Andreu M. Climent

Hospital General Universitario Gregorio Marañón | HGGM · Department of Cardiology

Anthracyclines are widely used in the treatment of many solid cancers, but their efficacy is limited by cardiotoxicity. As the number of pediatric cancer survivors continues to rise, there has been a concomitant increase in people living with anthracycline-induced cardiotoxicity. Accordingly, there is an ongoing need for new models to better unders...

Background and objective Electrocardiographic imaging (ECGI) has been used for guiding atrial fibrillation (AF) ablation, identifying reentrant activity by phase analysis with promising results. The objective of this study is to identify the best post-processing configuration for reentrant activity detection that better differentiates AF patients w...

Introduction Electrocardiographic Imaging is a non-invasive technique that requires cardiac Imaging for the reconstruction of cardiac electrical activity. In this study, we explored imageless ECGI by quantifying the errors of using heart meshes with either an inaccurate location inside the thorax or an inaccurate geometry. Methods Multiple‑lead bo...

Pulmonary vein isolation (PVI) is the most successful treatment for atrial fibrillation (AF) nowadays. However, not all AF patients benefit from PVI. In this study, we evaluate the use of ECGI to identify reentries and relate rotor density in the pulmonary vein (PV) area as an indicator of PVI outcome. Rotor maps were computed in a set of 29 AF pat...

The inverse problem of electrocardiography or electrocardiographic imaging (ECGI) is a technique for reconstructing electrical information about cardiac surfaces from noninvasive or non-contact recordings. ECGI has been used to characterize atrial and ventricular arrhythmias. Although it is a technology with years of progress, its development to ch...

Introduction: Electrocardiographic Imaging (ECGI) allows computing the electrical activity in the heart non-invasively using geometrical information of the patient and multiple body surface signals. In the present study we investigate the influence of the number of nodes of geometrical meshes and recording ECG electrodes distribution to compute ECG...

Funding Acknowledgements Type of funding sources: Public Institution(s). Main funding source(s): Instituto de Salud Carlos III, and Ministerio de Ciencia, Innovación y Universidades (supported by FEDER Fondo Europeo de Desarrollo Regional PI17/01106), Agencia Estatal de Investigación (RYC2018-024346B-750 and PID2020-119364RB-100), Generalitat Valen...

Atrial fibrillation (AF) is characterized by complex and irregular propagation patterns, and AF onset locations and drivers responsible for its perpetuation are the main targets for ablation procedures. ECG imaging (ECGI) has been demonstrated as a promising tool to identify AF drivers and guide ablation procedures, being able to reconstruct the el...

Background Electrocardiographic imaging (ECGI) allows evaluating the complexity of the reentrant activity of atrial fibrillation (AF) patients. In this study, we evaluated the ability of ECGI metrics to predict the success of pulmonary vein isolation (PVI) to treat AF. Methods ECGI of 24 AF patients (6 males, 13 paroxysmal, 61.8 ± 14 years) was re...

The high incidence of cardiac arrythmias underlines the need for the assessment of pharmacological therapies. In this field of drug efficacy, as in the field of drug safety highlighted by the Comprehensive in Vitro Proarrhythmia Assay initiative, new pillars for research have become crucial: firstly, the integration of in-silico experiments, and se...

Electrocardiographic imaging (ECGI) is a technique to reconstruct non-invasively the electrical activity on the heart surface from body-surface potential recordings and geometric information of the torso and the heart. ECGI has shown scientific and clinical value when used to characterize and treat both atrial and ventricular arrhythmias. Regarding...

The concept that cell-based repair of myocardial injury might be possible was introduced almost two decades ago; however, the field of cardiovascular reparative medicine has been criticized as translation to clinically effective approaches has been slow. The recent retraction of a series of papers has further impacted perception of this area of res...

Background Multipoint pacing (MPP) in cardiac resynchronization therapy (CRT) activates the left ventricle from two locations, thereby shortening the QRS duration and enabling better resynchronization; however, compared with conventional CRT, MPP reduces battery longevity. On the other hand, electrocardiogram‐based optimization using the fusion‐opt...

