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The Left and Right Ventricles Respond Differently to Variation of Pacing Delays in Cardiac Resynchronization Therapy: A Combined Experimental- Computational Approach

hal.structure.identifierCardiovascular Research Institute Maastricht [CARIM]
dc.contributor.authorWILLEMEN, Erik
hal.structure.identifierCardiovascular Research Institute Maastricht [CARIM]
dc.contributor.authorSCHREURS, Rick
hal.structure.identifierCardiovascular Research Institute Maastricht [CARIM]
dc.contributor.authorHUNTJENS, Peter
hal.structure.identifierMaastricht University Medical Centre [MUMC]
dc.contributor.authorSTRIK, Marc
hal.structure.identifierEuropean Space Research and Technology Centre [ESTEC]
dc.contributor.authorPLANK, Gernot
hal.structure.identifierModélisation et calculs pour l'électrophysiologie cardiaque [CARMEN]
dc.contributor.authorVIGMOND, Edward
hal.structure.identifierCardiovascular Research Institute Maastricht [CARIM]
dc.contributor.authorWALMSLEY, John
hal.structure.identifierMaastricht University [Maastricht]
dc.contributor.authorVERNOOY, Kevin
hal.structure.identifierCardiovascular Research Institute Maastricht [CARIM]
dc.contributor.authorDELHAAS, Tammo
hal.structure.identifierDepartment of Physiology [Maastricht]
dc.contributor.authorPRINZEN, Frits
hal.structure.identifierCardiovascular Research Institute Maastricht [CARIM]
dc.contributor.authorLUMENS, Joost
dc.date.accessioned2024-04-04T02:51:44Z
dc.date.available2024-04-04T02:51:44Z
dc.date.issued2019-02-01
dc.identifier.issn1664-042X
dc.identifier.urihttps://oskar-bordeaux.fr/handle/20.500.12278/192003
dc.description.abstractEnIntroduction: Timing of atrial, right (RV), and left ventricular (LV) stimulation in cardiac resynchronization therapy (CRT) is known to affect electrical activation and pump function of the LV. In this study, we used computer simulations, with input from animal experiments, to investigate the effect of varying pacing delays on both LV and RV electrical dyssynchrony and contractile function. Methods: A pacing protocol was performed in dogs with atrioventricular block (N = 6), using 100 different combinations of atrial (A)-LV and A-RV pacing delays. Regional LV and RV electrical activation times were measured using 112 electrodes and LV and RV pressures were measured with catheter-tip micromanometers. Contractile response to a pacing delay was defined as relative change of the maximum rate of LV and RV pressure rise (dP/dtmax) compared to RV pacing with an A-RV delay of 125 ms. The pacing protocol was simulated in the CircAdapt model of cardiovascular system dynamics, using the experimentally acquired electrical mapping data as input. Results: Ventricular electrical activation changed with changes in the amount of LV or RV pre-excitation. The resulting changes in dP/dtmax differed markedly between the LV and RV. Pacing the LV 10-50 ms before the RV led to the largest increases in LV dP/dtmax. In contrast, RV dP/dtmax was highest with RV pre-excitation and decreased up to 33% with LV pre-excitation. These opposite patterns of changes in RV and LV dP/dtmax were reproduced by the simulations. The simulations extended these observations by showing that changes in steady-state biventricular cardiac output differed from changes in both LV and RV dP/dtmax. The model allowed to explain the discrepant changes in dP/dtmax and cardiac output by coupling between atria and ventricles as well as between the ventricles. Conclusion: The LV and the RV respond in a opposite manner to variation in the amount of LV or RV pre-excitation. Computer simulations capture LV and RV behavior during pacing delay variation and may be used in the design of new CRT optimization studies.
dc.language.isoen
dc.publisherFrontiers
dc.subject.enCircAdapt
dc.subject.enCardiac resynchronization therapy
dc.subject.enComputer simulation
dc.subject.enDyssynchrony
dc.subject.enHemodynamics
dc.subject.enOptimization
dc.subject.enRight ventricle
dc.subject.enTherapy optimization studies
dc.title.enThe Left and Right Ventricles Respond Differently to Variation of Pacing Delays in Cardiac Resynchronization Therapy: A Combined Experimental- Computational Approach
dc.typeArticle de revue
dc.identifier.doi10.3389/fphys.2019.00017
dc.subject.halSciences du Vivant [q-bio]/Médecine humaine et pathologie/Cardiologie et système cardiovasculaire
bordeaux.journalFrontiers in Physiology
bordeaux.page17
bordeaux.volume10
bordeaux.hal.laboratoriesInstitut de Mathématiques de Bordeaux (IMB) - UMR 5251*
bordeaux.institutionUniversité de Bordeaux
bordeaux.institutionBordeaux INP
bordeaux.institutionCNRS
bordeaux.peerReviewedoui
hal.identifierhal-02885621
hal.version1
hal.popularnon
hal.audienceInternationale
hal.origin.linkhttps://hal.archives-ouvertes.fr//hal-02885621v1
bordeaux.COinSctx_ver=Z39.88-2004&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.jtitle=Frontiers%20in%20Physiology&rft.date=2019-02-01&rft.volume=10&rft.spage=17&rft.epage=17&rft.eissn=1664-042X&rft.issn=1664-042X&rft.au=WILLEMEN,%20Erik&SCHREURS,%20Rick&HUNTJENS,%20Peter&STRIK,%20Marc&PLANK,%20Gernot&rft.genre=article


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