Computational Modeling for Cardiac Resynchronization Therapy

Lee, A.W.C.; Costa, Caroline Mendonça; Strocchi, Marina; Rinaldi, Christopher Aldo; Niederer, Steven A.

doi:10.1007/s12265-017-9779-4

Cited by 46 publications

(38 citation statements)

References 149 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Computer simulation of the heart has emerged as a novel tool in cardiology research and its applications for CRT have already been reported [11]. Such applications include not only studies for understanding the mechanism of CRT and/or searches for optimal pacing strategies using standard heart models but also those attempting to predict therapeutic outcomes with patient-specific models, thus aiming at an alternative approach to patient selection [12,13].…”

Section: Introductionmentioning

confidence: 99%

Patient-specific heart simulation can identify non-responders to cardiac resynchronization therapy

et al. 2020

View full text Add to dashboard Cite

To identify non-responders to cardiac resynchronization therapy (CRT), various biomarkers have been proposed, but these attempts have not been successful to date. We tested the clinical applicability of computer simulation of CRT for the identification of non-responders. We used the multi-scale heart simulator "UT-Heart," which can reproduce the electrophysiology and mechanics of the heart based on a molecular model of the excitation-contraction mechanism. Patient-specific heart models were created for eight heart failure patients who were treated with CRT, based on the clinical data recorded before treatment. Using these heart models, bi-ventricular pacing simulations were performed at multiple pacing sites adopted in clinical practice. Improvement in pumping function measured by the relative change of maximum positive derivative of left ventricular pressure (%ΔdP/dt max) was compared with the clinical outcome. The operators of the simulation were blinded to the clinical outcome. In six patients, the relative reduction in end-systolic volume exceeded 15% in the follow-up echocardiogram at 3 months (responders) and the remaining two patients were judged as non-responders. The simulated %ΔdP/dt max at the best lead position could identify responders and non-responders successfully. With further refinement of the model, patient-specific simulation could be a useful tool for identifying non-responders to CRT.

show abstract

Section: Introductionmentioning

confidence: 99%

Patient-specific heart simulation can identify non-responders to cardiac resynchronization therapy

et al. 2020

View full text Add to dashboard Cite

show abstract

“…Some of the models use a complex and accurate description of the ion currents and propagation of action potential along the heart chambers. Such models are useful for simulation of arrhythmias . However, only a very few patient‐specific models provide an adequate description of mechanics or electromechanics of cardiac muscle .…”

Section: Introductionmentioning

confidence: 99%

“…Such models are useful for simulation of arrhythmias. 3 However, only a very few patient-specific models provide an adequate description of mechanics 4 or electromechanics of cardiac muscle. 5 The major problems arise from the lack of information that can be obtained from clinical measurements for fitting numerous model parameters, especially their distribution in different regions of the heart.…”

Section: Introductionmentioning

confidence: 99%

Multiscale simulation of the effects of atrioventricular block and valve diseases on heart performance

Syomin

Zberia

Tsaturyan

2019

Numer Methods Biomed Eng

View full text Add to dashboard Cite

A new mathematical model of the cardiovascular system is proposed. The left ventricle is described by an axisymmetric multiscale model where myocardium is treated as an incompressible transversely isotropic medium with a realistic distribution of fibre orientation. Active tension and its regulation by Ca2+ ions are described by our recent kinetic model. A lumped parameter model is used for the simulation of blood circulation, in which the left and right atria and the right ventricle are described by a system of ordinary differential equations for active pressure‐volume relationships. The stress and strain of the left ventricle myocardium were calculated by the finite element method implemented by the authors. The changes in the haemodynamics upon changes in preload of a healthy heart, upon physical exercise, and in case of atrioventricular block with different types of arrhythmias were simulated. To simulate the effect of stenosis or regurgitation of the aortic or mitral valves, the hydraulic and inertial flow resistances of the heart valves were set as functions of their orifice areas. The model reproduced a number of phenomena observed in clinical practice, including the classification of the severity of valve disease.

show abstract

“…As another limitation, these studies consider only elastic models for the myocardium, therefore, cannot not address the implications of viscosity on LV motion. In the second example, we present qualitative simulations of cardiac resynchronization therapy (CRT) in a continuously beating biventricle heart model generated from cardiac magnetic resonance imaging (cMRI) data. Most of the existing computational studies of CRT in the literature use weakly coupled algorithms . On the other hand, these studies mainly employ a monodomain model for the description of the electrophysiology.…”

Section: Introductionmentioning

confidence: 99%

Towards predictive computer simulations in cardiology: Finite element analysis of personalized heart models

et al. 2018

View full text Add to dashboard Cite

The goal of this manuscript is to demonstrate the feasibility of our recent numerical developments towards predictive computer simulations in cardiology. In contrast to existing weakly coupled and strongly coupled monolithic approaches in the literature, we utilize a fully implicit staggered solution scheme that enables to study the strong excitation-contraction coupling of the heart tissue in the monodomain and the bidomain setting through finite element simulations. On the constitutive level, we employ the recently proposed modified Hill model (CMAME 315; 434-466, 2017) that treats the myocardium as an electro-visco-active material. All the time integrations are evaluated via an implicit backward Euler scheme that ensures unconditional stability. The performance of the framework is demonstrated by means of two clinically relevant and interesting examples. Firstly, basic deformation characteristics of a personalized left ventricle model such as rotation, twist and longitudinal shortening are simulated along with a physiological pressure-volume relation. In addition, the results of the viscoelastic and elastic solutions are compared. In the second example, we simulate a continuously beating virtual biventricle model having dyssynchrony and imitate two different cardiac resynchronization therapy attempts in order to improve the cardiac output. The corresponding electrocardiograms and left ventricle volume-time relations are recorded during the simulation and compared to the healthy case. K E Y W O R D S cardiac resynchronization therapy, finite element analysis, heart electromechanics, left ventricular twist, personalized heart models

show abstract

Computational Modeling for Cardiac Resynchronization Therapy

Cited by 46 publications

References 149 publications

Patient-specific heart simulation can identify non-responders to cardiac resynchronization therapy

Patient-specific heart simulation can identify non-responders to cardiac resynchronization therapy

Multiscale simulation of the effects of atrioventricular block and valve diseases on heart performance

Towards predictive computer simulations in cardiology: Finite element analysis of personalized heart models

Contact Info

Product

Resources

About