Michel Haïssaguerre Explained

Michel Haïssaguerre
Birth Date:5 October 1955
Citizenship:France
Nationality:French
Field:Cardiac electrophysiology
Work Institution:Hôpital Cardiologique du Haut–Lévèque / IHU Liryc
Known For:Contributions in the area of cardiac fibrillation

Michel Haïssaguerre (October 1955) is a French cardiologist and electrophysiologist. His investigations have been the basis for development of new markers and therapies for atrial and ventricular fibrillation.

Biography

Haïssaguerre was born in Bayonne, France. He became a Professor of Cardiology in 1994. His present position is Chief of the Cardiac Pacing and Electrophysiology department at the Haut–Lévèque Cardiology Hospital, part of the Bordeaux University Hospital Community. He was elected a member of the French Academy of Sciences in 2010.

In 2011, he founded LIRYC, a research Institute focusing on Cardiac Electrophysiology and Modeling, which brings together 150 members from multiple disciplines. Its goal is to improve understanding of the electrical activity of the heart, to reduce suffering and mortality due to heart rhythm disorders.

His investigations have been the basis for development of new markers and therapies for atrial and ventricular fibrillation.[1]

Areas of research

Michel Haïssaguerre's research focuses on abnormalities of heart rhythm with particular interest in mapping and treatment for cardiac fibrillation.

In the early eighties, he investigated patients with cardiac arrhythmias caused by single pathological conditions, such as accessory pathway-related tachycardia (Wolff–Parkinson–White syndrome or Mahaim fibers), and junctional tachycardia. He showed that it was feasible to pinpoint the pathologies anywhere in the heart by direct recording electrical activity using intracardiac catheters. By delivering energy through the catheters and destroying tissue, the pathology could be eliminated, thereby curing the patient.[2] [3] [4]

Later, Michel Haïssaguerre's team investigated cardiac fibrillation, the most complex and severe type of arrhythmias, defined as "turbulent, disorganized electrical activity.[5] [6] Cardiac fibrillation involves different mechanisms acting separately or together, the main phenomenon being circus movement, or reentry (Georges Ralph Mines, 1913). A combination of spatiotemporal factors is required to establish reentry, a process occurring at a macroscopic scale rather than at the cellular level, with antiarrhythmic drugs (ion channel blockers) having limited efficacy or even proarrythmic effects in clinic (CAST trial). Apart from antiarrhythmic drugs, a surgical approach to block electrical reentries had been proposed, by James Cox et al (1987) to treat atrial fibrillation, using a series of full-thickness incisions (Cox maze procedur)).

Michel Haïssaguerre developed multi-electrode catheters to perform wide area mapping and identify the primary activity at the origin of the fibrillation. Long mapping studies were needed due to the random nature of initiation. These studies demonstrated that specific sources were the genesis of 'chaotic' arrhythmias, creating a paradigm shift with regard to therapeutic strategies.

Atrial fibrillation

Atrial fibrillation is the most common heart rhythm disorder, affecting 2 to 3% of the population of Europe and North America. It is the cause of 20–25% of ischemic brain strokes.[7] [8] Michel Haïssaguerre was the first to identify that in most cases, atrial fibrillation is triggered by abnormal electrical impulses originating from the pulmonary veins, structures hitherto considered to be devoid of electrical activity. He pioneered the use of catheter ablation to treat atrial fibrillation using the technique of pulmonary vein isolation to prevent this abnormal electrical activity from reaching the atria. This technique underlies methods now used for treatment worldwide.[9]

Ventricular fibrillation

Ventricular fibrillation is a major cause of cardiac arrest, or sudden cardiac death, which accounts for about 10% of mortality in adults, causing 350 000 deaths in the US each year.[10] Michel Haïssaguerre's team showed that patients with sudden cardiac death and structurally normal hearts frequently had triggers originating from Purkinje fibers, a physiological tissue representing 2% of myocardial mass. The same tissue was confirmed to also play a pathogenic role in ventricular fibrillation associated with myocardial infarction, cardiomyopathies and other conditions. The team pioneered the use of catheter ablation to treat ventricular fibrillation in 2002.[11]

