TY - CHAP
T1 - His Bundle Pacing but not Left Bundle Pacing Corrects Septal Flash in Left Bundle Branch Block Patients
AU - Strocchi, Marina
AU - Neic, Aurel
AU - Gsell, Matthias A.F.
AU - Augustin, Christoph M.
AU - Bouyssier, Julien
AU - Gillette, Karli
AU - Elliot, Mark K.
AU - Gould, Justin S.
AU - Behar, Jonathan M.
AU - Sidhu, Baldeep
AU - Bishop, Martin J.
AU - Vigmond, Edward J.
AU - Plank, Gernot
AU - Rinaldi, Christopher A.
AU - Niederer, Steven A.
N1 - Funding Information:
This study received support from the UK Engineering and Physical Sciences Research Council (EP/M012492/1, NS/A000049/1, EP/L015226/1 and EP/P01268X/1), the Wellcome EPSRC Centre for Medical Engineering (NS/A000049/1and WT 203148/Z/16/Z), the British Heart Foundation (PG/15/91/31812 and PG/13/37/30280), and Kings Health Partners London National Institute for Health Research (NIHR) Biomedical Research Centre. Dr Vigmond E.J., Dr Bouyssier J. and Dr Plank G. were supported by the ERA-Net ERACoSysMed Co-Fund 2015 (ANR 15 CMED 0003 01) and the Austrian Science Fund (FWF) (PI2760-B30). Dr Vigmond E.J. and Dr Bouyssier J. were supported by the Investments of the Future program managed by the National Research Agency (ANR), Grant reference ANR-10-IAHU-04. Dr Augustin C. M. was supported by the Marie Skłodowska-Curie fellowship (GA No 750835) by the European Unions Horizon 2020 research and innovation program. Miss Strocchi M. was supported by an unrestricted Abbott educational grant through the Centre for Doctoral Training in Medical Imaging at Kings College London. This work made use of ARCHER, the UKs national high-performance computing service located at the University of Edinburgh and funded by the Office of Science and Technology through Engineering and Physi- cal Sciences Research Councils High End Computing Programme.
Publisher Copyright:
© 2020 Creative Commons; the authors hold their copyright.
Copyright:
Copyright 2021 Elsevier B.V., All rights reserved.
PY - 2020/9/13
Y1 - 2020/9/13
N2 - His bundle pacing (HBP) and left bundle pacing (LBP) are novel delivery methods for cardiac resynchronisation therapy (CRT) for left bundle branch block (LBBB) patients. Septal flash (SF), an abnormal pre-ejection motion of the septum towards the left ventricle (LV) arising from dyssynchronous activation, has been shown in the past to be a robust and independent predictor for CRT response. Although small-cohort studies showed the feasibility and efficacy of HBP and LBP, the effects of HBP and LBP on septal motion have yet to be investigated. In this study, we used our four-chamber heart electro-mechanics simulation framework to determine whether HBP and LBP can correct for SF. We performed simulations in four four-chamber heart models. In synchronous and LBBB activation, simulated mean lateral septal movement from the right ventricle (RV) into the LV was -0.4±0.5mm and - 3.7±0.9mm (p<0.05), respectively. HBP reduced septal motion to -0.4±0.5mm (p=0.5 when compared to synchronous activation). In LBP, septal motion was reversed to 0.9±0.5mm and significantly different from synchronous activation (p<0.05). HBP was better able to recover septal function over LBP in patients with complete atrioventricular block.
AB - His bundle pacing (HBP) and left bundle pacing (LBP) are novel delivery methods for cardiac resynchronisation therapy (CRT) for left bundle branch block (LBBB) patients. Septal flash (SF), an abnormal pre-ejection motion of the septum towards the left ventricle (LV) arising from dyssynchronous activation, has been shown in the past to be a robust and independent predictor for CRT response. Although small-cohort studies showed the feasibility and efficacy of HBP and LBP, the effects of HBP and LBP on septal motion have yet to be investigated. In this study, we used our four-chamber heart electro-mechanics simulation framework to determine whether HBP and LBP can correct for SF. We performed simulations in four four-chamber heart models. In synchronous and LBBB activation, simulated mean lateral septal movement from the right ventricle (RV) into the LV was -0.4±0.5mm and - 3.7±0.9mm (p<0.05), respectively. HBP reduced septal motion to -0.4±0.5mm (p=0.5 when compared to synchronous activation). In LBP, septal motion was reversed to 0.9±0.5mm and significantly different from synchronous activation (p<0.05). HBP was better able to recover septal function over LBP in patients with complete atrioventricular block.
UR - http://www.scopus.com/inward/record.url?scp=85100942270&partnerID=8YFLogxK
U2 - 10.22489/CinC.2020.030
DO - 10.22489/CinC.2020.030
M3 - Conference paper
AN - SCOPUS:85100942270
T3 - Computing in Cardiology
BT - 2020 Computing in Cardiology, CinC 2020
PB - IEEE Computer Society
T2 - 2020 Computing in Cardiology, CinC 2020
Y2 - 13 September 2020 through 16 September 2020
ER -