His-bundle and left bundle pacing with optimized atrioventricular delay achieve superior electrical synchrony over endocardial and epicardial pacing in left bundle branch block patients

Strocchi, Marina; Lee, Angela W.C.; Neic, Aurel; Bouyssier, Julien; Gillette, Karli; Elliott, Mark K.; Gould, Justin; Behar, Jonathan M.; Sidhu, Baldeep S.; Mehta, Vishal; Bishop, Martin J.; Vigmond, Edward J.; Rinaldi, Christopher A.; Niederer, Steven

doi:10.1016/j.hrthm.2020.06.028

Cited by 51 publications

(49 citation statements)

References 33 publications

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“…conducting myocardium might restore native synchronous activation and lead to better ventricular function. Although small-cohort and single patient studies showed the feasibility and efficacy of both HBP and LBP in restoring electrical synchrony of the heart [2], there is still a lot to be understood about their effects on heart function. Furthermore, there are indications of negative effects of LBP on the right ventricle (RV) that have yet to be investigated.…”

Section: End-diastolementioning

confidence: 99%

“…A His-Purkinje system was generated on the LV and RV endocardial surfaces of each mesh using an open source code (https://github.com/fsahli/ fractal-tree), Figure 2. The Purkinje system was coupled with ventricular myocardium by connecting each terminal node of the Purkinje with the surrounding myocardium nodes to allow for stimulus propagation from the His-Purkinje network to the myocardium and viceversa [2]. We simulated LBBB by cutting the connection of the LV Purkinje system with the rest of the network along the His bundle.…”

Section: Model Generationmentioning

confidence: 99%

“…Ventricular myocardium was modelled as a transversely isotropic medium with the preferred direction of propagation aligned with the local myofibre orientation. Ventricular myocardium conduction velocity (CV) was set to 0.6m/s and 0.24m/s in the fibre and transverse direction [2], respectively. CV of the His-Purkinje tree was set to 4.0m/s [2].…”

Section: Electro-mechanics Simulationmentioning

confidence: 99%

“…Ventricular myocardium conduction velocity (CV) was set to 0.6m/s and 0.24m/s in the fibre and transverse direction [2], respectively. CV of the His-Purkinje tree was set to 4.0m/s [2].…”

Section: Electro-mechanics Simulationmentioning

confidence: 99%

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His Bundle Pacing but not Left Bundle Pacing Corrects Septal Flash in Left Bundle Branch Block Patients

Strocchi

Neic²,

Gsell

et al. 2020

2020 Computing in Cardiology Conference (CinC)

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His bundle pacing (HBP) and left bundle pacing (LBP) are novel delivery methods for cardiac resynchronisation therapy (CRT) for left bundle branch block (LBBB) patients. Septal flash (SF), an abnormal pre-ejection motion of the septum towards the left ventricle (LV) arising from dyssynchronous activation, has been shown in the past to be a robust and independent predictor for CRT response. Although small-cohort studies showed the feasibility and efficacy of HBP and LBP, the effects of HBP and LBP on septal motion have yet to be investigated. In this study, we used our four-chamber heart electro-mechanics simulation framework to determine whether HBP and LBP can correct for SF. We performed simulations in four fourchamber heart models. In synchronous and LBBB activation, simulated mean lateral septal movement from the right ventricle (RV) into the LV was-0.4±0.5mm and-3.7±0.9mm (p<0.05), respectively. HBP reduced septal motion to-0.4±0.5mm (p=0.5 when compared to synchronous activation). In LBP, septal motion was reversed to 0.9±0.5mm and significantly different from synchronous activation (p<0.05). HBP was better able to recover septal function over LBP in patients with complete atrioventricular block.

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Section: End-diastolementioning

confidence: 99%

Section: Model Generationmentioning

confidence: 99%

Section: Electro-mechanics Simulationmentioning

confidence: 99%

“…Ventricular myocardium conduction velocity (CV) was set to 0.6m/s and 0.24m/s in the fibre and transverse direction [2], respectively. CV of the His-Purkinje tree was set to 4.0m/s [2].…”

Section: Electro-mechanics Simulationmentioning

confidence: 99%

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His Bundle Pacing but not Left Bundle Pacing Corrects Septal Flash in Left Bundle Branch Block Patients

Strocchi

Neic²,

Gsell

et al. 2020

2020 Computing in Cardiology Conference (CinC)

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“…Therefore, LBBP has emerged as a novel technique that can directly capture the left bundle branch (LBB) or LBB area by a transventricular septal approach 4 . Different from HBP, LBBP induced a right bundle branch block (RBBB) morphology while shortening the stimuluspeak left ventricular activation time (stim-LVAT), which represents the negative effect of LBBP on right ventricular activation 5 . However, there is only limited information about LBBP performed on patients with RBBB.…”

Section: Introductionmentioning

confidence: 98%

Left bundle branch pacing in patients with right bundle branch block

Zhu

Sun

Cai

et al. 2021

Preprint

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Background The paced morphology of right bundle branch block (RBBB) pattern is one of the parameters which can be used to confirm the left bundle branch capture during left bundle branch pacing (LBBP) implantation. However, changes of paced morphology after LBBP performed in patients with RBBB have not been well discussed. Objective To compare the paced morphology in patients with RBBB before and after LBBP and to discuss the possible mechanisms behind such changes. Methods Patients with RBBB who underwent LBBP implantation were selected. The QRS duration was measured before and after the implantation of LBBP for each patient and compared Student t test. Results We included 34 consecutive patients (median age 72.76 years, 73.53% male), of whom 3 had sick sinus syndrome (SSS) and 31 had high-grade atrioventricular conduction block (AVB). The average QRS duration was 144.87±5.22ms before LBBP implantation and 116.18±6.15ms after LBBP implantation, with a mean decrease in QRS duration of 28.70±3.30ms (95% CI: 27.55-29.85 ms, P < 0.01). Conclusion In patients with RBBB, the QRS duration after LBBP is narrower than that before LBBP. The specific mechanism is still unclear.

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A Semi-automatic Pipeline for Generation of Large Cohorts of Four-Chamber Heart Meshes

Strocchi,

Rodero,

Roney

et al. 2023

Methods in Molecular Biology

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His-bundle and left bundle pacing with optimized atrioventricular delay achieve superior electrical synchrony over endocardial and epicardial pacing in left bundle branch block patients

Cited by 51 publications

References 33 publications

His Bundle Pacing but not Left Bundle Pacing Corrects Septal Flash in Left Bundle Branch Block Patients

His Bundle Pacing but not Left Bundle Pacing Corrects Septal Flash in Left Bundle Branch Block Patients

Left bundle branch pacing in patients with right bundle branch block

A Semi-automatic Pipeline for Generation of Large Cohorts of Four-Chamber Heart Meshes

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