Dissertations / Theses on the topic 'Arythmie ventriculaire'
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FERMOND, BRUNO. "Arythmie ventriculaire et hypertrophie ventriculaire gauche chez l'hypertendu essentiel : etude sur 90 patients." Toulouse 3, 1990. http://www.theses.fr/1990TOU31180.
Full textRAYBAUD, FLORENCE. "Troubles du rythme du sujet age : etude d'une population hospitalisee." Nice, 1991. http://www.theses.fr/1991NICE6839.
Full textDuchateau, Josselin. "Traitement et analyse du signal pour les arythmies ventriculaires." Thesis, Bordeaux, 2018. http://www.theses.fr/2018BORD0465/document.
Full textSignal processing tools are increasingly present in the electrophysiologist' s daily practice. These tools have the potential to enhance the detection of small electrical anomalies, and to enable the analysis of complex arrhythmia. Our work focuses on ventricular arrhythmia, and more specifically on how signal processing tech niques can help usbetter understand these diseases. lt is made up of three parts,focusing on different topics: uni-dimensional signal analysis (ECG and endocardial electrograms), non-invasive mapping, and invasive contact mapping. Concerning uni-dimensional signal analysis, we first propose a method to enhance the signal to noise ratio of ECG recordings. We use a combination of signal averaging and respiration gating to achieve this goal, and offer interesting perspectives for the detection of abnormal low amplitude potentials and non-invasive measurement of the HV interval. We then analyze the relationship between endocardial and ECG signais during ventricular fibrilla tion (VF) episodes. We demonstrate that endocardial and ECG dominant frequencies are similar,and that higher endocardial fragmentation results in a drop of the waveform amplitude on the surface ECG. Finally, we demonstrate through frequency domain analysis of 63 VF episodes a clear correlation between VF characteristics and clinical factors. Dominant frequency is particularly useful to dis criminate between different underlying causal substrates. We also demonstrate that VF characteris tics depend on the induction mode and induction site, in terms of dominant frequency, amount of fragmentation and ECG phase. Concerning non-invasive mapping, we compare different potential-based inverse problem resolution techniques. ECGi appears as one of the most reliable techniques. A clinical validation study of non-invasive ventricular activation mapping using ECGi isthen carried out. Fifty-five patients were included for whom non-invasive maps are compared to contact maps. We show a very poor overall correlation between non-invasive and invasive maps. Results are het erogeneous, with good correlation in patients with wide QRS activation patterns. Wethen propose different techniques to improve non-invasive activation mapping. A first study uses the surface laplacian and the gradient of the inverse-computed potential as inputs to activation map ping. A second study combines estimated delays between neighboring points and local activation time estimates to create a more globally coherent solution. Both studies demonstrate a significant improvement of activation maps. Concerning contact mapping, we first give an overview of interpolation domains and techniques that can be used to provide dense activation maps from sparse measures. We illustrate the influence of these techniques on the clinician's ability to make a correct diagnosis. We then use one of these interpolation techniques to create epicardial activation maps in Brugada patients. We show that these patients harbor epicardial electrical activity compatible with partial endo-epicardial conduction block. This phenomenon predominates in the right ventricular lateral wall and outflow tract. Finally,using an in silico model, we demonstrate the arrhythmogenic potential of such a dissociation. lnducibility peaks as the number of residual functional connections between endo and epicardium falls. ÜVERALL, our work uses signal processing techniques for different applications conceming ven tricular arrhythmia. We propose different methodological innovations that allow us to record and process cardiac electrical activity with increasing precision. Further progress is still required before non-invasive mapping can live up to its promises. The proposed methodological innovations can extend the use of electrocardiography and invasive mapping
BATTISTON, THIERRY. "Principaux facteurs generateurs de dysrythmies cardiaques chez l'hypertendu essentiel : etude sur 60 patients." Toulouse 3, 1991. http://www.theses.fr/1991TOU31039.
Full textLEVASSEUR, PIERRE. "Les arythmies ventriculaires chez le patient hemodialyse chronique : etude de la prevalence et des facteurs de risque a partir d'une population hemodialysee." Lille 2, 1990. http://www.theses.fr/1990LIL2M047.
