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152. AntagomiR-103 and -107 Treatment Affects Cardiac Function and Metabolism

Author

Rech, Monika, primary, Kuhn, Annika R., additional, Lumens, Joost, additional, Carai, Paolo, additional, van Leeuwen, Rick, additional, Verhesen, Wouter, additional, Verjans, Robin, additional, Lecomte, Julie, additional, Liu, Yilin, additional, Luiken, Joost J.F.P., additional, Mohren, Ronny, additional, Cillero-Pastor, Berta, additional, Heymans, Stephane, additional, Knoops, Kèvin, additional, van Bilsen, Marc, additional, and Schroen, Blanche, additional

Published
2019
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154. The Left and Right Ventricles Respond Differently to Variation of Pacing Delays in Cardiac Resynchronization Therapy: A Combined Experimental- Computational Approach

Author

Willemen, Erik, primary, Schreurs, Rick, additional, Huntjens, Peter R., additional, Strik, Marc, additional, Plank, Gernot, additional, Vigmond, Edward, additional, Walmsley, John, additional, Vernooy, Kevin, additional, Delhaas, Tammo, additional, Prinzen, Frits W., additional, and Lumens, Joost, additional

Published
2019
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155. Relative Impact of Right Ventricular Electromechanical Dyssynchrony Versus Pulmonary Regurgitation on Right Ventricular Dysfunction and Exercise Intolerance in Patients After Repair of Tetralogy of Fallot

Author

Lumens, Joost, primary, Fan, Chun‐Po Steve, additional, Walmsley, John, additional, Yim, Deane, additional, Manlhiot, Cedric, additional, Dragulescu, Andreea, additional, Grosse‐Wortmann, Lars, additional, Mertens, Luc, additional, Prinzen, Frits W., additional, Delhaas, Tammo, additional, and Friedberg, Mark K., additional

Published
2019
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157. Adding Speckle-Tracking Echocardiography to Visual Assessment of Systolic Wall Motion Abnormalities Improves the Detection of Myocardial Infarction

Author

van Mourik, Manouk J.W., primary, Zaar, Daniëlle V.J., additional, Smulders, Martijn W., additional, Heijman, Jordi, additional, Lumens, Joost, additional, Dokter, Jeffrey E., additional, Lima Passos, Valeria, additional, Schalla, Simon, additional, Knackstedt, Christian, additional, Schummers, Georg, additional, Gjesdal, Ola, additional, Edvardsen, Thor, additional, and Bekkers, Sebastiaan C.A.M., additional

Published
2019
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159. Linking cross-bridge cycling kinetics to response to cardiac resynchronization therapy: a multiscale modelling study

Author

Dupuis, Lauren J., Dupuis, Lauren J., Arts, Theo, Prinzen, Frits W., Delhaas, Tammo, Lumens, Joost, Dupuis, Lauren J., Dupuis, Lauren J., Arts, Theo, Prinzen, Frits W., Delhaas, Tammo, and Lumens, Joost

Abstract

Aims Cardiac resynchronization therapy (CRT) is currently the most widely used treatment for heart failure patients with left bundle branch block (LBBB). In recent years, the presence of septal rebound stretch (SRS) has been found to be a positive indicator for CRT response although the mechanism is unknown.Methods and results In an attempt to understand the relation between cellular mechanics and global pump function in CRT patients, we utilize the CircAdapt closed-loop cardiovascular system model in combination with the MechChem model of cardiac sarcomere contraction. Left bundle branch block has been simulated with increasing delay in left ventricular free wall and septal wall activation. In addition to the electrical dyssynchrony, myocardial mechanical function was diminished by decreasing the cross-bridge cycling rate. Our results have shown that a decrease in the cross-bridge cycling rate in addition to LBBB resulted in a decrease in SRS with a concomitant decreased response to resynchronization.Conclusions The results of our multiscale modelling study suggest that, while greater SRS during systole clearly indicates electrical dyssynchrony, it also predicts mechanical viability and healthy cross-bridge cycling rates in the myocardium. Hence, SRS positively indicates response to CRT.