Despite the effective treatments (implantable defibrillators, ablation) available for lethal ventricular arrhythmias, the major hurdle remains identification of subjects at risk of sudden death.[12] Michel Haïssaguerre's team showed the role of subtle phenotypic markers present on the ECG, and demonstrated in collaboration with groups from Bangkok and Tsukuba, that different mechanisms could also lead to a similar phenotype.[13] Further studies have focused on the enigmatic origin of 'sudden unexplained cardiac deaths': those for which no cause is found after a complete autopsy or detailed investigations (surviving patients). This pathology particularly affects young people at rest or during sleep.[14] After identification of reentrant sources, they showed the presence of localized myocardial alteration at the sources, which may be the final damage caused by a number of diseases.[15] This marker may open up new avenues for the early identification of subjects at risk, by electrical or imaging methods, combined with genetic analysis.

Awards

Professor Michel Haïssaguerre has received a number of honors and awards:

Scientific Papers

Michel Haïssaguerre and his team have published more than 800 publications in peer-reviewed cardiology journals dealing mainly with mapping and therapy of cardiac electrical disorders.

References

  1. Book: Lüderitz, Berndt. Profiles in cardiac pacing and electrophysiology. 2005. Blackwell Pub. 978-0-470-99491-7. Malden, Mass.. 184983481.
  2. Warin. J F. Haissaguerre. M. Lemetayer. P. Guillem. J P. Blanchot. P. October 1988. Catheter ablation of accessory pathways with a direct approach. Results in 35 patients.. Circulation. 78. 4. 800–815. 10.1161/01.cir.78.4.800. 3168189. 0009-7322. free.
  3. Haissaguerre. M. Warin. J F. Le Metayer. P. Maraud. L. De Roy. L. Montserrat. P. Massiere. J P. August 1990. Catheter ablation of Mahaim fibers with preservation of atrioventricular nodal conduction.. Circulation. en. 82. 2. 418–427. 10.1161/01.CIR.82.2.418. 2115408. 0009-7322. free.
  4. Haissaguerre. Michel. Warin. Jean Francois. Lemetayer. Philippe. Saoudi. Nadir. Guillem. Jean Pierre. Blanchot. Pierre. 16 February 1989. Closed-Chest Ablation of Retrograde Conduction in Patients with Atrioventricular Nodal Reentrant Tachycardia. New England Journal of Medicine. 320. 7. 426–433. 10.1056/nejm198902163200704. 2913508. 0028-4793.
  5. Panfilov. A.. Pertsov. A.. 15 June 2001. Ventricular fibrillation: evolution of the multiple–wavelet hypothesis. Philosophical Transactions of the Royal Society of London. Series A: Mathematical, Physical and Engineering Sciences. 359. 1783. 1315–1325. 10.1098/rsta.2001.0833. 2001RSPTA.359.1315P. 14635748. 1364-503X.
  6. Gray. Richard A.. Pertsov. Arkady M.. Jalife. José. 5 March 1998. Spatial and temporal organization during cardiac fibrillation. Nature. en. 392. 6671. 75–78. 10.1038/32164. 9510249. 1998Natur.392...75G. 4386639. 0028-0836.
  7. Nattel. Stanley. January 2002. New ideas about atrial fibrillation 50 years on. Nature. en. 415. 6868. 219–226. 10.1038/415219a. 11805846. 2002Natur.415..219N. 16959236. 0028-0836.