Full textCaillard, Jean-Baptiste. "Place de la transplantation cardiaque dans le traitement des tachyarythmies ventriculaires malignes : a propos de trois observations." Université Louis Pasteur (Strasbourg) (1971-2008), 1991. http://www.theses.fr/1991STR1M191.
Full textNguyen, Sy Hung Stéphane. "La dispersion de la repolarisation ventriculaire : étude critique, à partir de la catégorie de surface." Montpellier 1, 1995. http://www.theses.fr/1995MON11154.
Full textAISENFARB, JEAN-CHARLES. "Traitement des troubles du rythme ventriculaire d'origine ischemique par laser." Lille 2, 1989. http://www.theses.fr/1989LIL2M249.
Full textJOUBAUD, JACQUES. "Troubles du rythme ventriculaire dans le cadre de l'hyperparathyroidie primitive : observation personnelle, revue de la litterature." Angers, 1989. http://www.theses.fr/1989ANGE1018.
Full textFLEURANT, ERIC. "Arythmies ventriculaires malignes et mort subite : a propos de 160 observations." Lille 2, 1994. http://www.theses.fr/1994LIL2M137.
Full textRICARD, PHILIPPE. "Defibrillateur implantable : resultats de la voie transveineuse." Aix-Marseille 2, 1993. http://www.theses.fr/1993AIX20836.
Full textRobert, Frédéric. "Ablation de la conduction auriculo-ventriculaire par radiofréquence pour le traitement de l'arythmie supra-ventriculaire : résultats et devenir." Bordeaux 2, 1995. http://www.theses.fr/1995BOR23097.
Full textPerruc, François. "Analyse comparée des extra systoles ventriculaires sur cœur sain et sur dysplasie ventriculaire droite arythmogène." Bordeaux 2, 1989. http://www.theses.fr/1989BOR25020.
Full textChevalier, Philippe. "Le defibrillateur automatique implantable : resultats preliminaires d'une serie de 33 patients." Lyon 1, 1990. http://www.theses.fr/1990LYO1M361.
Full textLe, Franc Pierre. "Le defibrillateur automatique implantable : cinq ans d'experience ; 1988-1993." Lille 2, 1993. http://www.theses.fr/1993LIL2M360.
Full textBERTHAUX, XAVIER. "Les rythmes idioventriculaires acceleres idiopathiques : a propos de trois observations." Lille 2, 1989. http://www.theses.fr/1989LIL2M397.
Full textTesse, Benoît. "Signification de l'extrasystolie ventriculaire en médecine du sport." Caen, 1990. http://www.theses.fr/1990CAEN3044.
Full textRoussel, Julien. "Effets d’une variation de la concentration en acyl-carnitine sur le remodelage ventriculaire et les troubles du rythme." Thesis, Montpellier 2, 2014. http://www.theses.fr/2014MON20034.
Full textHeart contraction requires a considerable amount of energy. Mitochondrial fatty acid oxidation is the major source of energy production in the heart. Fatty acids diffuse through the mitochondrial membrane in the acyl-carnitine form. During excitation-contraction coupling, variations of membrane potential and calcium concentration allow the communication between contraction and metabolism. This communication allows the adaption of energy production into contractile function. Clinical and experimental observations indicate that metabolism modulates contraction mechanisms. In particular, the energetic imbalance observed in metabolic syndrome or primary carnitine deficiency induces a contractile disturbance and arrhythmias. Mitochondrial homeostasis seems to be an important participant though the mechanisms involved in this phenomenon remain to be completely elucidated. In this study, we examined the influence of acylcarnitine concentration variations on cardiac rhythm and ventricular remodeling. Through an integrative approach, we have demonstrated the pivotal role of the adenine nucleotide transporter (ANT) in the apparition of high acylcarnitine concentration associated arrhythmia. Furthermore, in vivo studies with carnitine deficient mice reveal, for the first time, a relationship between the QT interval duration (short QT) and metabolic disturbance
VIGNANCOUR, YVES. "La morte subite et sa prevention par la defibrillateur implantable : a propos de 7 observations personnelles." Clermont-Ferrand 1, 1991. http://www.theses.fr/1991CLF13042.
