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A V HILL LECTURE - Cardiac Arrest: From Genes to Mechanisms to Mind

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If you have a question about this talk, please contact Beverley Larner.

This lecture will give an overview of the mechanisms of abnormal heart rhythm disorders leading to “Cardiac Arrest” i.e. ventricular fibrillation. The lecture will be divided into 3 areas: Genes, Mechanisms and the Mind –examining the role of heart-brain interactions.

Initially, cardiac ion channel mutations in inherited cardiac conditions will be discussed examining both Long QT syndrome and Brugada Syndrome respectively. I will then focus on the role of “molecular autopsy’ in young sudden death cases and its application to family screening. Whole exome studies of the cardiovascular genes give a diagnostic yield of about 30% but there is a challenge in determining the pathogenicity of a number of variants. Studies have been extended to population level data and our “Electrogenomics” Group has discovered 30 new loci regulating heart rate during exercise and recovery in 70,000 subjects from UK Biobank.

Ventricular arrhythmias arise from the initiation of re-entry around regions of functional block. Identifying these sites and predicting their initiation remains a major challenge with implications for both targeting treatment and risk stratification. The molecular basis for cardiac alternans will be presented showing data from simultaneous cardiac mapping and targeted biopsy studies during open heart surgery. We have undertaken a number of studies in inherited and acquired cardiac conditions and shown that the dynamic changes in conduction and repolarisation can be used to predict ventricular arrhythmia locations using invasive mapping of the heart and non-invasive ECG Imaging. The ultimate goal will be to plan non-invasive ablation combined with CT/MRI imaging of the heart to target pro-arrhythmic sites.

It is well recognised that anxiety and stress can promote cardiac arrest and I will present data from studies we have undertaken in the cardiac catheterisation laboratory demonstrating the effects of mental stress, movies and music on cardiac electrophysiology.

This talk is part of the Cambridge Philosophical Society series.

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