Electromechanical Model to Predict Cardiac Resynchronization Therapy

Annu Int Conf IEEE Eng Med Biol Soc. 2018 Jul:2018:5446-5459. doi: 10.1109/EMBC.2018.8513539.

Abstract

Cardiac resynchronization therapy (CRT) can substantially improve dyssynchronous heart failure and reduce mortality. However, one-third of the CRT patients derive no measurable benefit from CRT, due to suboptimal placement of the left ventricular (LV) lead. We introduce a pipeline for improved CRT-therapy by creating an electromechanical model using patient-specific geometric parameters allowing individualization of therapy. The model successfully mimics expected changes when variables for tension, stiffness, and conduction are entered. Changing LV pacing site had a notable effect on maximum pressure gradient (dP/dtmax) in the presence of cardiac scarring, causing non-uniform excitation propagation through the LV. Tailoring CRT to the individual requires simulations with patient-specific biventricular meshes including cardiac geometry and conductivity properties.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Cardiac Resynchronization Therapy*
  • Heart Failure
  • Heart Rate
  • Heart Ventricles
  • Humans
  • Treatment Outcome