Full textRobert, Emmanuelle. "Etude des mécanismes d'initiation des tachycardies ventriculaires de type réentrée." Montpellier 1, 1998. http://www.theses.fr/1998MON1T035.
Full textEL, KOHEN BEN MESSAOUD MARIAM. "L'electrocardiographie en moyennage et haute amplification apres reparation de la tetralogie de fallot : relation avec les arythmies ventriculaires." Lille 2, 1991. http://www.theses.fr/1991LIL2M110.
Full textJoulin, Corinne. "Arythmies ventriculaires sévères aprés correction complète de tétralogie de Fallot : à propos d'une observation." Bordeaux 2, 1992. http://www.theses.fr/1992BOR2M180.
Full textCRAMBES, ANNE. "Approche pharmacologique des arythmies cardiaques ventriculaires d'origine centrale : un modele experimental chez le rat." Université Louis Pasteur (Strasbourg) (1971-2008), 1993. http://www.theses.fr/1993STR1M187.
Full textParisot, Marc. "Le choix d'un paramétre d'asservissement pour la stimulation ventriculaire, l'espace QT : apports des fonctions automatiques dont le holter incorporé, étude prospective chez quinze patients." Caen, 1990. http://www.theses.fr/1990CAEN3094.
Full textGRASSER, BENOIT. "La chirurgie guidee par cartographie des troubles du rythme ventriculaire sur cardiopathie ischemique : l'experience nanceienne a propos de 10 cas." Nancy 1, 1991. http://www.theses.fr/1991NAN11212.
Full textYin, Liheng. "Impact of the catecholaminergic polymorphic ventricular tachycardia (CPVT) mutation RyR2R420Q in cell function." Thesis, université Paris-Saclay, 2020. http://www.theses.fr/2020UPASS068.
Full textCatecholaminergic polymorphic ventricular tachycardia (CPVT) is a lethal genetic arrhythmia that manifests by syncope or sudden death in children and young adults under stress conditions without obvious cardiac structural abnormality. Several mechanisms have been proposed to explain the underlying Ca2+ release functional alterations due to mutations of RyR2 or of its accessory proteins. A novel CPVT mutation located on RyR2 N terminal portion has been identified in a Spanish family (RyR2R420Q). Here we used a KI mice model expressing the RyR2R420Q channel, and differentiated cardiomyocytes from induced pluripotent stem cells (hiPS-CM) generated from two brother patients (one with mutation, the other without mutation used as control). Confocal Ca2+ imaging analysis showed that human and mouse RyR2R420Q expressing ventricular cardiomyocytes have higher occurrence of Ca2+ sparks, enhanced fractional release, and significantly more proarrhythmogenic Ca2+ waves after isoproterenol stimulation. The action potential (AP) analysis, recorded using the micro-electrode technique in hiPSC-CMs and patch-clamp in KI mouse ventricular cells, showed Ca2+ -dependent delayed after depolarizations (DADs). The [Ca2+]i transient amplitudes of 1-Hz paced CPVT hiPSC-CMs was similar to control hiPSC-CMs. Whereas sarcoplasmic reticulum (SR) Ca2+ load, estimated by rapid caffeine (10 mM) application, was smaller in hiPS-CM from the RyR2R420Q carrier, both before and after 1 microM ISO application. However, the RyR2R420Q seems more prone to release Ca2+, as the [Ca2+]i transient normalized by the amount of Ca2+ stored in the SR, the fractional release, was higher in CPVT hiPSC-CMs. Even if SR Ca2+ load was smaller in CPVT hiPSC-CMs, they often presented proarrythmogenic behavior such as Ca2+ waves during diastolic periods. This behavior was further enhanced during β-adrenergic stimulation. Similar results were observed in KI mice, pointing to this model as a valuable tool to study the CPVT disease. We then studied the potential antiarrhythmic effect of venlafaxine and pregabalin in KI mouse cardiomyocytes and hiPS-CMs, two drugs among other medications that have been prescribed to one family carrier member and devoted of CPVT symptoms. We found that both of those drugs blunted ISO induced arrhythmogenic events in KI mouse cardiomyocytes. Venlafaxine showed antiarrhythmic effect in hiPS-CMs both by acute and chronic treatments.On overall, 1) the RyR2R420Q mutation shows enhanced diastolic Ca2+ release, which is further enhanced by isoproterenol inducing proarrhythmogenic events. 2) The effects were similar in hiPSC-CM and RyR2R420Q KI mice cardiomyocytes, pointing to hiPSC-CM as a valuable model to analyze pathological mechanisms; and 3) Venlafaxine may protect from arrhythmic CPVT patients, although more experiments are needed for in vivo test and to determine the mechanism of this antiarrhythmic effect
Baladon, Sylvie. "Arrêt circulatoire par tachycardie ventriculaire ou fibrillation ventriculaire au stade aigu de l'infarctus du myocarde : évolution à court, moyen et long terme." Bordeaux 2, 1989. http://www.theses.fr/1989BOR25252.