Published
2018

160. Innovation in cardiovascular disease in Europe with focus on arrhythmias: current status, opportunities, roadblocks, and the role of multiple stakeholders

Author

Prinzen, Frits W., Prinzen, Frits W., Dagres, Nikolaos, Bollmann, Andreas, Arnar, David O., Bove, Sylvie, Camm, John, Casadei, Barbara, Kirchhof, Paulus, Kuck, Karl-Heinz, Lumens, Joost, Michel, Martin C., Schwartz, Peter J., Van Vleymen, Betty, Vardas, Panos, Hindricks, Gerhard, Prinzen, Frits W., Prinzen, Frits W., Dagres, Nikolaos, Bollmann, Andreas, Arnar, David O., Bove, Sylvie, Camm, John, Casadei, Barbara, Kirchhof, Paulus, Kuck, Karl-Heinz, Lumens, Joost, Michel, Martin C., Schwartz, Peter J., Van Vleymen, Betty, Vardas, Panos, and Hindricks, Gerhard

Abstract

The European Heart Rhythm Association (EHRA) held an Innovation Forum in February 2016, to consider issues around innovation. The objective of the forum was to extend the innovation debate outside of the narrow world of arrhythmia specialists and cardiology in general, and seek input from all stakeholders including regulators, strategists, technologists, industry, academia, health providers, medical societies, payers, and patients. Innovation is indispensable for a continuing improvement in health care, preferably at higher efficacy and lower costs. It requires people who have been trained in a good scientific environment, high-quality research for achieving ground breaking inventions and the certainty of return on innovation investments. In the context of cardiovascular disease, innovation can imply better risk assessment and stratification, device technology, drug development, and process design. Several areas of promising developments were identified as well as several roadblocks to innovation. To drive innovation forward all stakeholders need to play a significant role. In a globalized and extremely competitive world, the leading role of Europe in medical innovation can only be achieved through a combined and well-coordinated effort from all involved parties.

Published
2018

161. Electrical Substrates Driving Response to Cardiac Resynchronization Therapy: A Combined Clinical–Computational Evaluation

Author

Huntjens, Peter R., Huntjens, Peter R., Ploux, Sylvain, Strik, Marc, Walmsley, John, Ritter, Philippe, Haissaguerre, Michel, Prinzen, Frits W., Delhaas, Tammo, Lumens, Joost, Bordachar, Pierre, Huntjens, Peter R., Huntjens, Peter R., Ploux, Sylvain, Strik, Marc, Walmsley, John, Ritter, Philippe, Haissaguerre, Michel, Prinzen, Frits W., Delhaas, Tammo, Lumens, Joost, and Bordachar, Pierre

Abstract

BACKGROUND: The predictive value of interventricular versus intraventricular dyssynchrony for response to cardiac resynchronization therapy (CRT) remains unclear. We investigated the relative importance of both ventricular electrical substrate components for left ventricular (LV) hemodynamic function. METHODS AND RESULTS: First, we used the cardiovascular computational model CircAdapt to characterize the isolated effect of intrinsic interventricular and intraventricular activation on CRT response (Delta LVdP/dt(max)). Simulated Delta LVdP/dt(max) (range: 1.3%-26.5%) increased considerably with increasing interventricular dyssynchrony. In contrast, the isolated effect of intraventricular dyssynchrony in either the LV or right ventricle was limited (Delta LVdP/dt(max) range: 12.3%-18.3% and 14.1%-15.7%, respectively). Effects of activation during biventricular pacing on Delta LVdP/dt(max) were small. Second, electrocardiographic imaging-derived activation characteristics of 51 CRT candidates were used to personalize ventricular activation in CircAdapt. The individualized models were subsequently used to assess the accuracy of Delta LVdP/dt(max) prediction based on the electrical data. The model-predicted Delta LVdP/dt(max) was close to the actual value in patients with left bundle branch block (measured-simulated: 2.7 +/- 9.0%) when only intrinsic interventricular dyssynchrony was personalized. Among patients without left bundle branch block, Delta LVdP/dt(max) was systematically overpredicted by CircAdapt (measured-simulated: 9.2 +/- 7.1%). Adding intraventricular activation to the model did not improve the accuracy of the response prediction. CONCLUSIONS: Computer simulations revealed that intrinsic interventricular dyssynchrony is the dominant component of the electrical substrate driving the response to CRT. Intrinsic intraventricular dyssynchrony and any dyssynchrony during biventricular pacing play a minor role in this respect. This may facilitate patient-specif

