Uncovering Mechanistic Drives of Cardiac Stereotactic Body Radiation Therapy through Novel Translational Models: Since joining Washington University, I have assisted in the development, processing, and analysis of a translational porcine model of ischemic monomorphic ventricular tachycardia treated with cardiac SBRT to examine the physiologic changes after a typical clinical cardiac SBRT treatment. We have identified key insights into the electrical changes that occur during cardiac SBRT that may drive clinical effectiveness. These results are in the final stages of publication preparation.
Experimental Examination of Partial Occlusion Acute Myocardial Ischemia: My contributions to this area were the main focus of my Ph.D. dissertation. The goal of these projects was to leverage recent experimental findings and breakthroughs about the onset and progression of ischemia as the basis for a comprehensive re-evaluation of acute myocardial ischemia. First, we refined our experimental model to include comprehensive electrical measurements sampled simultaneously from within the myocardium and on the heart surface and the torso surface. We then built on our experience with our novel large-animal experimental models of ischemia to measure and characterize the electrical changes that arise during acute myocardial ischemia created from various types of ischemic stress. We also explored possible mechanistic drivers for these differences. Finally, we assessed the transient changes common to ischemic signatures, including the appearance and disappearance of ischemic potentials recorded from epicardial and torso surface measurements. This work is funded through an NIH fellowship award. The results of these projects have been presented at international conferences and published in several peer-reviewed journals. Further work is ongoing.
Development and Assessment of Novel Electrocardiographic Imaging (ECGI) Techniques: These projects again leveraged large-animal experiments to assess the accuracy of ECGI techniques using ground truth experimental data and ECGI to localize regions of acute myocardial ischemia within the myocardial wall. We developed and incorporated several novel electrical recording arrays to determine the upper bounds of the accuracy of ECGI techniques. We also developed open-source software pipelines to improve ECGI localization of acute myocardial ischemia. This pipeline required creative combinations and modifications to current open-source ECGI software packages to be explicitly applied to myocardial ischemia detection. This research is currently active and being published in several journals.
Assessment of Atrial Fibrillation Patient-Reported Outcomes: These projects aim to better understand how patients with atrial fibrillation experience symptoms, how these symptoms respond to treatment, and how other diseases impact the severity of symptoms in real-world clinical practice. We incorporated a survey-based tool administered to all patients visiting the cardiac electrophysiology clinic at a tertiary care center. We have shown that patient-reported outcomes can vary based on predefined factors. We have also incorporated other data streams, including the cost of care and atrial fibrillation burden recorded from cardiac event monitors. These results are actively being presented and published.
Experimental Examination of Brain Perfusion During Atrial Fibrillation: Another important area of cardiac electrophysiology is understanding the interaction between cardiac arrhythmia and changes to other organs, including cognitive function. We designed and implemented an experimental study using a canine model of atrial fibrillation to assess the effects of atrial fibrillation on cerebrovascular reserve and overall brain function. We found that AF increases the risk of embolic stroke and decreases cerebrovascular perfusion. Our results suggest that multiple changes in atrial fibrillation may cause changes in cognitive function. These results are currently being published.
Cardiac Image and Shape Analysis: During my undergraduate research, I created computer models of left atria from late gadolinium enhancement magnetic resonance images, quantified diseased atrial tissue, and determined the unique role of different anatomical regions in the development of diseased tissue in atrial fibrillation patients. I also helped develop and test novel semi-automated segmentation techniques. I have expanded on this work to include other aspects of cardiac magnetic resonance image processing and computational shape analysis. I designed and implemented an image processing pipeline to create cardiac models of patients with tricuspid regurgitation. I then used shape analysis tools to determine how changes in cardiac shape related to different pathologies and disease severity. This research has been presented at several international conferences and published.
1F30HL149327-01A1, Project Title: Novel Characterization and Detection Techniques for Acute Myocardial Ischemia, National Heart Lung and Blood Institute. The goal of this project is to create and validate, through controlled experimental preparations and computer modeling approaches, a painless, inexpensive, and noninvasive detection system based on the electrocardiogram to localize regions of myocardial ischemia within the heart. (2020-Present)
My post-doc research is with Dr. Stacey Rentschler in translational model work with STAR therapy for treatment VT.
Designed and implemented an experimental study using a canine model to assess the effects of atrial fibrillation on cerebrovascular reserve and overall brain function. The goal of the project is to determine what important variables, including vascular perfusion, effect cognitive decline in patients with atrial fibrillation.
Designed and implemented an experimental model to asses pericardial adhesion development during sternotomy procedures. This method will be used to test new materials to reduce adhesions present following invasive thoracic procedures. (2019-2022)
Designed and implemented image processing and simulation techniques to evaluate mechanical function of the tricuspid valve to better predict risk and help guide treatment in patients with valve dysfunction. (2019-2022)
Patient reported outcomes research in context of cardiac arrhythmia complicated with heart failure and chronic cardiovascular disease. (2018-present)
Graduate thesis work studying the electrical changes occurring during myocardial ischemia. (2017-2023)
Determined the effect of atrial ablation power and catheter contact force on chronic and acute lesion formation using magnetic resonance imaging and gross histological examination. (2016)
Used advanced confocal microscopy techniques to isolate and quantify the change in myocardial tissue from ischemic damage. Specifically we examined the t-tubule direction, position, and changes induced in an experimental model of ischemic cardiomyopathy. (2015)
Role was to manage and assist in animal model experiments to asses the efficacy of a novel drug delivery device for long term foreign body response. (2015)
Created a computational model of animal experiments based on magnetic resonance imaging that was used to study the role of electrode placement in cardiac defibrillation. (2013-2014)
Successfully obtained an individual grant as an undergraduate student to determine the role of specific locations in the heart to fibrosis classification. (2014)
Segmented and analyzed patient left atria of the heart from magnetic resonance images to develop computational models for targeted ablation treatment.(2012-2015)
Member, American Physician Scientist Association (2018-Present)
Member, American Heart Association (2018- Present)
Member, Heart Rhythm Society (2017-Present)
Member, Biomedical Engineering Society (2018-Present)
Member, IEEE (2020-Present)