Computational Study to Understand the Cardiac Electromechanical Responses in LBBB and RBBB to the Application of CRT and LVAD

the aim of this study was to observe the combined effect of the CRT and LVAD on electromechanical cardiac behavior under LBBB and RBBB conditions computationally. We performed simulation by using advanced electromechanics model of failing ventricle combined with lumped model represents circulatory system, CRT and LVAD. We analyzed seven failing ventricle model including normal sinus rhythm, LBBB, LBBB coupled with CRT, LBBB coupled with CRT and LVAD, RBBB, RBBB coupled with CRT, and RBBB coupled with CRT and LVAD. We compared the effect from CRT and the effect from combined CRT and LVAD to both under LBBB and RBBB conditions. The results showed that the combined CRT and LVAD contributed a better hemodynamic compared to single CRT. This combined system synchronized the electrical activation greatly under LBBB and slightly under RBBB. It also shortened mechanical activation time which resulted short electromechanical delay. More importantly, the combined system produced better mechanical responses under both LBBB and RBBB conditions.