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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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Metadaten
Document Type:Article (reviewed)
Zitierlink: https://opus.hs-offenburg.de/4314
Bibliografische Angaben
Title (English):Electrode Model and Simulation of His-Bundle Pacing for Cardiac Resynchronization Therapy
Author:Domenic PascualORCiD, Matthias HeinkeStaff MemberORCiDGND, Reinhard EchleStaff MemberGND, Johannes HörthStaff MemberGND
Year of Publication:2020
Publisher:De Gruyter
Page Number:4
First Page:555
Last Page:558
Parent Title (English):Current Directions in Biomedical Engineering
Volume:6
Issue:3
ISSN:2364-5504
DOI:https://doi.org/10.1515/cdbme-2020-3142
URL:https://www.degruyter.com/view/journals/cdbme/6/3/article-p555.xml
Language:English
Inhaltliche Informationen
Institutes:Fakultät Elektrotechnik, Medizintechnik und Informatik (EMI) (ab 04/2019)
Institutes:Bibliografie
GND Keyword:Cardiac Resynchronization Therapy; Cardiac modelling; Heart rhythm simulation; His-bundle pacing; Physiological cardiac pacing
Formale Angaben
Open Access: Open Access 
Licence (German):License LogoCreative Commons - CC BY - Namensnennung 4.0 International
Comment:
Proceedings of the 2020 Annual Meeting of the German Society of Biomedical Engineering (29 September – 1 October 2020, Leipzig)