Computer assisted optimization of cardiac resynchronization by Raz Miri

By Raz Miri

The efficacy of cardiac resynchronization remedy (CRT) via biventricular pacing (BVP) has been confirmed by means of a number of stories in sufferers struggling with congestive center failure. so as to in attaining a tenet for optimum remedy with BVP units, an automatic non-invasive approach according to an electrophysiological laptop version of the center is gifted. The provided learn investigates an off-line optimization set of rules in response to varied electrode positioning and timing delays.

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B) Conducting system of the atria and ventricles. Myocardial cells, which are about 50 to 100 µm size and form the major part of heart tissue. They are responsible for contracting and relaxing, since these cells contain contractile proteins (actin and myosin). Once a depolarization wave reaches a myocyte, calcium is released within the cell causing it to contract (excitation contraction coupling). Myocardial cells can transmit an electrical current similar to electrical conducting cells but they do it less efficiently.

Posterior fascicle, which sweeps over the posterior surface of the left ventricle. The right bundle branch and the fascicles terminate in countless tiny Purkinje fibers. 19). The ventricular contraction is evident as a QRS complex on the ECG, due to ventricular depolarization. The amplitude of the QRS complex is much bigger than P wave since ventricles contain more muscle mass than atria. The QRS complex is complicated and variable in shape reflecting the greater complexity of the ventricular depolarization pathway.

As the left ventricle dilates and the heart assumes a more globular shape, the geometric relation between the papillary muscles and the mitral leaflets changes, causing restricted opening of the leaflets and distortion of the mitral apparatus. Dilatation of the annulus occurs as a result of increasing left ventricular or atrial size or as a result of regional abnormalities caused by myocardial infarction [71, 114, 133, 199]. The presence of mitral regurgitation results in an increasing volume overload on the overburdened left ventricle that further contributes to remodeling, the progression of disease, and to symptoms.

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