Myocardial electro-architecture underlying fibrillatory conduction in complex arrhythmogenesis (renewal: years 16-20)

The heart’s electrical wiring—the network of connections between muscle cells—can fray in ways that trigger chaotic, life-threatening rhythms, and this research aims to map exactly how that happens. Current treatments for complex arrhythmias like atrial fibrillation often target “driver” regions thought to sustain the chaos, but these approaches remain largely trial-and-error because no one understands the underlying mechanism. This programme investigates how the heart’s microscopic architecture—the shape and arrangement of its cells—shapes the electrical signals that can either keep a steady beat or spiral into fibrillation. By combining experiments on heart tissue, computer models, and clinical data, the team aims to identify the structural and electrical signatures that mark where a dangerous rhythm originates. If successful, this work could give clinicians a rational basis for choosing where to ablate or pace the heart, replacing empirical guesswork with targeted therapy. The research is fundamental science—it asks how the heart’s physical structure governs its electrical behaviour—but past discoveries from this same programme have already shifted clinical practice. A deeper understanding of electro-architecture could eventually make catheter ablation more precise and reduce the need for repeat procedures in patients with complex arrhythmias.