His Bundle Pacing but not Left Bundle Pacing Corrects Septal Flash in Left Bundle Branch Block Patients

Marina Strocchi; Aurel Neic; Matthias A.F. Gsell; Christoph M. Augustin; Julien Bouyssier; Karli Gillette; Mark K. Elliot; Justin S. Gould; Jonathan M. Behar; Baldeep Sidhu; Martin J. Bishop; Edward J. Vigmond; Gernot Plank; Christopher A. Rinaldi; Steven A. Niederer

doi:10.22489/CinC.2020.030

His Bundle Pacing but not Left Bundle Pacing Corrects Septal Flash in Left Bundle Branch Block Patients

Marina Strocchi^*, Aurel Neic, Matthias A.F. Gsell, Christoph M. Augustin, Julien Bouyssier, Karli Gillette, Mark K. Elliot, Justin S. Gould, Jonathan M. Behar, Baldeep Sidhu, Martin J. Bishop, Edward J. Vigmond, Gernot Plank, Christopher A. Rinaldi, Steven A. Niederer

^*Corresponding author for this work

Research output: Chapter in Book/Report/Conference proceeding › Conference paper › peer-review

1 Citation (Scopus)

Abstract

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.

Original language	English
Title of host publication	2020 Computing in Cardiology, CinC 2020
Publisher	IEEE Computer Society
ISBN (Electronic)	9781728173825
DOIs	https://doi.org/10.22489/CinC.2020.030
Publication status	Published - 13 Sept 2020
Event	2020 Computing in Cardiology, CinC 2020 - Rimini, Italy Duration: 13 Sept 2020 → 16 Sept 2020

Publication series

Name	Computing in Cardiology
Volume	2020-September
ISSN (Print)	2325-8861
ISSN (Electronic)	2325-887X

Conference

Conference	2020 Computing in Cardiology, CinC 2020
Country/Territory	Italy
City	Rimini
Period	13/09/2020 → 16/09/2020

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10.22489/CinC.2020.030

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Strocchi, M., Neic, A., Gsell, M. A. F., Augustin, C. M., Bouyssier, J., Gillette, K., Elliot, M. K., Gould, J. S., Behar, J. M., Sidhu, B., Bishop, M. J., Vigmond, E. J., Plank, G., Rinaldi, C. A., & Niederer, S. A. (2020). His Bundle Pacing but not Left Bundle Pacing Corrects Septal Flash in Left Bundle Branch Block Patients. In 2020 Computing in Cardiology, CinC 2020 Article 9344205 (Computing in Cardiology; Vol. 2020-September). IEEE Computer Society. https://doi.org/10.22489/CinC.2020.030

@inbook{d878f368c8d0418d9f5ebb79ef40dfd8,

title = "His Bundle Pacing but not Left Bundle Pacing Corrects Septal Flash in Left Bundle Branch Block Patients",

abstract = "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.",

author = "Marina Strocchi and Aurel Neic and Gsell, {Matthias A.F.} and Augustin, {Christoph M.} and Julien Bouyssier and Karli Gillette and Elliot, {Mark K.} and Gould, {Justin S.} and Behar, {Jonathan M.} and Baldeep Sidhu and Bishop, {Martin J.} and Vigmond, {Edward J.} and Gernot Plank and Rinaldi, {Christopher A.} and Niederer, {Steven A.}",

note = "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 Sk{\l}odowska-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: {\textcopyright} 2020 Creative Commons; the authors hold their copyright. Copyright: Copyright 2021 Elsevier B.V., All rights reserved.; 2020 Computing in Cardiology, CinC 2020 ; Conference date: 13-09-2020 Through 16-09-2020",

year = "2020",

month = sep,

day = "13",

doi = "10.22489/CinC.2020.030",

language = "English",

series = "Computing in Cardiology",

publisher = "IEEE Computer Society",

booktitle = "2020 Computing in Cardiology, CinC 2020",

address = "United States",

}

Strocchi, M, Neic, A, Gsell, MAF, Augustin, CM, Bouyssier, J, Gillette, K, Elliot, MK, Gould, JS , Behar, JM , Sidhu, B , Bishop, MJ, Vigmond, EJ, Plank, G, Rinaldi, CA & Niederer, SA 2020, His Bundle Pacing but not Left Bundle Pacing Corrects Septal Flash in Left Bundle Branch Block Patients. in 2020 Computing in Cardiology, CinC 2020., 9344205, Computing in Cardiology, vol. 2020-September, IEEE Computer Society, 2020 Computing in Cardiology, CinC 2020, Rimini, Italy, 13/09/2020. https://doi.org/10.22489/CinC.2020.030

His Bundle Pacing but not Left Bundle Pacing Corrects Septal Flash in Left Bundle Branch Block Patients. / Strocchi, Marina; Neic, Aurel; Gsell, Matthias A.F. et al.
2020 Computing in Cardiology, CinC 2020. IEEE Computer Society, 2020. 9344205 (Computing in Cardiology; Vol. 2020-September).

Research output: Chapter in Book/Report/Conference proceeding › Conference paper › peer-review

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.

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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 -

His Bundle Pacing but not Left Bundle Pacing Corrects Septal Flash in Left Bundle Branch Block Patients

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