Published
2018

162. Heart Failure With Recovered Ejection Fraction

Author

Merken, Jort, Merken, Jort, Brunner-La Rocca, Hans-Peter, Weerts, Jerremy, Verdonschot, Job, Hazebroek, Mark, Schummers, Georg, Schreckenberg, Marcus, Lumens, Joost, Heymans, Stephane, Knackstedt, Christian, Merken, Jort, Merken, Jort, Brunner-La Rocca, Hans-Peter, Weerts, Jerremy, Verdonschot, Job, Hazebroek, Mark, Schummers, Georg, Schreckenberg, Marcus, Lumens, Joost, Heymans, Stephane, and Knackstedt, Christian

Published
2018

163. Electromechanical substrate characterization in arrhythmogenic cardiomyopathy using imaging-based patient-specific computer simulations.

Author

Osta, Nick van, Kirkels, Feddo, Lyon, Aurore, Koopsen, Tijmen, Loon, Tim van, Cramer, Maarten-Jan, Teske, Arco J, Delhaas, Tammo, Lumens, Joost, van Osta, Nick, and van Loon, Tim

Subjects
BIOLOGICAL models, COMPUTER simulation, ECHOCARDIOGRAPHY, CARDIOMYOPATHIES, HEART ventricles, RIGHT ventricular dysfunction
Abstract

Aims: Arrhythmogenic cardiomyopathy (AC) is an inherited cardiac disease, characterized by life-threatening ventricular arrhythmias and progressive cardiac dysfunction. The aim of this study is to use computer simulations to non-invasively estimate the individual patient's myocardial tissue substrates underlying regional right ventricular (RV) deformation abnormalities in a cohort of AC mutation carriers.Methods and Results: In 68 AC mutation carriers and 20 control subjects, regional longitudinal deformation patterns of the RV free wall (RVfw), interventricular septum (IVS), and left ventricular free wall (LVfw) were obtained using speckle-tracking echocardiography. We developed and used a patient-specific parameter estimation protocol based on the multi-scale CircAdapt cardiovascular system model to create virtual AC subjects. Using the individual's deformation data as model input, this protocol automatically estimated regional RVfw and global IVS and LVfw tissue properties. The computational model was able to reproduce clinically measured regional deformation patterns for all subjects, with highly reproducible parameter estimations. Simulations revealed that regional RVfw heterogeneity of both contractile function and compliance were increased in subjects with clinically advanced disease compared to mutation carriers without clinically established disease (17 ± 13% vs. 8 ± 4%, P = 0.01 and 18 ± 11% vs. 10 ± 7%, P < 0.01, respectively). No significant difference in activation delay was found.Conclusion: Regional RV deformation abnormalities in AC mutation carriers were related to reduced regional contractile function and tissue compliance. In clinically advanced disease stages, a characteristic apex-to-base heterogeneity of tissue abnormalities was present in the majority of the subjects, with most pronounced disease in the basal region of the RVfw. [ABSTRACT FROM AUTHOR]

Published
2021
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164. Rocking and Flashing With RV Pacing Implications for Resynchronization Therapy

Author

Gorcsan, John, Lumens, Joost, Biomedische Technologie, and RS: CARIM - R2.09 - Cardiovascular system dynamics

Subjects
apical rocking, ACTIVATION, PACED PATIENTS, OUTCOMES, SPECKLE-TRACKING, septal flash, cardiac resynchronization therapy, mechanical dyssynchrony, HEART-FAILURE, ASSOCIATION, right ventricular pacing
Published
2017

