We request funds to acquire the St Jude/Abbott Ensite Precision Electroanatomical Mapping System to facilitate current and new collaborative translational research at Hunter Holmes McGuire VA Medical Center, and collaborations with investigators at Virginia Commonwealth University. This state-of-the- art system can perform diagnostic cardiac electrophysiologic (EP) and hemodynamic studies, high density arrhythmia mapping and therapeutic ablation. 1 Although designed for cardiac and vascular studies, it can be applied to record and stimulate electrical signals in the central and peripheral nervous systems. 2 Its primary role is to replace and upgrade out-of-date equipment critical to core VA-funded research, while expanding avenues of investigation across different specialties (cardiology, anesthesia, neurology, pharmacy) and collaboration with our university affiliate, Virginia Commonwealth University. The equipment?s specific capabilities include to record electrical signals, measure pressure waveforms, electrically stimulate target tissue, apply radiofrequency ablation, perform automated computerized high density 3-dimentional mapping of complex electrical activations during cardiac arrhythmias. Due to its broad capabilities, it can benefit researchers across different subspecialties. In contrast, the current system (GE Prucka CardioLab) has more limited diagnostic capabilities (recording and stimulation but no ablation), and has an out of date manual, sequential mapping system (vs automated) which makes it inadequate for current and future research proposals funded by VA, and extramural agencies such as NIH and AHA. Core VA research projects will investigate novel therapies for postoperative atrial fibrillation (POAF), 3 premature ventricular contraction-induced cardiomyopathy (PVC-CM), 4 5 demyelinating and neurodegenerative conditions 6 and cardioprotective and antiarrhythmic therapies targeted at improving function of mitochrondria, i.e. the cell?s energy sources, in ageing and ischemia related heart disease. 7 Other studies with direct translational applications include the testing of different ablation energies and techniques to optimize safe and effective ablation in human arrhythmia, 8 and testing different anesthesia types in diseased heart models in order to optimize their application in patients. VCU collaborations will utilize the equipment to determine the anti-arrhythmic and cardioprotective mechanisms of novel or ?repurposed? drugs that target inflammatory cytokines and their receptors to protect against ischemia-related injury and heart failure. 9,10
The primary objective of the proposal is to support translational research to improve understanding and/or testing of novel therapies for conditions of high prevalence and major consequence in the veteran population. These include atrial fibrillation, 3,11 heart failure, 12 4 myocardial infarction, 9,10,13,14 ageing related heart7 and neurodegenerative disease and multiple sclerosis. 15 16This research could ultimately reduce veteran morbidity, mortality and improve overall veterans? health. Recognizing that medicine is becoming more complex and future research endeavors need to be collaborative, the secondary objective is to foster research collaborations across multi-disciplines and institutions to improve their translational potential for veteran health benefit.