Atrial fibrillation (AF) is characterized by complex and irregular propagation patterns. Noninvasive electrocardiographic imaging (ECGI) has been tested during AF conditions with promising results. However, current regularization methods face important challenges in this type of unstable electrical activity scenarios. Combination of intracardiac an...

Background Great expectations have been set around the clinical potential of regenerative and reparative medicine in the treatment of cardiovascular diseases (i.e., in particular heart failure [HF]). Initial excitement, spurred by encouraging preclinical data, resulted in a rapid translation into clinical research. The sobering outcome of the resul...

Background The cardiac late sodium current (INaL) has been increasingly implicated in the initiation of atrial fibrillation (AF). In fact, it has been reported that the augmentation of INaL in pathophysiological conditions prolongs repolarization and facilitates the appearance of afterdepolarizations, which can act as triggers of arrhythmic activit...

Background Mechanical stretch increases Na⁺ inflow into myocytes, related to mechanisms including stretch-activated channels or Na⁺/H⁺ exchanger activation, involving Ca²⁺ increase that leads to changes in electrophysiological properties favoring arrhythmia induction. Ranolazine is an antianginal drug with confirmed beneficial effects against cardi...

Background: It is difficult to non-invasively phenotype atrial fibrillation (AF) in a way that reflects clinical endpoints such as response to therapy. We set out to map electrical patterns of disorganization and regions of reentrant activity in AF from the body surface using electrocardiographic imaging (ECGI), calibrated to panoramic intracardiac...

One of the aims of the citizen's initiative #CienciaenelParlamento is helping to establishing a parliamentary office of scientific and technological advice in the Spanish parliament. Said office would be in charge of fostering networking spaces between scientific knowledge and public policies and of triggering public debate between policy-makers, e...

Background Alternans have been associated with the development of ventricular fibrillation and its control has been proposed as antiarrhythmic strategy. However, cardiac arrhythmias are a spatiotemporal phenomenon in which multiple factors are involved (e.g. calcium and voltage spatial alternans or heterogeneous conduction velocity) and how an anti...

The myocardium consists of numerous cell types embedded in organized layers of ECM (extracellular matrix) and requires an intricate network of blood and lymphatic vessels and nerves to provide nutrients and electrical coupling to the cells. Although much of the focus has been on cardiomyocytes, these cells make up <40% of cells within a healthy adu...

Background: Several metabolic conditions can cause the Brugada ECG pattern, also called Brugada phenotype (BrPh). We aimed to define the clinical characteristics and outcome of BrPh patients and elucidate the mechanisms underlying BrPh attributed to hyperkalemia. Methods and Results: We prospectively identified patients hospitalized with severe hy...

Atrial Flutter (AFL) termination by ablating the path responsible for the arrhythmia maintenance is an extended practice. However, the difficulty associated with the identification of the circuit in the case of atypical AFL motivates the development of diagnostic techniques. We propose body surface phase map analysis as a noninvasive tool to identi...

Safety pharmacology aims at detectingundesirable effect of drugs during its development. However, limitations are present at both in-vitro and in-silico level because of its low detection efficacy during this process. In this work,the effect of drugs at tissue levelwas studiedand inducibility in a multivariable scenario including 127 models tested...

The international consortium TACTICS (Transnational Alliance for Regenerative Therapies in Cardiovascular Syndromes) has recently addressed key priorities in the field of cell-based therapy for cardiac repair, identifying the efficacy of translational research as one of the main challenges to ultimately improve the quality of life of patients with...

Cardiovascular regenerative medicine (CRM) has been defined as an innovative research field that includes all diagnostic and therapeutic strategies aimed at restoring cardiovascular health by enhancing the innate regenerative response of cardiac and vascular tissues.1 The TACTICS (Transnational Alliance for Regenerative Therapies in Cardiovascular...

In a context in which almost any student can have access to a university career, it is frequent to observe how the motivation and commitment of students has no comparison with previous years. New teaching methods must face this reality without falling into the banality of assuming the lack of motivation by default. In this communication, we present...