165. Cardiac resynchronization therapy: mechanisms of action and scope for further improvement in cardiac function

Author

Jones, Siana, Lumens, Joost, Sohaib, S. M. Afzal, Finegold, Judith A., Kanagaratnam, Prapa, Tanner, Mark, Duncan, Edward, Moore, Philip, Leyva, Francisco, Frenneaux, Mike, Mason, Mark, Hughes, Alun D., Francis, Darrel P., Whinnett, Zachary I., RS: CARIM - R2.09 - Cardiovascular system dynamics, and Biomedische Technologie

Subjects
AV delay, Cardiac resynchronization therapy, CRT mechanisms, CONGESTIVE-HEART-FAILURE, MORTALITY, INTERVENTRICULAR DELAY, ATRIOVENTRICULAR DELAY, BLOOD-PRESSURE, INTERVALS, PATTERN, DESIGN, CRT, Resynchronization, OPTIMIZATION
Abstract

Cardiac resynchronization therapy (CRT) may exert its beneficial haemodynamic effect by improving ventricular synchrony and improving atrioventricular (AV) timing. The aim of this study was to establish the relative importance of the mechanisms through which CRT improves cardiac function and explore the potential for additional improvements with improved ventricular resynchronization. We performed simulations using the CircAdapt haemodynamic model and performed haemodynamic measurements while adjusting AV delay, at low and high heart rates, in 87 patients with CRT devices. We assessed QRS duration, presence of fusion, and haemodynamic response. The simulations suggest that intrinsic PR interval and the magnitude of reduction in ventricular activation determine the relative importance of the mechanisms of benefit. For example, if PR interval is 201 ms and LV activation time is reduced by 25 ms (typical for current CRT methods), then AV delay optimization is responsible for 69% of overall improvement. Reducing LV activation time by an additional 25 ms produced an additional 2.6 mmHg increase in blood pressure (30% of effect size observed with current CRT). In the clinical population, ventricular fusion significantly shortened QRS duration (Delta-27 +/- 23 ms, P

Published
2017

171. Heart Failure With Recovered Ejection Fraction

Author

Merken, Jort, primary, Brunner-La Rocca, Hans-Peter, additional, Weerts, Jerremy, additional, Verdonschot, Job, additional, Hazebroek, Mark, additional, Schummers, Georg, additional, Schreckenberg, Marcus, additional, Lumens, Joost, additional, Heymans, Stephane, additional, and Knackstedt, Christian, additional

Published
2018
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174. Combining computer modelling and cardiac imaging to understand right ventricular pump function

Author

Cardiologie Arts-onderzoekers, Onderzoek Device, Cardiologie, Circulatory Health, Team Medisch, Walmsley, John, van Everdingen, Wouter, Cramer, Maarten J, Prinzen, Frits W, Delhaas, Tammo, Lumens, Joost, Cardiologie Arts-onderzoekers, Onderzoek Device, Cardiologie, Circulatory Health, Team Medisch, Walmsley, John, van Everdingen, Wouter, Cramer, Maarten J, Prinzen, Frits W, Delhaas, Tammo, and Lumens, Joost

Published
2017

176. Innovation in cardiovascular disease in Europe with focus on arrhythmias: current status, opportunities, roadblocks, and the role of multiple stakeholders

Author

Prinzen, Frits W, primary, Dagres, Nikolaos, additional, Bollmann, Andreas, additional, Arnar, David O, additional, Bove, Sylvie, additional, Camm, John, additional, Casadei, Barbara, additional, Kirchhof, Paulus, additional, Kuck, Karl-Heinz, additional, Lumens, Joost, additional, Michel, Martin C, additional, Schwartz, Peter J, additional, Van Vleymen, Betty, additional, Vardas, Panos, additional, and Hindricks, Gerhard, additional

Published
2017
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177. Distinctive Left Ventricular Activations Associated With ECG Pattern in Heart Failure Patients

Author

Derval, Nicolas, primary, Duchateau, Josselin, additional, Mahida, Saagar, additional, Eschalier, Romain, additional, Sacher, Frederic, additional, Lumens, Joost, additional, Cochet, Hubert, additional, Denis, Arnaud, additional, Pillois, Xavier, additional, Yamashita, Seigo, additional, Komatsu, Yuki, additional, Ploux, Sylvain, additional, Amraoui, Sana, additional, Zemmoura, Adlane, additional, Ritter, Philippe, additional, Hocini, Mélèze, additional, Haissaguerre, Michel, additional, Jaïs, Pierre, additional, and Bordachar, Pierre, additional

