Targeting the Electrical Heart From identified cells  to novel approaches against: Cardiac Arrhythmias Sudden Death Heart ...
Human Cardiac Arrhythmias <ul><li>Tachycardias </li></ul><ul><li>=1 focus or circuit </li></ul>Fibrillations  = multiple f...
The most common : Atrial Fibrillation <ul><li>1-2% of the population: 6 Millions subjects </li></ul><ul><li>Increases with...
<ul><li>Method:  Map of 100 ms preceding spontaneous initiation  1994.1998 </li></ul>Mapping the genesis of chaos NEJM 199...
Curative therapy of Paroxysmal Atrial Fibrillation 10 000 pts treated in 2000 - 200 000 patients in 2010 <ul><li>Therapy f...
Research Perspectives <ul><li>1.<1% of pts are treated by ablation: </li></ul><ul><li>Strong Need of  Drugs targeting  PV ...
INTERNATIONAL AWARDS <ul><li>Mirowski Excellence in Cardiology    Boston Award in Electrophysiology </li></ul><ul><li>Bes...
Sudden death is not a ‘cardiac arrest’ but Ventricular Fibrillation in  80%  <ul><ul><li>Mean Age 65 years , 80% at home <...
First maps in Humans with multiple VFs:  initiation by Purkinje cells (<2 % of cardiac mass) Arborized Network of Purkinje...
Research Perspectives <ul><li>Ablation can’t be the solution for everybody: Mechanisms of Purkinje firing to develop speci...
Heart Failure <ul><li>EUROPE: 9 MILLIONS INDIVIDUALS  </li></ul><ul><li>50%† at 5 yrs= 350 à 400 000 deaths/yr </li></ul>U...
Original Research Projects <ul><li>Investigate electrical dysfunction  </li></ul><ul><li>as a cause of Heart Failure  </li...
Unique Translational Research Center on Cardiac Electrical Disorders- BORDEAUX   Top level international expertise : Whole...
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16 rencontres biomédicale LIR Michel Haissaguerre

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2ND INTERNATIONAL RESEARCH MEETING
4 JUNE 2010- HÔTEL DE MARIGNY PARIS

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16 rencontres biomédicale LIR Michel Haissaguerre

  1. 1.
  2. 2. Targeting the Electrical Heart From identified cells to novel approaches against: Cardiac Arrhythmias Sudden Death Heart Failure Major Impact of Cardiac Electrical disorders on human Health
  3. 3. Human Cardiac Arrhythmias <ul><li>Tachycardias </li></ul><ul><li>=1 focus or circuit </li></ul>Fibrillations = multiple foci/circuits Chaos
  4. 4. The most common : Atrial Fibrillation <ul><li>1-2% of the population: 6 Millions subjects </li></ul><ul><li>Increases with age </li></ul><ul><li>1st US emergency: 6.65 billion $/yr </li></ul><ul><li>Main Cause of Embolic Strokes (20% of all strokes) </li></ul><ul><li>Vascular,senile & Alzheimer’s dementia X 2 </li></ul>In 2050 ( Olmsted County Study) 16 M in USA 25 M in Europe Atria Ventricles
  5. 5. <ul><li>Method: Map of 100 ms preceding spontaneous initiation 1994.1998 </li></ul>Mapping the genesis of chaos NEJM 1998 Results - Episodes of AF originate from Sources outside the heart - in vascular wall (pulmonary veins) Proof of Concept: local energy delivery eliminate recurrences
  6. 6. Curative therapy of Paroxysmal Atrial Fibrillation 10 000 pts treated in 2000 - 200 000 patients in 2010 <ul><li>Therapy for Drug Resistant AF </li></ul><ul><li>acknowledged by AHA/EHA 2007 </li></ul>Birth of a specific biotechnological industry ( X 5 next 10 years) (Sources: Philips-GE-Siemens) Thermo-exclusion of venous foci
  7. 7. Research Perspectives <ul><li>1.<1% of pts are treated by ablation: </li></ul><ul><li>Strong Need of Drugs targeting PV cells </li></ul><ul><li>2.Understand/image atrial structural remodeling- ageing to develop preventive drugs (Leducq-FP7) </li></ul><ul><li>3.Characterise AF individually for specific blockers ; Targeted sites for delivery; Thermally activated drugs; Local gene therapies </li></ul>
  8. 8. INTERNATIONAL AWARDS <ul><li>Mirowski Excellence in Cardiology  Boston Award in Electrophysiology </li></ul><ul><li>Best European Scientist Award  Pioneer North American Award </li></ul><ul><li>Jeantet Prize of Medecine  Grand Prize of Sciences Academy </li></ul><ul><li>Nylin Swedish Royal Society of Medecine </li></ul>INNOVATIONS Platelet GPIIbIIIa and P2Y12 receptors (Antiaggregants) Coinvention of Resynchronisation Propranolol in hemangioma Catheters, devices, softwares
  9. 9. Sudden death is not a ‘cardiac arrest’ but Ventricular Fibrillation in 80% <ul><ul><li>Mean Age 65 years , 80% at home </li></ul></ul><ul><ul><li>In Europe (or USA) : </li></ul></ul><ul><ul><li>(Newborns : 2500/ yr) </li></ul></ul><ul><ul><li>Largely underestimated: </li></ul></ul><ul><ul><li>VF = Breast + Colon </li></ul></ul><ul><ul><li>+ Lung Cancers </li></ul></ul><ul><ul><li>+ AIDS </li></ul></ul>300 000 adults/yr Survival rate 2% Fatal Electrical Tornado during night- M 57
  10. 10. First maps in Humans with multiple VFs: initiation by Purkinje cells (<2 % of cardiac mass) Arborized Network of Purkinje cells Lancet 2003 - Circulation 2004 et 2006 Proof of Responsibility : Focal energy eliminates recurrences F 37 yr- Arrhythmic storm
  11. 11. Research Perspectives <ul><li>Ablation can’t be the solution for everybody: Mechanisms of Purkinje firing to develop specific blockers </li></ul><ul><li>Identify pts at risk is unmet medical need: markers of Vulnerability in the broad population of cardiac pts </li></ul><ul><li>Tailored drugs aiming at preventing and/or reversing vulnerability (Ex: early repolarisation-Ito blockers NEJM ) </li></ul>Unique tools for mapping
  12. 12. Heart Failure <ul><li>EUROPE: 9 MILLIONS INDIVIDUALS </li></ul><ul><li>50%† at 5 yrs= 350 à 400 000 deaths/yr </li></ul>Unknown Role of Abnormal activation via Purkinje disease ? >50% of HF patients have electrical dysfunction Its role is largely unexplored
  13. 13. Original Research Projects <ul><li>Investigate electrical dysfunction </li></ul><ul><li>as a cause of Heart Failure </li></ul><ul><li>Earlier detection & Regenerative therapies </li></ul><ul><li>Optimize Resynchronisation Devices/strategies (signal-modelisation) </li></ul>
  14. 14. Unique Translational Research Center on Cardiac Electrical Disorders- BORDEAUX Top level international expertise : Whole heart ElectroPhysiology Computer Sciences ( Signal-Modelisation ) Cardiac Imaging Public & Private institutions Industrial Partnership *

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