Full textDUC, PHILIPPE. "Myocardiopathies hypertrophiques : arythmies ventriculaires et troubles perfusionnels, leur evolution sous amiodarone : resultats preliminaires." Nantes, 1991. http://www.theses.fr/1991NANT042M.
Full textPanagides, Demetrakis. "Potentiels tardifs et arythmies ventriculaires dans la maladie hypertensive et les myocardiopathies hypertrophiques." Aix-Marseille 2, 1989. http://www.theses.fr/1989AIX20830.
Full textCathelineau, Xavier. "Fulguration du faisceau de HIS dans les troubles du rythme supra ventriculaire chez les personnes agées : étude de 62 cas." Bordeaux 2, 1991. http://www.theses.fr/1991BOR2M087.
Full textRioufol, Gilles. "Effets du préconditionnement sur les arythmies ventriculaires au cours de l'ischémie chez le porc." Lyon 1, 2000. http://www.theses.fr/2000LYO1T148.
Full textBarc, Julien. "Génétique des troubles de la repolarisation ventriculaire : nouveaux concepts." Nantes, 2009. https://archive.bu.univ-nantes.fr/pollux/show/show?id=f1bba90a-8592-47d3-8bee-6af0f6c6d4e6.
Full textSudden cardiac death (SD) without structural heart disease affects about 12 to 20000 individuals each year in Europe. These sudden deaths concern mostly young population who died of a primary cardiac arrhythmia. Several studies have been lead on mendelian forms at high risk of SD such as long QT syndrome (LQTS), short QT syndrome (SQTS) and Brugada syndrome (BrS). The identification of genes in LQTS allowed us to explain arrhythmia pathophysiology and a better management for patients. However molecular diagnosis stay lacking within 25% of LQTS patients. A pangenomic approach by CGH array shows 3 deletions in KCNQ1 and KCNH2 genes, two of them concern KCNH2 gene, one take all of gene, the second is partial and was inherited in 6 patients on 3 generations. The SQTS is a rare and heterogeneous cardiopathy, 5 genes explain all of 8 cases reported today. A clinic and molecular study of new families affected by SQTS lead to identification of mutation in CACNA1C and SLC22A5 genes, suggesting a new molecular mechanism. Conversely of LQTS, a main gene (SCN5A) is associated with BrS. However SCN5A dot not constitute discerning marker for risk-stratification of SD. We evaluate the real implication of SCN5A gene in Brugada syndrome by 5 large families study in which the phenotype do not correlate with genotype. Our new molecular results suggest rather oligogenic model
Fenot, Remi Aliot Etienne. "Ablation de la jonction auriculo-ventriculaire par courant de radiofréquence résultats à long terme à propos de 247 cas /." [S.l.] : [s.n.], 2001. http://www.scd.uhp-nancy.fr/docnum/SCDMED_T_2001_FENOT_REMI.pdf.
Full textMestdagh, Fabrice. "Le défibrillateur automatique implantable : à propos de 21 cas." Lille 2, 1992. http://www.theses.fr/1992LIL2M003.
