Energetic ventricular balance during cardiac resynchronization therapy: numerical simulation

Cardiac Resynchronization Therapy (CRT), realised using biventricular pacemaker is used to treat patients with in systolic heart failure (HF) and with prolonged QRS. The goal of CRT is to eliminate or reduce the electromechanical dyssynchrony processes often responsible of cardiac remodelling. The aim of this work is to study the effects of CRT on the energetic left ventricular variables as external work, the pressure-volume area and the potential energy. In order to study the effects produced by CRT on energetic left ventricular balance it was used the numerical model of the cardiovascular system (CARDIOSIM©), able to reproduce the effects induced by biventricular pacemaker (BPM). Starting from literature data, the haemodynamic conditions of a group of patients, representative of the most common disease etiologies of heart failure, were simulated before and after CRT treatment. The trend of the energetic left ventricular variables was studied for each patient in order to evaluate the effects produced by the CRT. The obtained results shown that the software simulator can predict the dynamics of energetic left ventricular balance in patients affected by HF and treated with cardiac resynchronization therapy.