Virtual Electrode Theory of Pacing

Roth, Bradley J.; Sidorov, Veniamin Y.; Wikswo, John P.

doi:10.1007/978-3-030-63355-4_12

Cited by 4 publications

(4 citation statements)

References 221 publications

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“…This arrangement provides a larger "landing zone" for LBBP, which is the main reason for shorter procedure times. Furthermore, pacing at such sites of reticular arrangement may allow for a larger ''virtual electrode 27 , which may then allow for more rapid delivery of electrical depolarization and significantly shorten the QRS duration. 28 In patients with proximal LBB disease, LBBP directly stimulates the conduction system below the blockage.…”

Section: Discussionmentioning

confidence: 99%

“…This arrangement provides a larger “ landing zone ” for LBBP, which is the main reason for shorter procedure times. Furthermore, pacing at such sites of reticular arrangement may allow for a larger `` virtual electrode 27 , which may then allow for more rapid delivery of electrical depolarization and significantly shorten the QRS duration 28 . Finally, LBBP and HBP have both been proven to result in more physiologic repolarization as compared to BiVP, with improved QT and T‐peak‐to‐T‐end intervals (a measure of transmural dispersion of repolarization), possibly translating to lower proarrhythmic risk 29 .…”

Section: Discussionmentioning

confidence: 99%

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Beyond biventricular pacing: Exploring the advantages of his‐bundle pacing and left bundle branch pacing in heart failure—A systematic review and meta‐analysis

Al Hennawi,

Khan,

Khalid

et al. 2023

Pacing Clinical Electrophis

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BackgroundThis meta‐analysis compares His‐Purkinje system pacing (HPSP), a novel cardiac resynchronization therapy (CRT) technique that targets the intrinsic conduction system of the heart, with conventional biventricular pacing (BiVP) in heart failure (HF) patients with left ventricular (LV) dysfunction and dyssynchrony.MethodsWe searched multiple databases up to May 2023 and identified 18 studies (five randomized controlled trials and 13 observational studies) involving 1291 patients. The outcome measures were QRS duration, left ventricular ejection fraction (LVEF) improvement, left ventricular end‐diastolic diameter (LVEDD) change, HF hospitalization, and New York Heart Association (NYHA) functional class improvement. We used a random‐effects model to calculate odds ratios (OR), and mean differences (MD) with 95% confidence intervals (CI). We also assessed the methodological quality of the studies.ResultsThe mean LVEF was 30.7% and the mean follow‐up duration was 8.1 months. Among LBBP, HBP, and BiVP, HBP provided the shortest QRS duration [MD: −18.84 ms, 95% CI: −28.74 to −8.94; p = 0.0002], while LBBP showed the greatest improvement in LVEF [MD: 5.74, 95% CI: 2.74 to 7.46; p < 0.0001], LVEDD [MD: −5.55 mm, 95% CI: −7.51 to −3.59; p < 0.00001], and NYHA functional class [MD: −0.58, 95% CI: −0.80 to −‐0.35; p < 0.00001]. However, there was no significant difference in HF hospitalization between HPSP and BiVP.ConclusionLBBP as modality of HPSP demonstrated superior outcomes in achieving electrical ventricular synchrony and systolic function, as well as alleviating HF symptoms, compared to other pacing techniques.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Beyond biventricular pacing: Exploring the advantages of his‐bundle pacing and left bundle branch pacing in heart failure—A systematic review and meta‐analysis

Al Hennawi,

Khan,

Khalid

et al. 2023

Pacing Clinical Electrophis

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“…VF is lethal within minutes and the only chance of survival for a patient is defibrillation using a defibrillator. This device creates a large electrical field across to the heart, after which the heart is hopefully be able to restart its normal sinus rhythm [282,283]. Defibrillation can be applied using an external defibrillator or a implantable cardioverter defibrillator (ICD).…”

Section: Termination Of Fibrillation Using Shocksmentioning

confidence: 99%

“…Therefore, it would be advantageous to implement low-energy defibrillation techniques that are below the pain threshold and that are not harmful to the patient (for a recent review, see [295]). One of these techniques rely on the concept of so-called virtual electrodes [296,297,298,299,283]. These virtual electrodes arise from the difference in anisotropy between the intracellular domain (the cardiac cells) and the extracellular domain (the space surrounding the cells).…”

Section: Termination Of Fibrillation Using Shocksmentioning

confidence: 99%

The physics of heart rhythm disorders

Rappel

2022

Preprint

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Heart rhythm disorders, or arrhythmias, are a type of disease that is amenable to quantitative investigation. In this presentation, I review the application of quantitative methodologies, based on physics and mathematics, to explore dynamical questions pertaining to arrhythmias. I will begin by describing single-cell models of cardiac myocytes, from which two and three dimensional models can be constructed. Special focus is placed on results relating to pattern formation across these spatially-distributed systems, especially the formation of spiral waves of activation. Next, I will discuss mechanisms that can lead to the initiation of arrhythmias and outline proposed mechanisms perpetuating arrhythmias such as fibrillation. I will also review experimental and clinical results related to the spatio-temporal mapping of heart rhythm disorders. Finally, I will describe treatment options for heart rhythm disorders and demonstrate how statistical physics tools can provide insights into the dynamics of heart rhythm disorders.

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Bidomain modeling of electrical and mechanical properties of cardiac tissue

Roth

2021

Biophysics Reviews

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Throughout the history of cardiac research, there has been a clear need to establish mathematical models to complement experimental studies. In an effort to create a more complete picture of cardiac phenomena, the bidomain model was established in the late 1970s to better understand pacing and defibrillation in the heart. This mathematical model has seen ongoing use in cardiac research, offering mechanistic insight that could not be obtained from experimental pursuits. Introduced from a historical perspective, the origins of the bidomain model are reviewed to provide a foundation for researchers new to the field and those conducting interdisciplinary research. The interplay of theory and experiment with the bidomain model is explored, and the contributions of this model to cardiac biophysics are critically evaluated. Also discussed is the mechanical bidomain model, which is employed to describe mechanotransduction. Current challenges and outstanding questions in the use of the bidomain model are addressed to give a forward-facing perspective of the model in future studies.

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Virtual Electrode Theory of Pacing

Cited by 4 publications

References 221 publications

Beyond biventricular pacing: Exploring the advantages of his‐bundle pacing and left bundle branch pacing in heart failure—A systematic review and meta‐analysis

Beyond biventricular pacing: Exploring the advantages of his‐bundle pacing and left bundle branch pacing in heart failure—A systematic review and meta‐analysis

The physics of heart rhythm disorders

Bidomain modeling of electrical and mechanical properties of cardiac tissue

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