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Journal of cardiovascular electrophysiology v.28 no.2, 2017년, pp.208 - 215   SCI SCIE
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Biophysical Modeling to Determine the Optimization of Left Ventricular Pacing Site and AV/VV Delays in the Acute and Chronic Phase of Cardiac Resynchronization Therapy

LEE, ANGELA W. C. (Division of Imaging Sciences and Biomedical Engineering, King's College London, London, UK ) ; CROZIER, ANDREW (Institute of Biophysics, Medical University of Graz, Graz, Austria ) ; HYDE, EOIN R. (Division of Imaging Sciences and Biomedical Engineering, King's College London, London, UK ) ; LAMATA, PABLO (Division of Imaging Sciences and Biomedical Engineering, King's College London, London, UK ) ; TRUONG, MICHAEL (Division of Imaging Sciences and Biomedical Engineering, King's College London, London, UK ) ; SOHAL, MANAV (Division of Imaging Sciences and Biomedical Engineering, King's College London, London, UK ) ; JACKSON, THOMAS (Division of Imaging Sciences and Biomedical Engineering, King's College London, London, UK ) ; BEHAR, JONATHAN M. (Division of Imaging Sciences and Biomedical Engineering, King's College London, London, UK ) ; CLARIDGE, SIMON ; SHETTY, ANOOP ; SAMMUT, EVA ; PLANK, GERNOT ; RINALDI, CHRISTOPHER ALDO ; NIEDERER, STEVEN ;
  • 초록  

    Device Optimization for Acute and Chronic CRT Background Cardiac anatomy and function adapt in response to chronic cardiac resynchronization therapy (CRT). The effects of these changes on the optimal left ventricle (LV) lead location and timing delay settings have yet to be fully explored. Objective To predict the effects of chronic CRT on the optimal LV lead location and device timing settings over time. Methods Biophysical computational cardiac models were generated for 3 patients, immediately post‐implant (ACUTE) and after at least 6 months of CRT (CHRONIC). Optimal LV pacing area and device settings were predicted by pacing the ACUTE and CHRONIC models across the LV epicardium (49 sites each) with a range of 9 pacing settings and simulating the acute hemodynamic response (AHR) of the heart. Results There were statistically significant differences between the distribution of the AHR in the ACUTE and CHRONIC models (P Conclusion Optimization of the LV pacing location and device settings were important at the time of implant, with a reduced benefit over time, where the majority of the acute optimal LV pacing region and device settings remained optimal with chronic CRT.


  • 주제어

    atrioventricular delay .   cardiac resynchronization therapy .   computer modeling/simulations .   interventricular delay .   left bundle branch block .   left ventricular lead placement.  

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