Full textFrontera, Antonio. "ICD Algorithms in the management of arrhythmias : Pitfalls and advancements." Thesis, Bordeaux, 2019. http://www.theses.fr/2019BORD0324.
Full textThe objective of my research was to investigate the manner in which clinical devices, such as ICDs and PMs, detect the most common arrhythmias encountered in clinical practice. Nowadays, specific algorithms of discrimination are implemented in current devices. The pitfalls in the management of patients with arrhythmias are not uncommon; most often these include errors in detection and discrimination which may promote and/or perpetuate the arrhythmia or determine inappropriate therapies such as shocks. In fact, the incorrect discrimination of malignant arrhythmias could have a significant impact on morbidity and mortality. The best management of arrhythmias should consider improvements of current algorithms of proprietary based ICDs implanted in the clinical practice
COUPPIE, PHILIPPE. "Etude des troubles du rythme supra-ventriculaire chez l'insuffisant renal en hemodialyse : apport du moyennage de l'onde p et de l'etude de la variabilite sinusale." Université Louis Pasteur (Strasbourg) (1971-2008), 1994. http://www.theses.fr/1994STR1M173.
Full textAstanière, Françoise. "Évolution hémodynamique sévère d'un cas de dysplasie ventriculaire droite arythmogène avec hypoxie réfractaire : à propos d'une observation." Bordeaux 2, 1997. http://www.theses.fr/1997BOR2M098.
Full textSuaud, Sylvie. "Les tachycardies ventriculaires catécholergiques de l'enfant : à propos d'un cas." Bordeaux 2, 1997. http://www.theses.fr/1997BOR2M138.
Full textBeck, Lionel. "Arythmies ventriculaires spontanées et chroniques au cours de l'insuffisance cardiaque chez le rat post-infarctus." Montpellier 1, 2000. http://www.theses.fr/2000MON1T027.
Full textBessière, Francis. "Amélioration des techniques d’ablation pour le traitement des arythmies cardiaques : nouvelles modalités diagnostiques et thérapeutiques par ultrasons." Thesis, Lyon, 2019. http://www.theses.fr/2019LYSE1225/document.
Full textAt the crossroads of medicine and physics, this work aimed to provide innovative diagnostic and therapeutic tools based on ultrasound, in the field of cardiac electrophysiology. A system capable of delivering HIFU into the heart by a transesophageal route using ultrasound (US) imaging guidance was developed and tested in vivo in six male pigs. HIFU exposures were performed on atria and ventricles. At the time of autopsy, visual inspection identified thermal lesions in the targeted areas in three of the animals. These lesions were confirmed by histologic analysis (mean size: 5.5 mm2 x 11mm2). No esophageal thermal injury was observed. One animal presented with bradycardia due to an atrio-ventricular block, which provides real-time confirmation of an interaction between HIFU and the electrical circuits of the heart. There was still a lack of accuracy, mainly related to cardiac motion, and to anatomical structures in between the targets and the transducer. It was mainly related to the in vivo model and its anatomy, far from the human’s. The search for a better model led to conclusive imaging tests on baboons. Additional experiments were conduced in order to improve the mapping of ventricular arrhythmias and the monitoring of lesion formation during ablation. First, experiments were conducted on left ventricles of four isolated working mode swine hearts. The protocol aimed at demonstrating that different patterns of mechanical activation could be observed whether the ventricle was in sinus rhythm, paced from the epicardium, or from the endocardium. Electromechanical wave imaging (EWI) acquisitions were recorded on the anterior, lateral, and posterior segments of the left ventricle. Loop records were blindly assigned to two readers. EWI sequences interpretations were correct in 89% of cases. The