OPTIMIZING A-V AND V-V DELAY IN CARDIAC RESYNCHRONIZATION THERAPY IN SIMULATIONS INCLUDING VENTRICLE HETEROGENEITY

摘要

Congestive heart failure (CHF) is affecting more than 15 million people in the western population with an increasing number. Biventricular pacing as Cardiac Resynchroniza-tion Therapy (CRT) is a recognized therapy for the treatment of heart failure. The present paper investigates the optimal pacing sites and stimuli delays for stimulation, based on a complex three-dimensional computer model of the human heart. The anatomical features were derived from the Visible Man data set. The excitation propagation and intra-ventricular conduction were simulated with Ten Tusscher electrophysiological cell model and an adaptive cellular automaton. Biventricular pacing in AV block III and LBBB with different interventricular conduction delays were investigated. The simulated activation times of different my-ocytes in the healthy and diseased heart model are compared in terms of root mean square error (E_(RMS))- The outcomes of the investigation underline that the positioning of the electrodes considering a proper atrioventricular and intraventricular delay influences the efficiency of the resynchronization therapy. The results of this optimization strategy may assist the surgeon in therapy planning.