Published
2017
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179. Longitudinal Strain 'Think Globally, Track Locally'

Author

Lumens, Joost, Prinzen, Frits W., Delhaas, Tammo, Biomedische Technologie, Fysiologie, and RS: CARIM - R2 - Cardiac function and failure

Subjects
GLS, speckle tracking, systolic function, echocardiography, risk stratification
Published
2015

180. Hemodynamics in Aortic Regurgitation Simulated Using a Computational Cardiovascular System Model

Author

Palau Caballero, Georgina, Walmsley, John, Rudenick, P., Evangelista, A., Lumens, Joost, Delhaas, Tammo, van Assen, H., Bovendeerd, P., Delhaas, T., RS: CARIM - R2 - Cardiac function and failure, RS: CARIM School for Cardiovascular Diseases, Promovendi CD, and Biomedische Technologie

Subjects
medicine.medical_specialty, business.industry, Diastole, Hemodynamics, Blood volume, Regurgitation (circulation), Compliance (physiology), Orifice area, Internal medicine, cardiovascular system, Aortic tissue, Cardiology, Medicine, In patient, business
Abstract

The influence of left ventricular and aortic tissue properties on hemodynamics in patients with aortic regurgitation (AR) is unclear. In this study we aim: (1) to assess the capability of the CircAdapt model of the heart and circulation to simulate hemodynamics in AR; (2) to determine the interaction between aortic compliance and AR using CircAdapt. We simulated three degrees of AR by changing the aortic regurgitant orifice area (ROA) with normal and low aortic compliance. The higher the ROA is, the higher the systolic left ventricular and aortic pressures, the lower the diastolic aortic pressures and the higher the diastolic left ventricular pressures are. For low aortic compliance, those effects are exacerbated, but the regurgitant blood volume is decreased. These simulation data show the capability of CircAdapt to simulate hemodynamics in AR, and suggest that patient-to-patient variability in aortic compliance should be taken into account when assessing AR severity using imaging-based hemodynamic metrics.

Published
2015
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181. Right Ventricular Imaging and Computer Simulation for Electromechanical Substrate Characterization in Arrhythmogenic Right Ventricular Cardiomyopathy

Author

Mast, TP, Teske, Arco J, Walmsley, John, van der Heijden, Jeroen F, van Es, René, Prinzen, Frits W, Delhaas, Tammo, van Veen, Toon A, Loh, KP, Doevendans, Pieter A, Cramer, Maarten J, Lumens, Joost, Mast, TP, Teske, Arco J, Walmsley, John, van der Heijden, Jeroen F, van Es, René, Prinzen, Frits W, Delhaas, Tammo, van Veen, Toon A, Loh, KP, Doevendans, Pieter A, Cramer, Maarten J, and Lumens, Joost

Published
2016

182. Right Ventricular Imaging and Computer Simulation for Electromechanical Substrate Characterization in Arrhythmogenic Right Ventricular Cardiomyopathy

Author

Cardiologie Arts-onderzoekers, Cardiologie, Circulatory Health, Medische Fysiologie, Regenerative Medicine and Stem Cells, Mast, TP, Teske, Arco J, Walmsley, John, van der Heijden, Jeroen F, van Es, René, Prinzen, Frits W, Delhaas, Tammo, van Veen, Toon A, Loh, KP, Doevendans, Pieter A, Cramer, Maarten J, Lumens, Joost, Cardiologie Arts-onderzoekers, Cardiologie, Circulatory Health, Medische Fysiologie, Regenerative Medicine and Stem Cells, Mast, TP, Teske, Arco J, Walmsley, John, van der Heijden, Jeroen F, van Es, René, Prinzen, Frits W, Delhaas, Tammo, van Veen, Toon A, Loh, KP, Doevendans, Pieter A, Cramer, Maarten J, and Lumens, Joost

Published
2016

184. Right Ventricular Imaging and Computer Simulation for Electromechanical Substrate Characterization in Arrhythmogenic Right Ventricular Cardiomyopathy