overall agreement rate between the two readers was 83%. When in a paced ventricle, the origin of the wave front was focal and originating from the endocardium or the epicardium. In sinus rhythm, wave front was global and activated within the entire endocardium towards the epicardium at a speed of 1.7±0.28 m.s-1. Wave front speeds were respectively measured when the endocardium or the epicardium were paced at a speed of 1.1 ± 0.35 m.s-1 vs 1.3±0.34 m.s-1 (p=NS). Lastly, we investigated the feasibility of a dual therapy and imaging approach with the same transoesophageal device. We demonstrated on ex-vivo samples that transoesophageal shear wave imaging (SWE) can map the extent of the HIFU lesions. HIFU ablation was performed with the transoesophageal probe on ex-vivo chicken breast samples (n=3), then atrium (left, n=2) and ventricle (left n=1, right n=1) of swine heart tissues. SWE provided stiffness maps of the tissues before and after ablation. Areas of the lesions were obtained by tissue color change with gross pathology and compared to SWE. Shear modulus of the ablated zones increased from 4.8±1.1 kPa to 20.5+/-10.0 kPa (ratio 5.0±3.2) in the chicken breast, from 12.2±4.3 kPa to 30.3±10.3 (ratio 3.2±2.0) in the atria and from 21.2±3.3kPa to 73.8±13.9kPa (ratio 3.7±1.2) in the ventricles. On gross pathology, the size of the lesions ranged from 0.1 to 1.5cm2 in the imaging plane area and morphometric characteristics were fitting with elasticity-estimated depths and widths of the lesions
Valette, Benoît. "Corrélation entre les différents critéres de potentiels tardifs et la stimulation ventriculaire programmée au décours de l'infarctus myocardique aigu : étude prospective à propos de 79 observations consécutives." Caen, 1991. http://www.theses.fr/1991CAEN3090.
Full textPerdu-Kaaki, Agnès. "Arythmie ventriculaire grave révélatrice d'une naissance anormale de la coronaire gauche à partir de l'artère pulmonaire chez l'adulte : à propos de deux cas." Montpellier 1, 1998. http://www.theses.fr/1998MON11063.
Full textAllouis, Marie. "Approches génétiques et moléculaires des pathologies du rythme cardiaque." Nantes, 2005. https://archive.bu.univ-nantes.fr/pollux/show/show?id=67b41238-695a-4d34-bd42-0f94229e00b2.
Full textLife-threatening cardiac arrhythmias represent a clinically and genetically heterogenous group of disorders. Since 1995, several genes encoding mostly ionic channels have been identified but their pathophysiology remains poorly understood. Starting from several families affected by either Brugada syndrome or atrial fibrillation, I have identified, using a linkage analysis approach, two new loci for these diseases. A similar approach performed on 2 families diagnosed with long QT syndrome associated with Marfan syndrome or atypical ventricular catecholaminergic tachycardia, allowed the identification of the disease mutation respectively in KCNH2 and RyR2 genes. Phenotypical heterogeneity combined with low penetrance in Brugada syndrome or with late onset of the disease in progressive cardiac conduction defect challenges classical familial-based linkage analysis. Since these two pathologies have been associated with mutations in SCN5A gene, we speculate that proteins associated with cardiac sodium channel are good candidates for these conditions. Using a two hybrid screening approach, I identified the 14-3-3 protein as a new SCN5A cytosolic partner. 14-3-3 is known to act as a chaperon and preliminary results indicate that its interaction with SCN5A alters the voltage-sensitivity of the Na+ channel. Molecular screening of this new partner but also the still non-identified proteins should allow a better understanding and handling of cardiac arrhythmias
Takigawa, Masateru. "The impact of novel technologies on ablation therapy in scar-related tachycardia." Thesis, Bordeaux, 2019. http://www.theses.fr/2019BORD0180.
