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

  • A disturbed synchronization of the ventricular contraction can cause a highly developed systolic heart failure in affected patients with reduction of the left ventricular ejection fraction, 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. TheA disturbed synchronization of the ventricular contraction can cause a highly developed systolic heart failure in affected patients with reduction of the left ventricular ejection fraction, 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. 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. The non-responder rate of the CRT therapy is about one third of the CRT patients. 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 Hisbundle 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. Compared to conventional 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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Author:Domenic Pascual, Matthias HeinkeGND, Reinhard EchleGND, Johannes Hörth
Publisher:De Gruyter
Year of Publication:2020
Pagenumber:4
Language:English
GND Keyword:Cardiac Resynchronization Therapy; Cardiac modelling; Heart rhythm simulation; His-bundle pacing; Physiological cardiac pacing
Parent Title (English):Current Directions in Biomedical Engineering
Volume:6
Issue:3
ISSN:2364-5504
First Page:555
Last Page:558
Document Type:Article (reviewed)
Open Access:Frei zugänglich
Institutes:Bibliografie
Release Date:2020/12/07
Licence (German):License LogoCreative Commons - CC BY - Namensnennung 4.0 International
Note:
Proceedings of the 2020 Annual Meeting of the German Society of Biomedical Engineering (29 September – 1 October 2020, Leipzig)
URL:https://www.degruyter.com/view/journals/cdbme/6/3/article-p555.xml
DOI:https://doi.org/10.1515/cdbme-2020-3142