Laboratory of Larisa G. Tereshchenko, M.D., Ph.D.
The mission of the laboratory is to develop cutting-edge tools to advance prediction, prevention and treatment of the cardiac arrhythmias and to train future leaders in cardiac electrocardiology and electrophysiology.
Sudden cardiac death is the most devastating manifestation of cardiac arrhythmia. The overwhelming majority of sudden cardiac death cases occur in subjects without known heart disease. In about half of sudden cardiac death cases death is the first clinical manifestation of the disease, and an estimated 80% of sudden cardiac deaths are associated with coronary heart disease. Electrocardiogram (ECG) is an easily available, inexpensive and non-invasive tool, which carries valuable information on the electrophysiological properties of the heart. However, traditional analysis of ECG includes a very limited assessment of the arrhythmogenic substrate.
Our laboratory developed a novel approach for ECG analysis. We developed dynamic vectorcardiogram, or three-dimensional electrocardiogram, to measure repolarization lability and SAI QRST, in order to identify individuals at risk of life-threatening cardiac arrhythmias. The research in the laboratory is focused on developing novel diagnostic and prognostic markers of cardiac arrhythmias, advancing our understanding of the mechanisms of arrhythmogenesis, developing life-saving preventive approaches, and improving arrhythmia treatment options.
Our laboratory’s research interests focus on several subjects:
- Development of novel electrocardiographic markers of the risk of cardiac arrhythmias
- Holistic approach in the analysis of temporal variability of cardiac electrical, mechanical, and respiratory activity
- Prediction and prevention of ventricular arrhythmias, atrial fibrillation and sudden cardiac arrest
- Further development of non-invasive electrocardiographic imaging for non-invasive mapping of cardiac electrical activity in order to improve outcomes of cardiac ablation procedures
- Studies of intracardiac electrograms of implantable devices
- Study of reverse electrical remodeling in response to cardiac resynchronization therapy with the goal to improve CRT response
- Diagnosis of rare cardiac arrhythmias and unique analysis of continuous 14-day electrocardiogram
- Bayesian adaptive randomized clinical trials in electrophysiology
Illustration of dynamic vectorcardiography, mechanical alternans, electrocardiographic imaging, and intracardiac electrograms of ventricular arrhythmia.
For more information
Waks JW, Sitlani CM, Soliman EZ, Kabir M, Ghafoori E, Biggs ML, Henrikson CA, Sotoodehnia N, Biering-Sørensen T, Agarwal SK, Siscovick DS, Post WS, Solomon SD, Buxton AE, Josephson ME, Tereshchenko LG. Global Electric Heterogeneity Risk Score for Prediction of Sudden Cardiac Death in the General Population: The Atherosclerosis Risk in Communities (ARIC) and Cardiovascular Health (CHS) Studies. Circulation. 2016 Jun 7;133(23):2222-34. doi: 10.1161/CIRCULATIONAHA.116.021306. PubMed PMID: 27081116.
Junell A*, Thomas J*, Hawkins L, Sklenar J, Feldman T, Henrikson CA, Tereshchenko LG. Screening entire healthcare system ECG database: Association of deep terminal negativity of P wave in lead V1 and ECG referral with mortality. Int J Cardiol. 2017 Feb 1;228:219-224. doi: 10.1016/j.ijcard.2016.11.128. PubMed PMID: 27865189.
Kabir MM, Perez-Alday EA, Thomas J, Sedaghat G, Tereshchenko LG. Optimal configuration of adhesive ECG patches suitable for long-term monitoring of a vectorcardiogram. J Electrocardiol. 2016 Dec 29. pii: S0022-0736(16)30331-4. doi: 10.1016/j.jelectrocard.2016.12.005. [Epub ahead of print] PubMed PMID: 28069275.
Tereshchenko LG, Kim ED, Oehler A, Meoni LA, Ghafoori E, Rami T, Maly M, Kabir M, Hawkins L, Tomaselli GF, Lima JA, Jaar BG, Sozio SM, Estrella M, Kao WH, Parekh RS. Electrophysiologic Substrate and Risk of Mortality in Incident Hemodialysis. J Am Soc Nephrol. 2016 Nov;27(11):3413-3420. PubMed PMID: 27129390;PubMed Central PMCID: PMC5084888.
Waks JW, Soliman EZ, Henrikson CA, Sotoodehnia N, Han L, Agarwal SK, Arking DE, Siscovick DS, Solomon SD, Post WS, Josephson ME, Coresh J, Tereshchenko LG. Beat-to-Beat Spatiotemporal Variability in the T Vector Is Associated With Sudden Cardiac Death in Participants Without Left Ventricular Hypertrophy: The Atherosclerosis Risk in Communities (ARIC) Study. J Am Heart Assoc. 2015 Jan 19;4(1). pii: e001357. doi: 10.1161/JAHA.114.001357. PubMed PMID: 25600143.
Tiffany Win T, Ambale Venkatesh B, Volpe GJ, Mewton N, Rizzi P, Sharma RK, Strauss DG, Lima JA, Tereshchenko LG. Associations of electrocardiographic P-wave characteristics with left atrial function, and diffuse left ventricular fibrosis defined by cardiac magnetic resonance: The PRIMERI Study. Heart Rhythm. 2015 Jan;12(1):155-62. doi: 10.1016/j.hrthm.2014.09.044. Epub 2014 Oct 14. PubMed PMID: 25267584; PubMed Central PMCID: PMC4277898.
Tereshchenko LG, Shah AJ, Li Y, Soliman EZ. Electrocardiographic deep terminal negativity of the P wave in V1 and risk of mortality: the National Health and Nutrition Examination Survey III. J Cardiovasc Electrophysiol. 2014 Nov;25(11):1242-8. doi: 10.1111/jce.12453. Epub 2014 Jun 11. PubMed PMID: 24837486; PubMed Central PMCID: PMC4213235.
Kim R, Cingolani O, Wittstein I, McLean R, Han L, Cheng K, Robinson E, Brinker J, Schulman SS, Berger RD, Henrikson CA, Tereshchenko LG. Mechanical alternans is associated with mortality in acute hospitalized heart failure: prospective mechanical alternans study (MAS). Circ Arrhythm Electrophysiol. 2014 Apr;7(2):259-66. doi: 10.1161/CIRCEP.113.000958. Epub 2014 Mar 1. PubMed PMID: 24585716.
A full biography for Larisa Tereshchenko and list of publications is available here