  8. Fuster. Valentin. Rydén. Lars E.. Cannom. David S.. Crijns. Harry J.. Curtis. Anne B.. Ellenbogen. Kenneth A.. Halperin. Jonathan L.. Le Heuzey. Jean-Yves. Kay. G. Neal. Lowe. James E.. Olsson. S. Bertil. 15 August 2006. ACC/AHA/ESC 2006 Guidelines for the Management of Patients With Atrial Fibrillation: A Report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines and the European Society of Cardiology Committee for Practice Guidelines (Writing Committee to Revise the 2001 Guidelines for the Management of Patients With Atrial Fibrillation): Developed in Collaboration With the European Heart Rhythm Association and the Heart Rhythm Society. Circulation. en. 114. 7. e257-354. 10.1161/CIRCULATIONAHA.106.177292. 16908781. 0009-7322. free.
  9. Haïssaguerre. Michel. Jaïs. Pierre. Shah. Dipen C.. Takahashi. Atsushi. Hocini. Mélèze. Quiniou. Gilles. Garrigue. Stéphane. Le Mouroux. Alain. Le Métayer. Philippe. Clémenty. Jacques. 3 September 1998. Spontaneous Initiation of Atrial Fibrillation by Ectopic Beats Originating in the Pulmonary Veins. New England Journal of Medicine. en. 339. 10. 659–666. 10.1056/NEJM199809033391003. 9725923. 0028-4793. free.
  10. Al-Khatib. Sana M.. Stevenson. William G.. Ackerman. Michael J.. Bryant. William J.. Callans. David J.. Curtis. Anne B.. Deal. Barbara J.. Dickfeld. Timm. Field. Michael E.. Fonarow. Gregg C.. Gillis. Anne M.. 25 September 2018. 2017 AHA/ACC/HRS Guideline for Management of Patients With Ventricular Arrhythmias and the Prevention of Sudden Cardiac Death: A Report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines and the Heart Rhythm Society. Circulation. en. 138. 13. e272–e391. 10.1161/CIR.0000000000000549. 29084731. 0009-7322. free.
  11. Haissaguerre. Michel. Vigmond. Edward. Stuyvers. Bruno. Hocini. Meleze. Bernus. Olivier. March 2016. Ventricular arrhythmias and the His–Purkinje system. Nature Reviews Cardiology. en. 13. 3. 155–166. 10.1038/nrcardio.2015.193. 26727298. 1759-5002. free.
  12. Fishman Glenn I.. Chugh Sumeet S.. DiMarco John P.. Albert Christine M.. Anderson Mark E.. Bonow Robert O.. Buxton Alfred E.. Chen Peng-Sheng. Estes Mark. Jouven Xavier. Kwong Raymond. 30 November 2010. Sudden Cardiac Death Prediction and Prevention. Circulation. 122. 22. 2335–2348. 10.1161/CIRCULATIONAHA.110.976092. 3016224. 21147730.
  13. Nademanee Koonlawee. Haissaguerre Michel. Hocini Mélèze. Nogami Akihiko. Cheniti Ghassen. Duchateau Josselin. Behr Elijah R.. Saba Magdi. Bokan Ryan. Lou Qing. Amnueypol Montawatt. 29 October 2019. Mapping and Ablation of Ventricular Fibrillation Associated With Early Repolarization Syndrome. Circulation. 140. 18. 1477–1490. 10.1161/CIRCULATIONAHA.118.039022. 31542949. free.
  14. Bagnall . Richard D. . Weintraub . Robert G. . Ingles . Jodie . Jodie Ingles . Duflou . Johan . Yeates . Laura . Lam . Lien . Davis . Andrew M. . Thompson . Tina . Connell . Vanessa . Wallace . Jennie . Naylor . Charles . 23 June 2016 . A Prospective Study of Sudden Cardiac Death among Children and Young Adults . New England Journal of Medicine . en . 374 . 25 . 2441–2452 . 10.1056/NEJMoa1510687 . 0028-4793 . 27332903 . free.
  15. Haïssaguerre. Michel. Hocini. Mélèze. Cheniti. Ghassen. Duchateau. Josselin. Sacher. Frédéric. Puyo. Stéphane. Cochet. Hubert. Takigawa. Masateru. Denis. Arnaud. Martin. Ruairidh. Derval. Nicolas. July 2018. Localized Structural Alterations Underlying a Subset of Unexplained Sudden Cardiac Death. Circulation: Arrhythmia and Electrophysiology. 11. 7. e006120. 10.1161/circep.117.006120. 30002064. 7661047. 1941-3149. free.
  16. News: 24 April 2015. Michel Haïssaguerre. Institut de France. Grands Prix des Fondations. 12 December 2017.
  17. Web site: Professeur Michel HAÏSSAGUERRE | Jeantet. 1 October 2017.

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