Full textRecent improvement in ablation such as irrigation catheter and contact force has been dramatically raised a safety and efficacy, and several balloon technologies such as cryoballoon has significantly shorten the procedure time. Electroporation may remarkably decrease complications with maintaining a lesion durability and transmurality. However, not only such developments in ablation technologies but also those in mapping technologies are mandatory for the best outcome of an arrhythmia treatment. A circuit of atrial tachycardia (AT) and ventricular tachycardia (VT) normally has a critical isthmus to maintain the tachycardia. Successful detection of this isthmus as well as a durable lesion formation can be a limiting factor in the efficacy of ablation therapy for these tachyarrhythmias. In addition to some ablation technologies, several mapping technologies for guiding ablation therapy have recently emerged. In particular, the remarkable improvement of mapping catheters and imaging technologies may have an impact on diagnosing a tachycardia mechanism and identifying substrates and circuits of tachycardias, leading to a procedural efficacy. Multipolar mapping catheters are increasingly utilized for substrate delineation. However, the clinical impact of inter-electrode spacing and size of the electrode on the local electrograms has not been systematically examined. Additionally, the clinical efficacy of using an ultra high resolution/high-density mapping system and multipolar catheters with small electrodes and spacing has not been fully examined. Imaging information from Cardia Magnetic Resonance (CMR) and computerized tomography (CT) scan (e.g. scar area, wall thickness) can be combined with the elecroanatomical information from the 3 dimensional mapping system by a novel computational tool ‘MUSIC’ system. However, the true clinical impact of this technology has not been reported. Therefore, the aims of this research project are to (1) clarify how the signals are affected by the difference of electrode length and interelectrode spacing, and demonstrate the characteristics of each multipolar catheter in an animal model (2) to observe a clinical advantage of using an ultra high resolution/high-density mapping system and multipolar catheters with small electrodes and spacing in identifying a practical strategy to detect the isthmus of the tachycardia circuit and treat it based on these technologies, (3) to evaluate the relation between the information from imaging and voltages in each multipolar catheter, and (4) to elucidate the clinical impact of an imaging guided-VT ablation therapy with the MUSIC system. To elucidate these points, we conducted three main studies including one series of animal experiments and two series of clinical studies. The first series of 4 animal experiments demonstrated the effect of electrode size, inter-electrode spacing, and activation orientation on the local electrograms and voltage threshold determining scars. The clinical parts composed of two main studies. First, we elucidated the efficacy of using the novel ultra highresolution/high-density mapping system, 'RhtymiaTM', with the Orion TM multipolar catheter with small electrodes and inter-elecotrode spacing catheter, in diagnosing several forms of complex post-AF ATs. The second part of the clinical study describes the relationship between wall thickness distribution on CT imaging and substrate mapping on the electroanatomical mapping system in patients with ventricular tachycardias based on ischemic cardiomyopathy. [...]
Gauffre, Olivier. "Ablation par cathéter endocavitaire des fibres de mahain : à propos de 6 cas." Bordeaux 2, 1992. http://www.theses.fr/1992BOR23073.
Full textJagu, Benoît. "Étude des implications du gène SCN5A dans les arythmies et les remodelages ventriculaires post ischémiques observés suite à un infarctus du myocarde chez un modèle murin de ligature coronaire." Nantes, 2015. http://archive.bu.univ-nantes.fr/pollux/show.action?id=4686ac9f-eb82-49b1-80e3-1306807ba11b.
Full textThe voltage dependant sodium channel Nav1. 5, encoded by the gene SCN5A, plays an essential role for the electrical activity of the heart. Cardiac congenital disorders are associated with mutations for this gene. Moreover, several modifications of the expression and the activity of Nav1. 5 have been reported during heart failure. Several clinical cases suggest a link between mutations of SCN5A, coronary heart disease, and an increase of the occurrence of ventricular arrhythmic storms associated with sudden cardiac death. The aim of this study was to validate this link for the identification of a new population at risk. By a preclinical study, we have observed an elevation of ventricular arrhythmias during the first 24 hours after a myocardial infarction on mouse model invalidated at the heterozygous state for the gene SCN5A. In the same time, we are characterized a pro inflammatory pattern and a more reduced reserve of conduction in these KO mice. The observations suggest a more severe ischemic cardiac remodelling, which seem to be confirmed by preliminary data. In this framework, we have also identified an expression and functionality for Nav1. 5 in lungs. This new seat of expression for Nav1. 5 could have some repercussions in the setting of post ischemic remodelling. In the same time, I contribute to characterize a new knock-in mouse model for the human T220I mutation for Nav1. 5. Key-words: SCN5A, Nav1. 5, myocardial infarction, ventricular arrhythmias, cardiac remodelling, heart failure, sudden cardiac death and risk stratification
Guérard, Nicolas. "Mesure de la dispersion de la repolarisation ventriculaire et évaluation de la proparythmogénicité des médicaments : developpement d'un modéle de coeur isolé de lapin." Caen, 2008. http://www.theses.fr/2008CAEN3106.
