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Clinical Feasibility Study Of Omega-3 PUFA Therapy For The Reduction Of Post-cardiac Surgery Atrial Arrhythmias
Funder
National Health and Medical Research Council
Funding Amount
$442,092.00
Summary
The aim of this study is to determine the molecular and clinical impact of omega-3 polyunsaturated fatty acids (PUFA) pre-treatment 2 weeks before cardiac surgery in 150 patients. The outcome of this proposal will indicate proof of molecular concepts, clinical feasibility and specific design elements of a future, large scale, placebo controlled, prospective randomised trial of oral therapy with omega-3 polyunsaturated fatty acids (PUFA). Recently, omega-3 PUFA via fish diet was reported to be li ....The aim of this study is to determine the molecular and clinical impact of omega-3 polyunsaturated fatty acids (PUFA) pre-treatment 2 weeks before cardiac surgery in 150 patients. The outcome of this proposal will indicate proof of molecular concepts, clinical feasibility and specific design elements of a future, large scale, placebo controlled, prospective randomised trial of oral therapy with omega-3 polyunsaturated fatty acids (PUFA). Recently, omega-3 PUFA via fish diet was reported to be linked to low incidence of AF. The main aim is to provide a cheap and safe preventative therapy against post-operative atrial fibrillation (AF), a key heart rhythm disorder that occurs in at least 1 in 4 patients after heart surgery and increases post-operative complications, limits recovery and increases hospital stay and cost. Biochemical study elements are important to gain valuable insight into the molecular mechanisms (directly in human heart) that underlie post-operative heart rhythm disorder and may delineate new more precise molecular targets for therapy. No previous clinical study has ever examined whether omega-3 PUFA therapy prevents post-operative heart rhythm disorder. Use of 3g-day omega-3 PUFA pre-treatment in the surgical setting has been shown to be safe in a number of small studies, including our own. Our preliminary data indicates that therapy increases heart and blood content of omega-3 PUFA ~2-fold, and reduces the incidence of AF. Post-operative AF is an expensive resource burden in all cardiothoracic surgery units of Australian hospitals and targets key health priorities. Due to the non-patentable nature of omega-3 PUFA, significant industry based support for clinical research is limited. A positive outcome would rapidly pave the way for widespread use in elective surgery. Reduced length of hospital stay, cost-savings, and the increase in productivity as healthy individuals return to their communities would nationally repay the investment many fold.Read moreRead less
Understanding The Mechanisms Of Atrial Fibrillation: High Density Intra-operative Mapping
Funder
National Health and Medical Research Council
Funding Amount
$94,025.00
Summary
We hypothesize that: During atrial fibrillation, regions acting as short cycle length drivers will demonstrate characteristic sinus rhythm electrophysiology including conduction slowing and abbreviated refractoriness. We aim to correlate the nature of electrical activity in atrial fibrillation with that in sinus rhythm. We will focus on particular anatomic locations that have been shown to be regions of anisotropy and sites where short cycle length rotors have been observed. The anatomic locat ....We hypothesize that: During atrial fibrillation, regions acting as short cycle length drivers will demonstrate characteristic sinus rhythm electrophysiology including conduction slowing and abbreviated refractoriness. We aim to correlate the nature of electrical activity in atrial fibrillation with that in sinus rhythm. We will focus on particular anatomic locations that have been shown to be regions of anisotropy and sites where short cycle length rotors have been observed. The anatomic location and electrophysiologic (EP) characteristics of these regions will vary according to the underlying atrial substrate. We aim to characterise the differences in atrial electrophysiology in AF and sinus rhythm between different pathophysiologic substrates. With high density mapping targeted to critical anatomic sites it will be possible to determine the EP mechanism of short cycle length rotors. We aim to characterise the EP mechanism of these short cycle length regions by analysis of recordings from high density mapping plaques.Read moreRead less
Closing The Gap: Implementing Effective Treatments To Improve Post-operative Nausea And Vomiting
Funder
National Health and Medical Research Council
Funding Amount
$175,303.00
Summary
Nausea and vomiting are common after surgery, concern 80% people undergoing surgery, and are managed by drugs with unwanted side effects. High quality evidence supports acupuncture being a safe and effective non-drug therapy for this complaint. This study will examine if and how acupuncture can be delivered by doctors and nurses around operation time. In future, people may have the choice of using acupuncture or drugs, or both, for preventing or treating nausea and vomiting after surgery.
Analysis Of Atrial Electrical Remodelling In Patients With Paroxysmal And Persistent Atrial Fibrillation
Funder
National Health and Medical Research Council
Funding Amount
$127,516.00
Summary
I am a cardiologist undertaking further training in the management of electrical abnormalities of the heart. My research will focus on the mechanisms responsible for atrial fibrillation, the most common serious heart rhythm disorder. I intend to do this by examining the nature of the electrical activity in patients with atrial fibrillation and comparing this to electrical activity in patients without this disorder, who are undergoing treatment procedures for their electrical disorder.