Computer model for the optimization of AV and VV delay in cardiac resynchronization therapy

Reumann, Matthias; Farina, D.; Miri, R.; Lurz, S.; Osswald, Brigitte; Dössel, Olaf

doi:10.1007/s11517-007-0230-x

Cited by 28 publications

(22 citation statements)

References 25 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Despite its relevance, its structure and effects are commonly not considered in cardiac simulations. 33 Previous studies have attempted to model the Purkinje system (PS) following anatomical landmarks based on maps of the activation sequence. These maps helped determine roughly the Purkinje myocardial junctions (PMJ) which are contact points for electric impulse transmission between the PS and bulk myocardium.…”

Section: Introductionmentioning

confidence: 99%

“…34 Previous model studies on paced hearts include work focused on the electromechanical effects of pacing each ventricle, 17 or optimizing CRT pacemaker settings based on electrical information. 33 The study presented in this paper aims to elucidate changes in the activation pattern due to the interaction of CRT pacing and PS in normal and pathological human geometries. For this purpose, a specific CRT model was built which included a novel and more accurate modeling of the cardiac conduction system than previous approaches.…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Effects of the Purkinje System and Cardiac Geometry on Biventricular Pacing: A Model Study

et al. 2010

View full text Add to dashboard Cite

Abstract-Heart failure leads to gross cardiac structural changes. While cardiac resynchronization therapy (CRT) is a recognized treatment for restoring synchronous activation, it is not clear how changes in cardiac shape and size affect the electrical pacing therapy. This study used a human heart computer model which incorporated anatomical structures such as myofiber orientation and a Purkinje system (PS) to study how pacing affected failing hearts. The PS was modeled as a tree structure that reproduced its retrograde activation feature. In addition to a normal geometry, two cardiomyopathies were modeled: dilatation and hypertrophy.A biventricular pacing protocol was tested in the context of atrio-ventricular block. The contribution of the PS was examined by removing it, as well as by increasing endocardial conductivity. Results showed that retrograde conduction into the PS was a determining factor for achieving intraventricular synchrony. Omission of the PS led to an overestimate of the degree of electrical dyssynchrony while assessing CRT. The activation patterns for the three geometries showed local changes in the order of activation of the lateral wall in response to the same pacing strategy. These factors should be carefully considered when determining lead placement and optimizing device parameters in clinical practice.

show abstract

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Effects of the Purkinje System and Cardiac Geometry on Biventricular Pacing: A Model Study

et al. 2010

View full text Add to dashboard Cite

show abstract

“…2 The infarction was modeled by a spherical area of about 30 voxels volume including necrotic tissue with an excitation conduction velocity of zero in the center and a surrounding ischemic area with slower conduction velocity. 6,13,14,17 The LBBB was modeled with a disconnection in the excitation conduction system right behind the bundle of His in the left bundle. The simulated and measured 12 standard ECG channels are demonstrated in Fig.…”

Section: Clinical Measurements and The Pathological Modelingmentioning

confidence: 99%

Applicability of Body Surface Potential Map in Computerized Optimization of Biventricular Pacing

et al. 2010

Self Cite

View full text Add to dashboard Cite

Biventricular pacing (BVP) could be improved by identifying the patient-specific optimal electrode positions. Body surface potential map (BSPM) is a non-invasive technique for obtaining the electrophysiology and pathology of a patient. The study proposes the use of BSPM as input for an automated non-invasive strategy based on a personalized computer model of the heart, to identify the patient pathology and specific optimal treatment with BVP devices. The anatomy of a patient suffering from left bundle branch block and myocardial infarction is extracted from a series of MR data sets. The clinical measurements of BSPM are used to parameterize the computer model of the heart to represent the individual pathology. Cardiac electrophysiology is simulated with ten Tusscher cell model and excitation propagation is calculated with adaptive cellular automaton, at physiological and pathological conduction levels. The optimal electrode configurations are identified by evaluating the QRS error between healthy and pathology case with/without pacing. Afterwards, the simulated ECGs for optimal pacing are compared to the post-implantation clinically measured ECGs. Both simulation and clinical optimization methods identified the right ventricular (RV) apex and the LV posterolateral regions as being the optimal electrode configuration for the patient. The QRS duration is reduced both in measured and simulated ECG after implantation with 20 and 14%, respectively. The optimized electrode positions found by simulation are comparable to the ones used in hospital. The similarity in QRS duration reduction between measured and simulated ECG signals indicates the success of the method. The computer model presented in this work is a suitable tool to investigate individual pathologies. The personalized model could assist therapy planning of BVP in patients with congestive heart failure. The proposed method could be used as prototype for further clinically oriented investigations of computerized optimization of biventricular pacing.

show abstract

“…Mathematical models of cardiac electrical activity are important tools for evaluating heart conditions and pathological mechanisms [1,2,3]. Electrophysiological models of cardiac tissues describe how ion channels control the transmembrane potential of each cell and how this cellular action potential propagates across the heart.…”

Section: Introductionmentioning

confidence: 99%

Adaptive step ODE algorithms for the 3D simulation of electric heart activity with graphics processing units

Garcia-Mollá¹,

Liberos²,

Vidal³

et al. 2014

Computers in Biology and Medicine

View full text Add to dashboard Cite

ElsevierGarcía Mollá, VM.; Liberos Mascarell, A.; Vidal Maciá, AM.; Guillem Sánchez, MS.; Millet Roig, J.; González Salvador, A.; Gonzalez, A.... (2014). Adaptive step ODE algorithms for the 3D simulation of electric heart activity with graphics processing units. Computers in Biology and Medicine. 44:15-26. doi:10.1016/j.compbiomed.2013.10.023. Adaptive step ODE algorithms for the 3D simulation of electric heart activity with graphics processing units AbstractIn this paper we studied the implementation and performance of adaptive step methods for large systems of ordinary differential equations systems in Graphics Processing Units, focusing on the simulation of thre-dimensional electric cardiac activity. The RushLarsen method was applied in all of the implemented solvers to improve efficiency. We compared the adaptive methods with the fixed step methods, and we found that the fixed step methods can be faster while the adaptive step methods are better in terms of accuracy and robustness.

show abstract

Computer model for the optimization of AV and VV delay in cardiac resynchronization therapy

Cited by 28 publications

References 25 publications

Effects of the Purkinje System and Cardiac Geometry on Biventricular Pacing: A Model Study

Effects of the Purkinje System and Cardiac Geometry on Biventricular Pacing: A Model Study

Applicability of Body Surface Potential Map in Computerized Optimization of Biventricular Pacing

Adaptive step ODE algorithms for the 3D simulation of electric heart activity with graphics processing units

Contact Info

Product

Resources

About