EUTrigTreat statement of mission

The EUTrigTreat project investigates life-threatening forms of electrical heart disease (ventricular arrhythmias) associated with a high risk of sudden cardiac death. Conceptually, both inherited (e.g. ion channel mutations) and acquired forms (e.g. heart failure) of arrhythmia syndromes occur frequently, and represent highly significant public health problems. However, and in sharp contrast to the high incidence of arrhythmia associated deaths, modern drug- and device-based preventive strategies remain to a large degree ineffective and are prone to side effects. Importantly, sudden death from arrhythmias remains an unresolved issue in patients with heart failure, the most common admitting diagnosis in many industrialized nations. In addition, some genetic variants underlying the Long QT arrhythmia syndrome historically considered as ‘rare’ in fact occur frequently and significantly increase sudden cardiac death risk in mutation carriers. To overcome the incomplete understanding and treatment strategies of arrhythmias, EUTrigTreat investigates mechanisms and biomarkers of arrhythmia risk, considers key genetic and environmental arrhythmia risk modulators, and develops groundbreaking novel treatment options.

An urgent dilemma to treat patients at risk for arrhythmias exists: both insufficient diagnostic means to accurately predict the individual patient’s arrhythmia risk and significantly limited sudden cardiac death prevention strategies contribute to this difficult situation. Currently, patients with life-threatening arrhythmias are largely treated by invasive and costly internal cardioverter defibrillator (ICD) devices and based largely on empirical recommendations. However, a large number of patients treated with ICD therapy may not benefit from these devices. In addition, the majority of arrhythmia related deaths occur in patients who have not been identified previously due to lack of diagnostic strategies or other unknown factors. EUTrigTreat investigates in a patient cohort with internal cardioverter defibrillator (ICD) devices if risk prediction through novel diagnostic procedures can be improved. In summary, EUTrigTreat investigates arrhythmia initiating mechanisms (‘triggers’), biomarkers which may indicate increased arrhythmia risk, and new therapeutic intervention strategies (‘treatment’). In particular, arrhythmia mechanism based diagnosis and treatment options are addressed through the following general objectives:

· Overcome the current lack of understanding of complex arrhythmia mechanisms
· Apply an innovative translational strategy including patient and experimental studies
· Characterize genetic and environmental arrhythmia modulators and their interactions
· Develop novel risk biomarkers, diagnostic strategies and therapeutic rationales of EUTrigTreat