Clinical Academic Training

Therapeutics or Clinical Pharmacology (project 2) – Cardiology/Clinical Pharmacology and Therapeutics/Public Health Medicine

Arrhythmias and Cardiac Electrophysiology (AF therapies)

  • Andre Ng

Atrial fibrillation (AF) is the commonest arrhythmia seen in clinical practice, affecting 1-2% of the general population (>1 million in UK) but 1 in 10 in people aged over 70, thus increasing at epidemic rate due to the ageing population. AF increases stroke risk five-fold, and is associated with increased mortality as well as morbidity with heart failure, posing significant burden in healthcare costs (1% of NHS budget, £1.5 billion/annum).

Medication is often inadequate and catheter ablation has been established as an invasive key-hole procedure where catheters are inserted via venous access to burn (ablate) tissues in the atria to treat the arrhythmia. Early in the disease, triggers can be targeted and the outcome of ablation has improved to an acceptable level (80% success at 1 year). Persistent AF represents an advanced stage where substrate is responsible for the maintenance of AF and ablation success is limited.

The University has a strong track record advancing research in the area of novel therapies in heart rhythm disturbance including AF. Professor Andre Ng has established a strong collaboration with companies in the medical technology industry where there is early access to novel therapeutic platforms in the treatment of arrhythmias. He was first in the world to use a robotic catheter manipulation system in electrophysiology procedures and AF ablation and has used novel 3D mapping systems (Topera, EPD-Kodex) and ablation catheters (Q-mode+) in UK-first experiences aimed at making procedures safer and faster and with better patient outcomes. The department has a strong track record of supervising ACFs and PhDs and have authored high-impact publications ranging from fundamental science on AF to pivotal multicentre trials in its treatment.

The ACF will join an established interdisciplinary group of research including basic scientists, clinicians, engineers and computer scientists. Their project will involve the characterisation of mapping system and ablation catheter data collected during AF ablation to correlate with procedure outcome aimed at demonstration of efficacy and identifying areas of refinement. Electrogram characteristics relevant to success ablation outcomes will be used to inform advanced signal processing analysis of the atrial substrate. These will be correlated with contemporary standard practice as cross-sectional comparison in addition to follow up outcome in longitudinal studies. Research training will include statistics, electrogram analysis, trial design, signal processing, machine learning methods and arrhythmia mechanisms appropriate to the project. The aim of this project is to improve the outcome of AF ablation procedures with advancement of understanding the arrhythmia mechanisms and application novel mapping and ablation tools.

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