PMID- 26136400
OWN - NLM
STAT- MEDLINE
DCOM- 20160201
LR  - 20220129
IS  - 1941-3084 (Electronic)
IS  - 1941-3084 (Linking)
VI  - 8
IP  - 5
DP  - 2015 Oct
TI  - Beneficial Effect on Cardiac Resynchronization From Left Ventricular Endocardial 
      Pacing Is Mediated by Early Access to High Conduction Velocity Tissue: 
      Electrophysiological Simulation Study.
PG  - 1164-72
LID - 10.1161/CIRCEP.115.002677 [doi]
AB  - BACKGROUND: Cardiac resynchronization therapy (CRT) delivered via left 
      ventricular (LV) endocardial pacing (ENDO-CRT) is associated with improved acute 
      hemodynamic response compared with LV epicardial pacing (EPI-CRT). The role of 
      cardiac anatomy and physiology in this improved response remains controversial. 
      We used computational electrophysiological models to quantify the role of cardiac 
      geometry, tissue anisotropy, and the presence of fast endocardial conduction on 
      myocardial activation during ENDO-CRT and EPI-CRT. METHODS AND RESULTS: Cardiac 
      activation was simulated using the monodomain tissue excitation model in 
      2-dimensional (2D) canine and human and 3D canine biventricular models. The 
      latest activation times (LATs) for LV endocardial and biventricular epicardial 
      tissue were calculated (LVLAT and TLAT), as well the percentage decrease in LATs 
      for endocardial (en) versus epicardial (ep) LV pacing (defined as 
      %dLV=100x(LVLATep-LVLATen)/LVLATep and %dT=100x(TLATep-TLATen)/TLATep, 
      respectively). Normal canine cardiac anatomy is responsible for %dLV and %dT 
      values of 7.4% and 5.5%, respectively. Concentric and eccentric remodeled 
      anatomies resulted in %dT values of 15.6% and 1.3%, respectively. The 3D 
      biventricular-paced canine model resulted in %dLV and %dT values of -7.1% and 
      1.5%, in contrast to the experimental observations of 16% and 11%, respectively. 
      Adding fast endocardial conduction to this model altered %dLV and %dT to 13.1% 
      and 10.1%, respectively. CONCLUSIONS: Our results provide a physiological 
      explanation for improved response to ENDO-CRT. We predict that patients with 
      viable fast-conducting endocardial tissue or distal Purkinje network or both, as 
      well as concentric remodeling, are more likely to benefit from reduced ATs and 
      increased synchrony arising from endocardial pacing.
CI  - (c) 2015 American Heart Association, Inc.
FAU - Hyde, Eoin R
AU  - Hyde ER
AD  - From the Department of Biomedical Engineering, King's College London, London, 
      United Kingdom (E.R.H., J.M.B., S.C., T.J., A.W.C.L., M.S., R.R., C.A.R., 
      S.A.N.); Department of Cardiology, Guy's and St Thomas' NHS Foundation Trust, 
      London, United Kingdom (J.M.B., S.C., T.J., M.S., C.A.R.); Institute for Surgical 
      Research, Oslo University Hospital, Rikshospitalet and KG Jebsen Cardiac Research 
      Centre, University of Oslo, Oslo, Norway (E.W.R.); and Institut fur Biophysik, 
      Medizinische Universitat, Graz, Austria (G.P.).
FAU - Behar, Jonathan M
AU  - Behar JM
AD  - From the Department of Biomedical Engineering, King's College London, London, 
      United Kingdom (E.R.H., J.M.B., S.C., T.J., A.W.C.L., M.S., R.R., C.A.R., 
      S.A.N.); Department of Cardiology, Guy's and St Thomas' NHS Foundation Trust, 
      London, United Kingdom (J.M.B., S.C., T.J., M.S., C.A.R.); Institute for Surgical 
      Research, Oslo University Hospital, Rikshospitalet and KG Jebsen Cardiac Research 
      Centre, University of Oslo, Oslo, Norway (E.W.R.); and Institut fur Biophysik, 
      Medizinische Universitat, Graz, Austria (G.P.).
