Predicting the response to cardiac resynchronization therapy using in silico heart models: pilot study of comparison between in silico and real cardiac resynchronization therapy outcomes
- Author:
Jae-Sun UHM
1
;
Minki HWANG
;
Eun Bo SHIM
;
Daehoon KIM
;
Chan Joo LEE
;
Jaewon OH
;
Hee Tae YU
;
Tae-Hoon KIM
;
Boyoung JOUNG
;
Hui-Nam PAK
;
Seok-Min KANG
;
Moon-Hyoung LEE
Author Information
- Publication Type:Research
- From:International Journal of Arrhythmia 2025;26(1):e9-
- CountryRepublic of Korea
- Language:English
-
Abstract:
Background and Objectives:Cardiac resynchronization therapy (CRT) is a treatment option for patients with heart failure and left ventricular (LV) dyssynchrony. However, one-third of CRT patients are non-responders. The objective of this study is to evaluate the feasibility of an in silico electromechanical heart model to predict CRT outcomes.
Methods:The three-dimensional heart geometries of 11 patients (age, 64.0 ± 10.7 years, 4 men) with CRT were constructed from cardiac computed tomography images. The finite element method was used to simulate the electrical wave propagation and mechanics in the heart. We coupled cardiac electrical excitation and mechanical contraction with vascular hemodynamics using a lumped parameter model. We predicted the LV end-diastolic and end-systolic volumes and LV ejection fraction (LVEF) after CRT implantation using the in silico CRT simulation model. A CRT responder was defined as a patient with an absolute LVEF increase ≥ 5%. We compared the in silico CRT outcomes with the real CRT outcomes.
Results:Two patients were in silico CRT responders, and those 2 patients were also real CRT responders. Nine patients were in silico CRT non-responders, 8 who were real CRT non-responders, and 1 who was a real CRT responder. The in silico CRT outcomes agreed with the real CRT outcomes in 10 of 11 patients. The positive and negative predictive values, accuracy, sensitivity, and specificity of the in silico CRT model were 100%, 88.9%, 90.9%, 66.7%, and 100%, respectively.
Conclusion:The in silico CRT simulation model is feasible for predicting real CRT outcomes.
