving patients. Likewise, affected family members of patients with a (suspected) inherited arrhythmia syndrome should be screened as early as possible. Here, gender differences will be explicitly investigated. Ultimately, the VIGILANCE project will generate new ECGI tools for characterizing proarrhythmic substrates and provide stratification parameters with the highest clinical applicability for personalized preventive therapy for idiopathic VF.

Volders: "Samen met co-PIs Joachim Wildberger, Rutger Hassink (UMCU), Arthur Wilde (AMC) en teams gaan wij het vóórkomen van "idiopathisch kamerfibrilleren" in Nederland inventariseren en in een registry bundelen. Patiënten in deze registry worden uitgenodigd om de nieuwe techniek van ECG-imaging te ondergaan. Dat is een niet-invasieve techniek waarbij de elektrische eigenschappen van het humane hart in beeld worden gebracht; tevens onderwerp van het proefschrift van Matthijs Cluitmans hier aan de UM in 2016. Wij onderzoeken of deze elektrische eigenschappen details verraden die een verhoogd risico op kamerfibrilleren aangeven. Dit project zal een looptijd van 5 jaar hebben."