New Case Report: Intra-procedural evaluation of Computational Modeling Method for CRT

Buliard et al., Intra-procedural evaluation of a computational modelling method for cardiac resynchronization therapy, EP Europace, Volume 22, Issue 4, April 2020, Page 656, https://doi.org/10.1093/europace/euz239

With the team we developed a way to measure response to cardiac resynchronization therapy (CRT). CRT is a common tool used in cardiac electrophysiology (CEP), but it relies on perfect placement of the left ventricular (LV) lead. Our research team has been working on a project that evaluates how simulations can be incorporated into CEP for better lead implantation. Our case report, published in EP Europace, explores the guidance of LV lead implantation using intra-procedural CEP simulations.

To do this, we first made a computational model of CEP based on each individual patient’s cardiac MRI and ECG about one day before the CRT. During the procedure, we implanted a CRT system with a quadripolar LV lead. Using each patient’s individual data, we updated the model. We were able to sense ventricular delays and epicardial activation. We changed LV lead positions and AV delays to evaluate 6 different CRT protocols. We then simulated CRT.

We found that there was excellent agreement between the actual QRS duration and the QRS duration we had predicted. These results show that it could be possible to use computational simulations of CEP intraprocedurally to guide CRT!