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A study of novel electrographic body surface mapping for detection of transient regional myocardial ischaemia and development of sensing configuration of subcutaneous implantable cardioverter defibrillator

A study of novel electrographic body surface mapping for detection of transient regional myocardial ischaemia and development of sensing configuration of subcutaneous implantable cardioverter defibrillator
A study of novel electrographic body surface mapping for detection of transient regional myocardial ischaemia and development of sensing configuration of subcutaneous implantable cardioverter defibrillator
The diagnosis of ischemic heart disease (IHD) and the prevention of sudden cardiac death (SCD) remains a global challenge.

The diagnostic pathways for IHD are significantly dependant on the standard 12-lead electrocardiography (ECG), which itself has flaws due to a limited number of electrodes. The 80-electrode body surface mapping (BSM) allows more comprehensive assessment of electrocardiac activity. However, the interpretation of the BSM data is laborious and complex. Therefore, in order to simplify the analysis, we have introduced the concept of BSM Delta map, which is based on 80-electrode ECG. However, BSM Delta map needs to be evaluated in the clinical settings.

The role of the implantable cardioverter defibrillator (ICD) in the primary and secondary prevention of SCD is well established, however, due to the associated complications and its invasive nature, it is under utilised. The novel subcutaneous ICD (S-ICD) is considered minimally invasive and a suitable alternative, however, S-ICD is associated with high incidence of inappropriate shocks and sensing algorithm failures. The BSM has a potential to allow further exploration and improvement of S-ICD sensing algorithm.

The objectives of the studies in this thesis are: Firstly, to investigate the novel BSM Delta map, which is derived from 80-electrode body surface map (BSM) for the detection of reversible myocardial ischaemia and to assess its clinical efficacy in patients with stable and unstable IHD. Secondly, to use BSM as a tool with which to study and develop the sensing algorithm of S-ICD in patients with and without complex congenital heart diseases (C-CHD).

These studies are published and have led to significant changes in the current clinical practice and have provided a foundation for further improvement in the diagnostic algorithm of IHD and sensing algorithm of S-ICD. These studies have led to the development of a new automated device for the screening of patients for S-ICD.
University of Southampton
Zeb, Mehmood
469fda8e-8318-4fe5-97f3-a46eec60f333
Zeb, Mehmood
469fda8e-8318-4fe5-97f3-a46eec60f333
Morgan, John
7bd04ada-ca61-4a2c-b1cf-1750ffa9d89c
Hanson, Mark
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Curzen, Nicholas
70f3ea49-51b1-418f-8e56-8210aef1abf4

Zeb, Mehmood (2016) A study of novel electrographic body surface mapping for detection of transient regional myocardial ischaemia and development of sensing configuration of subcutaneous implantable cardioverter defibrillator. University of Southampton, Doctoral Thesis, 366pp.

Record type: Thesis (Doctoral)

Abstract

The diagnosis of ischemic heart disease (IHD) and the prevention of sudden cardiac death (SCD) remains a global challenge.

The diagnostic pathways for IHD are significantly dependant on the standard 12-lead electrocardiography (ECG), which itself has flaws due to a limited number of electrodes. The 80-electrode body surface mapping (BSM) allows more comprehensive assessment of electrocardiac activity. However, the interpretation of the BSM data is laborious and complex. Therefore, in order to simplify the analysis, we have introduced the concept of BSM Delta map, which is based on 80-electrode ECG. However, BSM Delta map needs to be evaluated in the clinical settings.

The role of the implantable cardioverter defibrillator (ICD) in the primary and secondary prevention of SCD is well established, however, due to the associated complications and its invasive nature, it is under utilised. The novel subcutaneous ICD (S-ICD) is considered minimally invasive and a suitable alternative, however, S-ICD is associated with high incidence of inappropriate shocks and sensing algorithm failures. The BSM has a potential to allow further exploration and improvement of S-ICD sensing algorithm.

The objectives of the studies in this thesis are: Firstly, to investigate the novel BSM Delta map, which is derived from 80-electrode body surface map (BSM) for the detection of reversible myocardial ischaemia and to assess its clinical efficacy in patients with stable and unstable IHD. Secondly, to use BSM as a tool with which to study and develop the sensing algorithm of S-ICD in patients with and without complex congenital heart diseases (C-CHD).

These studies are published and have led to significant changes in the current clinical practice and have provided a foundation for further improvement in the diagnostic algorithm of IHD and sensing algorithm of S-ICD. These studies have led to the development of a new automated device for the screening of patients for S-ICD.

Text
Dr Mehmood Zeb Thesis 2016 e-print - Version of Record
Available under License University of Southampton Thesis Licence.
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Published date: September 2016

Identifiers

Local EPrints ID: 434126
URI: http://eprints.soton.ac.uk/id/eprint/434126
PURE UUID: 7f336568-39e9-4a3f-83ab-19ba6500b9c0
ORCID for Mark Hanson: ORCID iD orcid.org/0000-0002-6907-613X
ORCID for Nicholas Curzen: ORCID iD orcid.org/0000-0001-9651-7829

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Date deposited: 13 Sep 2019 16:30
Last modified: 18 Feb 2021 17:04

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