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Electrode Model and Simulation of His Bundle Pacing for Cardiac Resynchronization Therapy

  • Background: A disturbed synchronization of the ventricular contraction can cause a highly developed systolic heart failure in affected patients, which can often be explained by a diseased left bundle branch block (LBBB). If medication remains unresponsive, the concerned patients will be treated with a cardiac resynchronization therapy (CRT) system. The aim of this study was to integrate His bundleBackground: A disturbed synchronization of the ventricular contraction can cause a highly developed systolic heart failure in affected patients, which can often be explained by a diseased left bundle branch block (LBBB). If medication remains unresponsive, the concerned patients will be treated with a cardiac resynchronization therapy (CRT) system. The aim of this study was to integrate His bundle pacing into the Offenburg heart rhythm model in order to visualize the electrical pacing field generated by His bundle pacing. Methods: Modelling and electrical field simulation activities were performed with the software CST (Computer Simulation Technology) from Dessault Systèms. CRT with biventricular pacing is to be achieved by an apical right ventricular electrode and an additional left ventricular electrode, which is floated into the coronary vein sinus. This conventional type of biventricular pacing leads to a reduction of the left ventricular ejection fraction. Furthermore, the non-responder rate of the CRT therapy is about one third of the CRT patients. Results: His bundle pacing represents a physiological alternative to conventional cardiac pacing and cardiac resynchronization. An electrode implanted in the His bundle emits a stronger electrical pacing field than the electrical pacing field of conventional cardiac pacemakers. The pacing of the His bundle was performed by the Medtronic Select Secure 3830 electrode with pacing voltage amplitudes of 3 V, 2 V and 1.5 V in combination with a pacing pulse duration of 1 ms. Conclusions: Compared to conventional cardiac pacemaker pacing, His bundle pacing is capable of bridging LBBB conduction disorders in the left ventricle. The His bundle pacing electrical field is able to spread via the physiological pathway in the right and left ventricles for CRT with a narrow QRS-complex in the surface ECG.show moreshow less

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Metadaten
Document Type:Conference Proceeding
Conference Type:Konferenz-Poster
Zitierlink: https://opus.hs-offenburg.de/4484
Bibliografische Angaben
Title (English):Electrode Model and Simulation of His Bundle Pacing for Cardiac Resynchronization Therapy
Conference:BMT 2020: Annual Conference of the German Society for Biomedical Engineering / DGBMT Jahrestagung (54. : 29. September – 1. Oktober 2020 : Leipzig)
Author:Domenic PascualORCiD, Matthias HeinkeStaff MemberORCiDGND, Reinhard EchleStaff MemberGND, Johannes HörthStaff MemberGND
Year of Publication:2020
Creating Corporation:Joint Journal of the German Society for Biomedical Engineering in VDE and the Austrian and Swiss Societies for Biomedical Engineering and the German Society of Biomaterials
Place of publication:Berlin, Boston
Publisher:Walter de Gruyter
Page Number:1
First Page:258
Parent Title (English):Biomedical Engineering / Biomedizinische Technik
Volume:65
Issue:s1
ISSN:1862-278X (Online)
ISSN:0013-5585 (Print)
DOI:https://doi.org/10.1515/bmt-2020-6044
URL:https://www.degruyter.com/view/journals/bmte/65/s1/article-p255.xml
Language:English
Inhaltliche Informationen
Institutes:Fakultät Elektrotechnik, Medizintechnik und Informatik (EMI) (ab 04/2019)
Institutes:Bibliografie
DDC classes:600 Technik, Medizin, angewandte Wissenschaften
Tag:3D-Modelling; Cardiac Resynchronization Therapy; Heart Rhythm Simulation; His-Bundle Pacing; Physiological Pacing
Formale Angaben
Open Access: Open Access 
Licence (German):License LogoUrheberrechtlich geschützt