Title
A study of mechanical optimization strategy for cardiac resynchronization therapy based on an electromechanical model.
Abstract
An optimal electrode position and interventricular (VV) delay in cardiac resynchronization therapy (CRT) improves its success. However, the precise quantification of cardiac dyssynchrony and magnitude of resynchronization achieved by biventricular (BiV) pacing therapy with mechanical optimization strategies based on computational models remain scant. The maximum circumferential uniformity ratio estimate (CURE) was used here as mechanical optimization index, which was automatically computed for 6 different electrode positions based on a three-dimensional electromechanical canine model of heart failure (HF) caused by complete left bundle branch block (CLBBB). VV delay timing was adjusted accordingly. The heart excitation propagation was simulated with a monodomain model. The quantification of mechanical intra-and interventricular asynchrony was then investigated with eight-node isoparametric element method. The results showed that (i) the optimal pacing location from maximal CURE of 0.8516 was found at the left ventricle (LV) lateral wall near the equator site with a VV delay of 60 ms, in accordance with current clinical studies, (ii) compared with electrical optimization strategy of E-RMS, the LV synchronous contraction and the hemodynamics improved more with mechanical optimization strategy. Therefore, measures of mechanical dyssynchrony improve the sensitivity and specificity of predicting responders more. The model was subject to validation in future clinical studies.
Year
DOI
Venue
2012
10.1155/2012/948781
COMPUTATIONAL AND MATHEMATICAL METHODS IN MEDICINE
Keywords
Field
DocType
heart,electrophysiology,automation,algorithms,diagnostic imaging,computational biology,electrodes
Hemodynamics,Asynchrony,Left bundle branch block,Heart failure,Monodomain model,Computer science,Internal medicine,Medical imaging,Cardiology,Ventricle,Cardiac resynchronization therapy
Journal
Volume
Issue
ISSN
2012
null
1748-670X
Citations 
PageRank 
References 
0
0.34
2
Authors
9
Name
Order
Citations
PageRank
Jianhong Dou100.68
Ling Xia2319.07
Dongdong Deng3543.49
Yunliang Zang400.34
Guofa Shou5406.90
Cesar Bustos600.34
Weifeng Tu700.34
Feng Liu88219.52
Stuart Crozier913014.02