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Title: 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
Author: Zeb, Mehmood
ISNI:       0000 0004 7972 0878
Awarding Body: University of Southampton
Current Institution: University of Southampton
Date of Award: 2016
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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.
Supervisor: Morgan, John ; Hanson, Mark ; Curzen, Nicholas Sponsor: Not available
Qualification Name: Thesis (Ph.D.) Qualification Level: Doctoral
EThOS ID:  DOI: Not available