Ventricular tachyarrhythmias are an important mode of sudden death in patients with cardiomyopathy. Animal studies suggest that abnormal ventricular repolarization can lead to ventricular arrhythmias. In humans, the relevance of cardiac repolarization as a substrate for arrhythmogenesis is not well understood. Our laboratory is characterizing the spatiotemporal distribution of ventricular repolarization in patients with cardiomyopathy and defining the dynamic range of repolarization in response to physiologic stress that can trigger ventricular arrhythmias. The experiments involve body surface and intracardiac recordings of repolarization under varying physiological conditions. Using linear and nonlinear dynamics, several aspects of cardiac repolarization are quantified including spatiotemporal heterogeneity, restitution, memory and alternans. The knowledge gained from our experiments will provide better understanding of the pathogenesis of lethal ventricular arrhythmias in cardiomyopathic patients which may lead to the development of novel antiarrhythmic therapies.
JACC Clin Electrophysiol. 2019 Apr;5(4):504-512
Body surface distribution of T wave alternans is modulated by heart rate and ventricular activation sequence in patients with cardiomyopathy.
PLoS One. 2019;14(4):e0214729
Health Care Utilization After Ventricular Tachycardia Ablation: A Propensity Score-Matched Cohort Study.
Can J Cardiol. 2019 Feb;35(2):169-177
Pacing Clin Electrophysiol. 2018 Dec 04;:
Early Repolarization Pattern Inheritance in the Cardiac Arrest Survivors With Preserved Ejection Fraction Registry (CASPER).
JACC Clin Electrophysiol. 2018 Nov;4(11):1473-1479
J Interv Card Electrophysiol. 2018 Oct 08;:
J Electrocardiol. 2018 Jul - Aug;51(4):720-722
Reduced T wave alternans in heart failure responders to cardiac resynchronization therapy: Evidence of electrical remodeling.
PLoS One. 2018;13(6):e0199637
Complex interactions in a novel SCN5A compound mutation associated with long QT and Brugada syndrome: Implications for Na+ channel blocking pharmacotherapy for de novo conduction disease.
PLoS One. 2018;13(5):e0197273
Spatial Relationships of Complex Fractionated Atrial Electrograms and Continuous Electrical Activity to Focal Electrical Sources: Implications for Substrate Ablation in Human Atrial Fibrillation.
JACC Clin Electrophysiol. 2017 Nov;3(11):1220-1228
Scientist, Toronto General Hospital Research Institute (TGHRI)
Associate Professor, Department of Physiology, University of Toronto