Computer Modelling for Better Diagnosis and Therapy of Patients by Cardiac Resynchronisation Therapy

Abstract

Mathematical or computer models have become increasingly popular in biomedical science. Although they are a simplification of reality, computer models are able to link a multitude of processes to each other. In the fields of cardiac physiology and cardiology, models can be used to describe the combined activity of all ion channels (electrical models) or contraction-related processes (mechanical models) in potentially millions of cardiac cells. Electromechanical models go one step further by coupling electrical and mechanical processes and incorporating mechano-electrical feedback. The field of cardiac computer modelling is making rapid progress due to advances in research and the ever-increasing calculation power of computers. Computer models have helped to provide better understanding of disease mechanisms and treatment. The ultimate goal will be to create patient-specific models using diagnostic measurements from the individual patient. This paper gives a brief overview of computer models in the field of cardiology and mentions some scientific achievements and clinical applications, especially in relation to cardiac resynchronisation therapy (CRT).

Keywords: Computer model; bidomain model; cardiac resynchronisation therapy; finite element model; heart failure; monodomain model.

Figure 1:. Einthoven’s Triangle as an Example of a Simple Model

Figure 2:. Simplified Representation of a Bidomain Model

Figure 3:. Comparison of Measured and Simulated Data in One Patient

Figure 4:. Results from a Biventricular FEM Based on the LV FEM32 During Normal Sinus Rhythm, Left Bundle Branch Block and Biventricular Pacing

Figure 5:. Measured and Simulated Septal Deformation Patterns for a Normal Healthy Subject (NORMAL) and Three Representative Patients (LBBB-1, LBBB-2 and LBBB-3)

Figure 6:. Whole-heart Modelling