Author

Mast, Thomas P., primary, Teske, Arco J., additional, Walmsley, John, additional, van der Heijden, Jeroen F., additional, van Es, René, additional, Prinzen, Frits W., additional, Delhaas, Tammo, additional, van Veen, Toon A., additional, Loh, Peter, additional, Doevendans, Pieter A., additional, Cramer, Maarten J., additional, and Lumens, Joost, additional

Published
2016
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187. Cardiac resynchronization therapy: mechanisms of action and scope for further improvement in cardiac function

Author

Jones, Siana, primary, Lumens, Joost, additional, Sohaib, S. M. Afzal, additional, Finegold, Judith A., additional, Kanagaratnam, Prapa, additional, Tanner, Mark, additional, Duncan, Edward, additional, Moore, Philip, additional, Leyva, Francisco, additional, Frenneaux, Mike, additional, Mason, Mark, additional, Hughes, Alun D., additional, Francis, Darrel P., additional, and Whinnett, Zachary I., additional

Published
2016
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188. 16-68: Right ventricular dysfunction complicates prediction of response to cardiac resynchronization therapy by mechanical dyssynchrony parameters: combined clinical-modeling approach

Author

Van Everdingen, Wouter M., primary, Walmsley, John, additional, Cramer, Maarten J., additional, Van Hagen, Iris, additional, De Boeck, Bart W.l., additional, Meine, Mathias, additional, Doevendans, Pieter, additional, Prinzen, Frits, additional, Lumens, Joost, additional, and Leenders, Geert E., additional

Published
2016
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192. Right heart adaptation to pulmonary arterial hypertension: physiology and pathobiology

Author

Vonk-Noordegraaf, Anton, Haddad, François, Chin, Kelly M, Forfia, Paul R, Kawut, Steven M, Lumens, Joost, Naeije, Robert, Newman, John, Oudiz, Ronald J, Provencher, Steve, Torbicki, Adam, Voelkel, Norbert F, Hassoun, Paul M, Biomedische Technologie, and RS: CARIM School for Cardiovascular Diseases

Subjects
Ventricular Remodeling, Research Support, N.I.H., Extramural, Hypertension, Pulmonary, Ventricular Dysfunction, Right, Ventricular Function, Right, Journal Article, Animals, Humans, Familial Primary Pulmonary Hypertension, Review, Adaptation, Physiological, Research Support, U.S. Gov't, Non-P.H.S
Abstract

Survival in patients with pulmonary arterial hypertension (PAH) is closely related to right ventricular (RV) function. Although pulmonary load is an important determinant of RV systolic function in PAH, there remains a significant variability in RV adaptation to pulmonary hypertension. In this report, the authors discuss the emerging concepts of right heart pathobiology in PAH. More specifically, the discussion focuses on the following questions. 1) How is right heart failure syndrome best defined? 2) What are the underlying molecular mechanisms of the failing right ventricle in PAH? 3) How are RV contractility and function and their prognostic implications best assessed? 4) What is the role of targeted RV therapy? Throughout the report, the authors highlight differences between right and left heart failure and outline key areas of future investigation.

Published
2013

193. Noninvasive Electrocardiographic Mapping to Improve Patient Selection for Cardiac Resynchronization Therapy Beyond QRS Duration and Left Bundle Branch Block Morphology

Author

Ploux, Sylvain, Lumens, Joost, Whinnett, Zachary, Montaudon, Michel, Strom, Maria, Ramanathan, Charu, Derval, Nicolas, Zemmoura, Adlane, Denis, Arnaud, De Guillebon, Maxime, Shah, Ashok, Hocini, Mélèze, Jaïs, Pierre, Ritter, Philippe, Haïssaguerre, Michel, Wilkoff, Bruce L., Bordachar, Pierre, Biomedische Technologie, Fysiologie, and RS: CARIM School for Cardiovascular Diseases

Subjects
ventricular mapping, electrocardiography, cardiovascular system, cardiac resynchronization therapy, heart failure, cardiovascular diseases, electrical dyssynchrony
Abstract

