A study of mechanical optimization strategy for cardiac resynchronization therapy based on an electromechanical model

Dou, Jianhong, Xia, Ling, Deng, Dongdong, Zang, Yunliang, Shou, Guofa, Bustos, Cesar, Tu, Weifeng, Liu, Feng and Crozier, Stuart (2012) A study of mechanical optimization strategy for cardiac resynchronization therapy based on an electromechanical model. Computational and Mathematical Methods in Medicine, 2012 : 948781.1-948781.13.


Author Dou, Jianhong
Xia, Ling
Deng, Dongdong
Zang, Yunliang
Shou, Guofa
Bustos, Cesar
Tu, Weifeng
Liu, Feng
Crozier, Stuart
Title A study of mechanical optimization strategy for cardiac resynchronization therapy based on an electromechanical model
Journal name Computational and Mathematical Methods in Medicine  (ERA 2012 Listed)    (ERA 2010 Rank A*)   Check publisher's open access policy
Publication date 2012
Sub-type Article
DOI 10.1155/2012/948781
Volume number 2012
ISSN 1748-670X
Start page 948781.1
End page 948781.13
Total pages 13
Place of publication New York, United States
Publisher Hindawi Publishing
Collection year 2013
Language eng
Formatted 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 ERMS, 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.
Q-Index Code C1
Q-Index Status Confirmed Code
Institutional Status UQ
Additional Notes Article ID 948781

Document type: Journal Article
Sub-type: Article
Collections: Official 2013 Collection
School of Information Technology and Electrical Engineering Publications
 
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