Full textTorsade de Pointes (TdP), potentially lethal ventricular tachycardia, are associated with a prolongation of ventricular repolarization and an inhibition of IKr. Transmural dispersion (TDR) and velocity of repolarization are also predictive indices for TdP. These parameters can be modulated by IKs, involved in the repolarization reserve concept. Apico-basal (AB) dispersion of repolarization is less referenced. The effects of a reduced repolarization reserve and AB dispersion on TDR have been assessed in a Langendorff model of isolated rabbit heart 1) recording monophasic action potential with d,l-sotalol and quinidine (± 20 µM chromanol 293B; CHRO; IKs inhibitor), haloperidol and E4031; 2) we developed a module analyzing unipolar electrograms (TRI) from base to apex and from endocardium (endo) to epicardium (epi) with E4031 and d,l-sotalol or quinidine (± CHRO). Our results show that IKr block (i) increase MAP triangulation, (ii) induce TdP at maximum MAP triangulation, (iii) prolong homogeneously TRI and Tp from endo to epi and from base to apex. Inhibition of IKr and IKs (i) reinforce MAP triangulation, (ii) increase TdP incidence, (iii) increase the prolongation effects on TRI at base and epi. IKr inhibition induces (i) a slowing of final repolarization, (ii) a homogeneous prolongation of repolarization. Concomitant IKs block increase TdP incidence by slowing final repolarization and reveals the AB component of dispersion of repolarization. Prolongation of repolarization and triangulation are observed at concentrations corresponding to plamatic levels inducing TdP in clinic. The AB dispersion of repolarization should be considered in the evaluation of drug torsadogenicity
Dubes, Virginie. "Mécanismes arythmogènes dans le ventricule droit sain et dans la dysfonction ventriculaire droite." Thesis, Bordeaux, 2016. http://www.theses.fr/2016BORD0050/document.
Full textThe right ventricle (RV) has different embryologic history, geometry andbiomechanics properties compared to the left ventricle (LV). The right ventricular outflow tract(RVOT) is a common arrhythmia origin in the healthy or pathological RV. Tetralogy of Fallot(TOF) is the most frequent cyanotic congenital heart disease and is associated with RVdysfunction. Surgical correction has significantly increased patient’s life expectancy butsurgical lesions often lead to heart failure, arrhythmias even sudden cardiac death inadulthood. The aims of this work are to: (i) define RVOT electrophysiological and structuralproperties in the healthy pig and (ii) characterize a potential arrhythmogenic remodeling inboth ventricles in a porcine model mimicking repaired TOF (rTOF). We showed the presenceof repolarization and conduction heterogeneities in the healthy RV in relation to a specific ionchannel expression profile in the RVOT epicardium. Moreover, an histological approachhighlighted the presence of a specific tissue structure likely to contribute to the slowconduction observed in this region. A pro-arrhythmic electrophysiological and structuralremodeling was found in the RV of rTOF pigs. This remodeling was characterized by anincreased dispersion of repolarization and slower conduction properties which were linked toa molecular and structural remodeling. Interestingly, we also described a distinct electricaland structural arrhythmogenic remodeling in the rTOF LV in the absence of hemodynamicalteration. To conclude, this work revealed the presence of an arrhythmogenic substratewithin the healthy RV and a profound arrhythmogenic remodeling of both ventricles in rTOF
Lataste, Dominique. "Qualité de vie avant et aprés fulguration du faisceau de His." Bordeaux 2, 1992. http://www.theses.fr/1992BOR2M051.
Full textRestier, Lioara. "Caractérisation des troubles du rythme cardiaque héréditaires par analyse spatiotemporelle de l'ECG." Lyon 1, 2007. http://www.theses.fr/2007LYO10262.
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