FAU - Claridge, Simon
AU  - Claridge S
AD  - From the Department of Biomedical Engineering, King's College London, London, 
      United Kingdom (E.R.H., J.M.B., S.C., T.J., A.W.C.L., M.S., R.R., C.A.R., 
      S.A.N.); Department of Cardiology, Guy's and St Thomas' NHS Foundation Trust, 
      London, United Kingdom (J.M.B., S.C., T.J., M.S., C.A.R.); Institute for Surgical 
      Research, Oslo University Hospital, Rikshospitalet and KG Jebsen Cardiac Research 
      Centre, University of Oslo, Oslo, Norway (E.W.R.); and Institut fur Biophysik, 
      Medizinische Universitat, Graz, Austria (G.P.).
FAU - Jackson, Tom
AU  - Jackson T
AD  - From the Department of Biomedical Engineering, King's College London, London, 
      United Kingdom (E.R.H., J.M.B., S.C., T.J., A.W.C.L., M.S., R.R., C.A.R., 
      S.A.N.); Department of Cardiology, Guy's and St Thomas' NHS Foundation Trust, 
      London, United Kingdom (J.M.B., S.C., T.J., M.S., C.A.R.); Institute for Surgical 
      Research, Oslo University Hospital, Rikshospitalet and KG Jebsen Cardiac Research 
      Centre, University of Oslo, Oslo, Norway (E.W.R.); and Institut fur Biophysik, 
      Medizinische Universitat, Graz, Austria (G.P.).
FAU - Lee, Angela W C
AU  - Lee AW
AD  - From the Department of Biomedical Engineering, King's College London, London, 
      United Kingdom (E.R.H., J.M.B., S.C., T.J., A.W.C.L., M.S., R.R., C.A.R., 
      S.A.N.); Department of Cardiology, Guy's and St Thomas' NHS Foundation Trust, 
      London, United Kingdom (J.M.B., S.C., T.J., M.S., C.A.R.); Institute for Surgical 
      Research, Oslo University Hospital, Rikshospitalet and KG Jebsen Cardiac Research 
      Centre, University of Oslo, Oslo, Norway (E.W.R.); and Institut fur Biophysik, 
      Medizinische Universitat, Graz, Austria (G.P.).
FAU - Remme, Espen W
AU  - Remme EW
AD  - From the Department of Biomedical Engineering, King's College London, London, 
      United Kingdom (E.R.H., J.M.B., S.C., T.J., A.W.C.L., M.S., R.R., C.A.R., 
      S.A.N.); Department of Cardiology, Guy's and St Thomas' NHS Foundation Trust, 
      London, United Kingdom (J.M.B., S.C., T.J., M.S., C.A.R.); Institute for Surgical 
      Research, Oslo University Hospital, Rikshospitalet and KG Jebsen Cardiac Research 
      Centre, University of Oslo, Oslo, Norway (E.W.R.); and Institut fur Biophysik, 
      Medizinische Universitat, Graz, Austria (G.P.).
FAU - Sohal, Manav
AU  - Sohal M
AD  - From the Department of Biomedical Engineering, King's College London, London, 
      United Kingdom (E.R.H., J.M.B., S.C., T.J., A.W.C.L., M.S., R.R., C.A.R., 
      S.A.N.); Department of Cardiology, Guy's and St Thomas' NHS Foundation Trust, 
      London, United Kingdom (J.M.B., S.C., T.J., M.S., C.A.R.); Institute for Surgical 
      Research, Oslo University Hospital, Rikshospitalet and KG Jebsen Cardiac Research 
      Centre, University of Oslo, Oslo, Norway (E.W.R.); and Institut fur Biophysik, 
      Medizinische Universitat, Graz, Austria (G.P.).
FAU - Plank, Gernot
AU  - Plank G
AD  - From the Department of Biomedical Engineering, King's College London, London, 
      United Kingdom (E.R.H., J.M.B., S.C., T.J., A.W.C.L., M.S., R.R., C.A.R., 
      S.A.N.); Department of Cardiology, Guy's and St Thomas' NHS Foundation Trust, 
      London, United Kingdom (J.M.B., S.C., T.J., M.S., C.A.R.); Institute for Surgical 
      Research, Oslo University Hospital, Rikshospitalet and KG Jebsen Cardiac Research 
      Centre, University of Oslo, Oslo, Norway (E.W.R.); and Institut fur Biophysik, 
      Medizinische Universitat, Graz, Austria (G.P.).
