lek. Łukasz Zarębski

  ORCID: 0000-0003-2524-7950

The topic of my dissertation is: „Deceleration capacity as an indicator of parasympathetic nervous system activity in patients with paroxysmal atrial fibrillation”.

Atrial fibrillation (AF) is the most common arrhythmia, and the number of patients with AF is steadily increasing. AF may lead to heart failure, stroke, may require frequent hospitalizations and is usually associated with significant deterioration in quality of life. The established treatment for AF is ablation, which involves pulmonary vein isolation (PVI) of the left atrium. However, its effectiveness is unsatisfactory and is associated with a significant incidence of serious complications.

For this reason, more effective and safer methods of treating patients with AF are being sought. Pathomechanisms of AF are diverse, and it seems that more selective methods of treatment are possible depending on the phenotype of the arrhythmia. Such a specific phenotype is a vagal AF, which can be treated by attenuating of the parasympathetic tone, achieved by cardioneuroablation (CNA) - a new method of treating cardiac arrhythmias dependent on the increased parasympathetic tone. CNA is a minimally invasive method with a low risk of complications. Despite this, data on the feasibility of identifying potential candidates for this method are lacking.

Recent studies suggest that a specific value of deceleration capacity (DC) can be used to easily and inexpensively identify patients with increased parasympathetic tone, which is responsible for the vasovagal etiology of syncope. Reflex syncope has a pathogenesis similar to vagal AF - in both of them, a key role is played by an increased parasympathetic component. Hence, there is reason to believe that DC in patients with AF can be exploited analogously to that in patients with vasovagal syncope.

In my dissertation I intend to determine whether the parameter of DC can be used to identify patients with paroxysmal atrial fibrillation and increased parasympathetic tone. If the research hypothesis is confirmed, a basis will be created for assessing DC of certain patients who are candidates for PVI and qualifying them for less invasive methods compared to classical, empirical PVI.

Publications:

  • Ł. Zarębski, P. Futyma. Ultrakrótkoterminowa zdolność spowolnienia rytmu zatokowego oraz zmienność rytmu serca jako wskaźniki denerwacji przywspółczulnej przed i po izolacji żył płucnych, Polish Heart Journal, Vol 81, Supp. I (2023)
  • M. Hanson, P. Futyma, WD. Bode et al. Catheter ablation of intramural outflow tract premature ventricular complexes: a multicentre study, EP Europace, Volume 25, Issue 5, May 2023
  • A. Burbelka, Ł. Zarebski, M. Futyma et al. Weight-loss management after catheter ablation of atrial fibrillation, EP Europace, Volume 25, Issue Supplement_1, June 2023
  • P. Futyma, Ł. Zarębski, S. Chen et al. Risk Assessment and Management of Outflow Tract Arrhythmias Refractory to Prior Treatments. Curr Cardiovasc Risk Rep 17, 21–26 (2023)
  • P. Futyma, S. Bordignon, G. Imnadze et al. Bipolar ablation of refractory ventricular arrhythmias using a novel dedicated adapter. A multicenter study. European Heart Journal 43, no. Supplement_2 (2022)
  • P. Futyma, Ł. Zarebski, A. Wrzos et al. Right anterior ganglionated plexus ablation for the treatment of vagally-mediated atrial fibrillation, EP Europace, Volume 24, Issue Supplement_1, May 2022
  • P. Futyma, Ł. Zarebski, M. Futyma et al. Reversed U-curve mapping and ablation of the left pulmonic cusp for treatment of the left ventricular summit arrhythmias, EP Europace, Volume 24, Issue Supplement_1, May 2022
  • P. Futyma, Ł. Zarebski, A. Burbelka et al. High power bipolar ablation of a thick myocardium: ex-vivo study using externally-irrigated large-tip ablation catheters, EP Europace, Volume 24, Issue Supplement_1, May 2022
  • A. Enriquez, WD. Bode, P. Futyma et al. Catheter ablation of intramural outflow tract ventricular arrhythmias: a multicenter study, Heart Rhythm 19.5 (2022): S303
  • P. Futyma, P. Santangeli, Ł. Zarebski et al. Noninvasive programmed ventricular stimulation for prediction of future events in patients with cardioverter-defibrillator implanted for primary prevention of sudden cardiac death, EP Europace, Volume 23, Issue Supplement_3, May 2021
  • P. Futyma, Ł. Zarebski, A. Wrzos et al. Catheter ablation of atrial fibrillation without pulmonary vein isolation, EP Europace, Volume 23, Issue Supplement_3, May 2021
  • P. Futyma, Ł. Zarębski, A. Wrzos et al. Respiratory cycle-dependent atrial tachycardia originating from the left atrial roof. J Electrocardiol. 2020; 63:21-23
  • Ł. Zarębski, A. Wrzos, M. Sowa-Kucma. Jak neurony kontrolują aktywność mózgu? Znaczenie dynamiki zmian w pobudzającej synapsie glutaminianergicznej. Wszechświat. 2020; 121.4-6.
  • M. Superson, K. Szmyt, K. Szymańska et al. Clinical application of monoclonal antibodies in targeted therapy. Eur J Clin Exp Med. 2019; T. 17, z. 4 (2019), s. 338–346