A simple ear clip to keep the most common cardiac arrhythmia under control or maybe even prevent it. Rohit Kharbanda, PhD student at Erasmus MC and researcher within the scientific program Medical Delta Cardiac Arrhythmia Lab, is investigating whether this is possible. He received the prestigious Dekker grant for this research, awarded by the Hartstichting, the Dutch Heart Foundation.
Every year the Hartstichting awards Dekker grants to talented cardiovascular researchers. The grants are named after the late Dr. Bart Dekker, who was medical director of the Hartstichting from 1971 to 1987. After an extensive selection procedure, Kharbanda was declared the winner in his category: ‘junior clinical scientist’. With the amount of € 80,000 he can extend his doctoral research into atrial fibrillation.
Kharbanda's research is part of the Medical Delta Cardiac Arrhythmia Lab scientific program. His research focuses primarily on atrial fibrillation, the most common cardiac arrhythmia in the world. With arrhythmia the heart beats irregularly and in many cases too fast.
For his research, the PhD candidate of Prof. Natasja de Groot and Prof. Ad Bogers, like his colleagues at the Medical Delta Cardiac Arrhythmia Lab, has ongoing contact with patients. Kharbanda, for example, is actively involved in the Atrial Fibrillation Innovation Platform (AFIP), a patient organization especially for people with atrial fibrillation. “We try to be close to the patients, so that we can include their experiences in the research. Conversations with them sometimes lead to new research ideas or makes you recognize certain complaint patterns.”
Many patients with atrial fibrillation describe similar symptoms prior to the heart rhythm disorder. Atrial fibrillation, for example, often occurs during stress or after consuming certain foods or beverages. It is also the most common arrhythmia after heart interventions such as open heart surgery. “The autonomous nervous system plays an important role in all these examples. What this role is exactly, has not been researched extensively yet - a reason for me to start this research."
”Building the right bridges between different disciplines is the key to innovative research.”
The heart rhythm is controlled by, among others, the brain. Nerves ensure that the brain communicates with organs such as the heart. The so-called "vagus nerve" is one of the nerves with many nerve paths towards the heart. Branches of this nerve run through the ear and can possibly be influenced there. By placing a special ear clip, this nerve and thus the part in your brain that determines your heart rhythm may be stimulated. "With my research, I want to understand the role of the nervous system in atrial fibrillation, how we can influence it and how we can potentially treat or even prevent cardiac arrhythmias," says Kharbanda. “Ultimately, I want to be able to substantiate this scientifically, so that I can offer patients with atrial fibrillation a better quality of life.
For various research purposes, the researchers from Medical Delta Cardiac Arrhythmia Lab place electrodes on the heart during these open heart operations. This allows them to map the electrical activity of the atrium very accurately. During open heart surgery, Kharbanda will measure the effects of stimulation of certain nerve bundles on the electrical conduction of the atria. He performs these measurements both before and after stimulation of the nerve. Patients therefore always form their own control group. The measurements are performed on as many men as women. Also patients with and without atrial fibrillation are examined. "This is important because there may be differences between patient groups."
Kharbanda's research can be seen as ‘typical Medical Delta’: interdisciplinary, solution-oriented, from a scientific basis and together with patients. As a cum laude medical student, he knows a lot about his own discipline, but by no means everything about the technical aspects of nerve stimulation and measurements that are done. He works closely with the bio-electronics research group of Prof. Wouter Serdijn of TU Delft. He receives help from Dr. Maarten Roos-Serote and Prof. Alle-Jan van der Veen for processing the measured signals from the heart. But he also maintains close contact with molecular biologist Prof. Bianca Brundel for his research.
“Initially it takes a while before you learn to speak each other's languages, but you eventually need each other to come to excellent research. By clearly indicating what you want to calculate, you can adjust each other and make use of each other's expertise. I am happy that I can use the knowledge from their disciplines for my research, because that is not included in the Medicine study. Building the right bridges between different disciplines is the key to innovative research, with the patient at the center.”