FAU - Razavi, Reza
AU  - Razavi R
AD  - From the Department of Biomedical Engineering, King's College London, London, 
      United Kingdom (E.R.H., J.M.B., S.C., T.J., A.W.C.L., M.S., R.R., C.A.R., 
      S.A.N.); Department of Cardiology, Guy's and St Thomas' NHS Foundation Trust, 
      London, United Kingdom (J.M.B., S.C., T.J., M.S., C.A.R.); Institute for Surgical 
      Research, Oslo University Hospital, Rikshospitalet and KG Jebsen Cardiac Research 
      Centre, University of Oslo, Oslo, Norway (E.W.R.); and Institut fur Biophysik, 
      Medizinische Universitat, Graz, Austria (G.P.).
FAU - Rinaldi, Christopher A
AU  - Rinaldi CA
AD  - From the Department of Biomedical Engineering, King's College London, London, 
      United Kingdom (E.R.H., J.M.B., S.C., T.J., A.W.C.L., M.S., R.R., C.A.R., 
      S.A.N.); Department of Cardiology, Guy's and St Thomas' NHS Foundation Trust, 
      London, United Kingdom (J.M.B., S.C., T.J., M.S., C.A.R.); Institute for Surgical 
      Research, Oslo University Hospital, Rikshospitalet and KG Jebsen Cardiac Research 
      Centre, University of Oslo, Oslo, Norway (E.W.R.); and Institut fur Biophysik, 
      Medizinische Universitat, Graz, Austria (G.P.).
FAU - Niederer, Steven A
AU  - Niederer SA
AD  - From the Department of Biomedical Engineering, King's College London, London, 
      United Kingdom (E.R.H., J.M.B., S.C., T.J., A.W.C.L., M.S., R.R., C.A.R., 
      S.A.N.); Department of Cardiology, Guy's and St Thomas' NHS Foundation Trust, 
      London, United Kingdom (J.M.B., S.C., T.J., M.S., C.A.R.); Institute for Surgical 
      Research, Oslo University Hospital, Rikshospitalet and KG Jebsen Cardiac Research 
      Centre, University of Oslo, Oslo, Norway (E.W.R.); and Institut fur Biophysik, 
      Medizinische Universitat, Graz, Austria (G.P.). steven.niederer@kcl.ac.uk.
LA  - eng
GR  - PG/11/101/29212/BHF_/British Heart Foundation/United Kingdom
GR  - PG/11/101/292/British Heart Foundation/United Kingdom
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
DEP - 20150701
PL  - United States
TA  - Circ Arrhythm Electrophysiol
JT  - Circulation. Arrhythmia and electrophysiology
JID - 101474365
SB  - IM
MH  - Animals
MH  - Anisotropy
MH  - Cardiac Resynchronization Therapy/*methods
MH  - Dogs
MH  - *Electrophysiologic Techniques, Cardiac
MH  - Endocardium/*physiopathology
MH  - Heart Failure/physiopathology/*therapy
MH  - Heart Ventricles/*physiopathology
MH  - Hemodynamics/physiology
MH  - Humans
OTO - NOTNLM
OT  - cardiac resynchronization therapy
OT  - electric stimulation
OT  - electrophysiology
OT  - heart failure
OT  - heart ventricles
EDAT- 2015/07/03 06:00
MHDA- 2016/02/02 06:00
CRDT- 2015/07/03 06:00
PHST- 2015/01/05 00:00 [received]
PHST- 2015/06/23 00:00 [accepted]
PHST- 2015/07/03 06:00 [entrez]
PHST- 2015/07/03 06:00 [pubmed]
PHST- 2016/02/02 06:00 [medline]
AID - CIRCEP.115.002677 [pii]
AID - 10.1161/CIRCEP.115.002677 [doi]
PST - ppublish
SO  - Circ Arrhythm Electrophysiol. 2015 Oct;8(5):1164-72. doi: 
      10.1161/CIRCEP.115.002677. Epub 2015 Jul 1.