In a study from Johns Hopkins and elsewhere, scientists found a major cause of deadly heart rhythm disorders.
They found that fat intermingling with scar tissue is the driving force behind the development of heart rhythm disturbances.
Heart attacks scar the heart, leaving patients vulnerable to heart rhythm disorders that can lead to sudden death.
While not all who have experienced a cardiac infarction will develop an arrhythmia, if they do, it will typically happen about three years post-attack.
In these patients, fat penetrates the heart wall in the region of the scar after three years, as well.
Until now, however, the link between those fat deposits and the development of arrhythmias was unclear.
In the study, the team tested 24 post-infarction patients who were scheduled to undergo an invasive treatment for their arrhythmias and had both an MRI and a CT scan taken.
Using the personalized heart models, the team found that larger amounts of fat in a patient’s heart wall were predictive of an increased likelihood of arrhythmias.
In contrast, a larger amount of scarring was not associated with an increased arrhythmia likelihood.
Using both the patient heart models and the clinical recordings acquired during the procedure, the presence of fat in the heart wall was found to slow down the conduction of electrical signals that underlie heart rhythm, making them more likely to behave in a disorderly fashion.
Overall, the study demonstrated that penetrating fat rather than scarring in the heart is the primary reason for arrhythmia occurrence in these patients.
These findings implicate the fat that penetrates the walls of the heart as a new, significant player in post-infarct arrhythmias.
This finding challenges conventional wisdom, which considers scarring in the heart as the main reason for heart rhythm disorders in patients with infarction.
The team says this new knowledge will motivate novel, patient-specific therapeutic strategies to mitigate heart rhythm disorders.
The study was conducted by Natalia Trayanova et al and published in Nature Cardiovascular Research.
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