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Abstract: Electric field of biventricular (BV) pacing, left ventricular (LV) electrode position and electrical interventricular desynchronization are important parameters for successful cardiac resynchronization therapy (CRT) in patients with heart failure, sinus rhythm and reduced LV ejection fraction. The aim of the study was to evaluate electric pacing field of transesophageal left atrial (LA) pacing and BV pacing with 3D heart rhythm simulation. Bipolar right atrial (RA), right ventricular (RV), LV electrodes and multipolar hemispherical esophageal LA electrodes were modeled with CST (Computer Simulation Technology, Darmstadt). Electric pacing field were simulated with bipolar RA and RV pacing with Solid S (Biotronik) electrode, bipolar LV pacing with Attain 4194 (Medtronic) electrode and bipolar LA pacing with TO8 (Osypka) esophageal electrode. 3D heart rhythm model with esophagus allowed electric pacing field simulation of 4-chamber pacing with bipolar intracardiac RA, RV, LV pacing and bipolar transesophageal LA pacing. The pacing amplitudes were 3V RA pacing amplitude, 50V LA pacing amplitude, 1.5V RV pacing amplitude and 3V LV pacing amplitude with 0.5ms pacing pulse duration. The atrioventricular delay between RA pacing and BV pacing was 140ms atrioventricular pacing delay and simultaneous RV and LV pacing. Electric pacing fields were simulated during the different pacing modes AAI, VVI, DDD and DDD0V. The intracardiac far-field pacing potentials were evaluated with intracardiac electrodes and a distance of 1mm from the electrodes with RA electrode 1.104V, RV electrode 0.703V and LV electrode 1.32V. The transesophageal far-field pacing potential was evaluated with transesophageal electrode and a distance of 10mm from the elelctrode with LA electrode 6.076V. Heart rhythm model simulation with esophagus allows evaluation of electric pacing fields in AAI, VVI, DDD, DDD0V and DDD0D pacing modes. Electric pacing field of RA, RV and LV pacing in combination with LA pacing may additional useful pacing mode in CRT non-responders.
The improvements in the hardware and software of communication devices have allowed running Virtual Reality (VR) and Augmented Reality (AR) applications on those. Nowadays, it is possible to overlay synthetic information on real images, or even to play 3D on-line games on smart phones or some other mobile devices. Hence the use of 3D data for business and specially for education purposes is ubiquitous. Due to always available at hand and always ready to use properties of mobile phones, those are considered as most potential communication devices. The total numbers of mobile phone users are increasing all over the world every day and that makes mobile phones the most suitable device to reach a huge number of end clients either for education or for business purposes. There are different standards, protocols and specifications to establish the communication among different communication devices but there is no initiative taken so far to make it sure that the send data through this communication process will be understood and used by the destination device. Since all the devices are not able to deal with all kind of 3D data formats and it is also not realistic to have different version of the same data to make it compatible with the destination device, it is necessary to have a prevalent solution. The proposed architecture in this paper describes a device and purpose independent 3D data visibility any time anywhere to the right person in suitable format. There is no solution without limitation. The architecture is implemented in a prototype to make an experimental validation of the architecture which also shows the difference between theory and practice.