Cardiovascular diseases such as dilated cardiomyopathy, hypertrophic cardiomyopathy, and myocardial infarction can lead to adverse structural and electrical remodeling of the heart, predisposing these patients to dangerous cardiac arrhythmias and sudden cardiac death. Anti-arrhythmic drugs targeted to specific cardiac ion channels have been largely unsuccessful in treating and preventing cardiac arrhythmias. These approaches mainly focus on treating the symptom (arrhythmia) rather than the cause (molecular, structural, and electrical remodeling).
"A picture shows me at a glance what it takes dozens of pages of a book to expound." –Ivan Turgenev, 1862
We think that seeing is believing; thus the major approach used in our lab is to combine multiple imaging modalities across multiple spatial scales to determine factors contributing to cardiac arrhythmias. In vivo molecular and structural imaging combined with ex vivo high-speed, high-resolution functional optical imaging of transmembrane potential and intracellular calcium in isolated hearts is used to systematically characterize individual factors contributing to arrhythmia. Using this integrative approach to better understand the mechanisms of arrhythmia genesis and maintenance in different disease states, we hope to develop novel anti-arrhythmic therapies that target the underlying causes of cardiac arrhythmias.

Selected Publications

Ripplinger CM, Krinski VI, Nikolski VP, Efimov IR. Mechanisms of unpinning and termination of ventricular tachycardia. Am J Physiol Heart Circ Physiol, 291(1): H184-92, Jul 2006.

Qu F, Ripplinger CM, Nikolski VP, Grimm C, Efimov IR. Three-dimensional panoramic imaging of cardiac arrhythmias in the rabbit heart. J Biomed Optics, 12(4):044091, Jul-Aug 2007.

Ripplinger CM, Li W, Hadley J, Chen J, Rothenberg F, Lombardi R, Wickline SA, Marian AJ, Efimov IR. Enhanced transmural fiber rotation and Cx43 heterogeneity are associated with an increased upper limit of vulnerability in a transgenic rabbit model of human hypertrophic cardiomyopathy. , 101(10): 1049-1057, Nov 2007.

Fleming CP, Ripplinger CM, Webb B, Efimov IR, Rollins AM. Quantification of cardiac fiber orientation using 3D optical coherence tomography. J Biomed Optics, 13(3): 030505, 2008.

Lou Q, Ripplinger CM, Bayly PV, Efimov IR. Quantitative panoramic imaging of epicardial electrical activity. Ann Biomed Eng, 36(10): 1649-58, Jul 2008.

Hucker WJ, Ripplinger CM, Fleming CF, Fedorov VV, Rollins AM, Efimov IR. Multimodal Biophotonic Imaging to Correlate Structure and Function in Cardiac Tissue. J Biomed Optics, 13(5): 054012, 2008.

Ripplinger CM, Lou Q, Li W, Hadley J, Efimov IR. Panoramic imaging reveals basic mechanisms of induction and termination of ventricular tachycardia in rabbit heart with chronic infarction: Implications for low-voltage cardioversion. Heart Rhythm, 6(1): 87 – 97, 2009.

Lombardi R, Rodriguez G, Chen SN, Ripplinger CM, Li W, Chen J, Willerson JT, Betocchi S, Wickline SA, Efimov IR, Marian AJ. Resolution of established cardiac hypertrophy and fibrosis and prevention of heart failure in a transgenic rabbit model of human cardiomyopathy through thiol-sensitive mechanisms. Circulation, 119(10): 1398 – 407, 2009.

Li W, Ripplinger CM, Lou Q, Efimov IR. Multiple monophasic shocks improve electrotherapy of ventricular tachycardia in a rabbit model of chronic infarction. Heart Rhythm, 6(7): 1020-7, 2009.

Moreno JD, Zhu ZI, Yang PC, Bankston JR, Jeng MT, Kang C, Wang L, Bayer JD, Christini DJ, Trayanova NA, Ripplinger CM, Kass RS, Clancy CE. A computational model to predict the effects of class I anti-arrhythmic drugs on ventricular rhythms. Science Translational Medicine, 3(98): 98ra83, 2011.

Myles RC, Wang L, Kang C, Bers DM, Ripplinger CM. Local beta-adrenergic stimulation overcomes source-sink mismatch to generate focal arrhythmia. Circ Res, 110(11): 1454-64, May 2012.

See: Complete List of Publications