Computer assisted optimization of cardiac resynchronization therapy

308 Pages·2008·11.576 MB·English

by  Raz Miri

Universität Karlsruhe (TH) Karlsruhe Transactions on Biomedical Engineering
Institute of Biomedical Engineering
Vol. 6
The efficacy of cardiac resynchronization therapy (CRT) through y Raz Miri
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biventricular pacing (BVP) has been demonstrated by numerous r
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studies in patients suffering from congestive heart failure. In T

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order to achieve a guideline for optimal treatment with BVP o Computer Assisted Optimization of
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devices, an automated non-invasive strategy based on an elect-
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n Cardiac Resynchronization Therapy
rophysiological computer model of the heart is presented. The o
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presented research investigates an off-line optimization algo- c
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rithm based on different electrode positioning and timing delays. s
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A computer model of the heart was used to simulate the left R

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bundle branch block (LBBB), myocardial infarction (MI) and a
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reduction of intraventricular conduction velocity. The optimiza- a
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tion method evaluates the error between the healthy case and
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the pathology with/without pacing case in terms of activation n
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times and QRS duration.The clinical measurements of body at
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surface potential map (BSPM) are used to parameterize the m
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t
computer model of the heart to represent the individual patho- p
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logy by solving the inverse problem, which leads to a more rea- d
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t
listic heart model for simulations. Afterwards, the simulated s
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s
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ECGs for optimal pacing are compared to the measured ECGs A

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after implantation. The similarity in the QRS duration between e
t
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measured and simulated ECG signals indicates the success of p
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the method. o
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ISSN: 1864-5933 i
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ISBN: 978-3-86644-360-0

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www.uvka.de R

Raz Miri
Computer Assisted Optimization of Cardiac Resynchronization
Therapy
Vol. 6
Karlsruhe Transactions on Biomedical Engineering
Editor:
Universität Karlsruhe (TH)
Institute of Biomedical Engineering
Computer Assisted Optimization of
Cardiac Resynchronization Therapy
by
Raz Miri
Dissertation, Universität Karlsruhe (TH)
Fakultät für Elektrotechnik und Informationstechnik, 2008
Impressum
Universitätsverlag Karlsruhe
c/o Universitätsbibliothek
Straße am Forum 2
D-76131 Karlsruhe
www.uvka.de
Dieses Werk ist unter folgender Creative Commons-Lizenz
lizenziert: http://creativecommons.org/licenses/by-nc-nd/3.0/de/
Universitätsverlag Karlsruhe 2009
Print on Demand
ISSN: 1864-5933
ISBN: 978-3-86644-360-0

Computer Assisted Optimization
of Cardiac Resynchronization
Therapy
Zur Erlangung des akademischen Grades eines
DOKTOR-INGENIEURS
an der Fakult¨at fu¨r
Elektrotechnik und Informationstechnik
der Universit¨at Fridericiana Karlsruhe
genehmigte
DISSERTATION
von
M. Sc. Raz Miri
geboren in Teheran
Tag der mu¨ndlichen Pru¨fung: 8. Dezember 2008
Hauptreferent: Prof. Dr. rer. nat. Olaf D¨ossel
Korreferenten: Prof. Dr. med. Christian Wolpert
Prof. i. R. Dr.-Ing. Karsten Meyer-Waarden