Abstract
Lead placement in cardiac resynchronization therapy (CRT) has been identified as an important variable that can potentially be manipulated at the time of implantation. Recent studies have demonstrated the variability of the acute hemodynamic response of patients to different lead positions and have proposed different strategies to identify the optimal lead location. In clinical studies of lead position the maximum rate of pressure development is used as a single scalar measure of the efficacy of an individual pacing location, despite limited clinical evidence that this correlates with long term outcomes. In this study, we use a patient-specific computational model to evaluate metrics of cardiac function for different lead positions. The model predicts a large, common, optimal location for all evaluated metrics. This supports use of the maximum rate of pressure development as a representation of general cardiac function for optimizing CRT.
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Niederer, S., Plank, G., Rezavi, R., Rinaldi, A., Smith, N. (2012). The Dependence of Clinical Metrics of Cardiac Function on Lead Position in Cardiac Resynchronization Therapy: A Biophysical Modeling Study. In: Nielsen, P., Wittek, A., Miller, K. (eds) Computational Biomechanics for Medicine. Springer, New York, NY. https://doi.org/10.1007/978-1-4614-3172-5_3
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DOI: https://doi.org/10.1007/978-1-4614-3172-5_3
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