Objectives This study sought to investigate whether noninvasive electrocardiographic activation mapping is a useful method for predicting response to cardiac resynchronization therapy (CRT). Background One third of the patients appear not to respond to CRT when they are selected according to QRS duration. Methods We performed electrocardiographic activation mapping in 33 consecutive CRT candidates (QRS duration >= 120 ms). In 18 patients, the 12-lead electrocardiographic morphology was left bundle branch block (LBBB), and in 15, it was nonspecific intraventricular conduction disturbance (NICD). Three indexes of electrical dyssynchrony were derived from intrinsic maps: right and left ventricular total activation times and ventricular electrical uncoupling (VEU) (difference between the left ventricular [LV] and right ventricular mean activation times). We assessed the ability of these parameters to predict response, measured using a clinical composite score, after 6 months of CRT. Results Electrocardiographic maps revealed homogeneous patterns of activation and consistently greater VEU and LV total activation time (LVTAT) in patients with LBBB compared with heterogeneous activation sequences and shorter VEU and LVTAT in NICD patients (VEU: 75 +/- 12 ms vs. 40 +/- 22 ms; p

Published
2013

194. Clinical Applications of Patient-Specific Models: The Case for a Simple Approach.

Author

Holmes, Jeffrey W. and Lumens, Joost

Abstract

Over the past several decades, increasingly sophisticated models of the heart have provided important insights into cardiac physiology and are increasingly used to predict the impact of diseases and therapies on the heart. In an era of personalized medicine, many envision patient-specific computational models as a powerful tool for personalizing therapy. Yet the complexity of current models poses important challenges, including identifying model parameters and completing calculations quickly enough for routine clinical use. We propose that early clinical successes are likely to arise from an alternative approach: relatively simple, fast, phenomenologic models with a small number of parameters that can be easily (and automatically) customized. We discuss examples of simple yet foundational models that have already made a tremendous impact on clinical education and practice, and make the case that reducing rather than increasing model complexity may be the key to realizing the promise of patient-specific modeling for clinical applications. [ABSTRACT FROM AUTHOR]

Published
2018
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195. Computational models in cardiology

Author

Niederer, Steven A., Lumens, Joost, and Trayanova, Natalia A.

Abstract

The treatment of individual patients in cardiology practice increasingly relies on advanced imaging, genetic screening and devices. As the amount of imaging and other diagnostic data increases, paralleled by the greater capacity to personalize treatment, the difficulty of using the full array of measurements of a patient to determine an optimal treatment seems also to be paradoxically increasing. Computational models are progressively addressing this issue by providing a common framework for integrating multiple data sets from individual patients. These models, which are based on physiology and physics rather than on population statistics, enable computational simulations to reveal diagnostic information that would have otherwise remained concealed and to predict treatment outcomes for individual patients. The inherent need for patient-specific models in cardiology is clear and is driving the rapid development of tools and techniques for creating personalized methods to guide pharmaceutical therapy, deployment of devices and surgical interventions.

Published
2019
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197. Differentiating Electromechanical From Non–Electrical Substrates of Mechanical Discoordination to Identify Responders to Cardiac Resynchronization Therapy

Author

Lumens, Joost, primary, Tayal, Bhupendar, additional, Walmsley, John, additional, Delgado-Montero, Antonia, additional, Huntjens, Peter R., additional, Schwartzman, David, additional, Althouse, Andrew D., additional, Delhaas, Tammo, additional, Prinzen, Frits W., additional, and Gorcsan, John, additional

Published
2015
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200. Electrical dyssynchrony induced by biventricular pacing: Implications for patient selection and therapy improvement

Author

Ploux, Sylvain, primary, Eschalier, Romain, additional, Whinnett, Zachary I., additional, Lumens, Joost, additional, Derval, Nicolas, additional, Sacher, Frederic, additional, Hocini, Mélèze, additional, Jaïs, Pierre, additional, Dubois, Remi, additional, Ritter, Philippe, additional, Haïssaguerre, Michel, additional, Wilkoff, Bruce L., additional, Francis, Darrel P., additional, and Bordachar, Pierre, additional

Published
2015
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