Absence of Rapid Propagation through the Purkinje Network as a Potential Cause of Line Block in the Human Heart with Left Bundle Branch Block

Frontiers in Physiology
Jun-Ichi OkadaSeiryo Sugiura

Abstract

Background: Cardiac resynchronization therapy is an effective device therapy for heart failure patients with conduction block. However, a problem with this invasive technique is the nearly 30% of non-responders. A number of studies have reported a functional line of block of cardiac excitation propagation in responders. However, this can only be detected using non-contact endocardial mapping. Further, although the line of block is considered a sign of responders to therapy, the mechanism remains unclear.Methods:Herein, we created two patient-specific heart models with conduction block and simulated the propagation of excitation based on a cellmodel of electrophysiology. In one model with a relatively narrow QRS width (176 ms), we modeled the Purkinje network using a thin endocardial layer with rapid conduction. To reproduce a wider QRS complex (200 ms) in the second model, we eliminated the Purkinje network, and we simulated the endocardial mapping by solving the inverse problem according to the actual mapping system.Results:We successfully observed the line of block using non-contact mapping in the model without the rapid propagation of excitation through the Purkinje network, although the excitation in the wall propagated smo...Continue Reading

References

Jun 1, 1970·Circulation·D DurrerR C Arzbaecher
Jun 1, 1995·IEEE Transactions on Bio-medical Engineering·M A CamachoS R Eisenberg
Feb 1, 1995·IEEE Transactions on Bio-medical Engineering·D PanescuR A Stratbucker
Dec 6, 2003·American Journal of Physiology. Heart and Circulatory Physiology·K H W J ten TusscherA V Panfilov
Dec 19, 2003·Journal of the American College of Cardiology·Angelo AuricchioUNKNOWN Guidant Heart Failure Research Group
Dec 20, 2005·Journal of the American College of Cardiology·Jeroen J BaxCheuk-Man Yu
Dec 20, 2005·Journal of the American College of Cardiology·Jeroen J BaxCheuk-Man Yu
Dec 9, 2008·American Journal of Physiology. Heart and Circulatory Physiology·R H KeldermannA V Panfilov
Apr 5, 2011·American Journal of Physiology. Heart and Circulatory Physiology·Jun-Ichi OkadaToshiaki Hisada
Jul 15, 2011·Europace : European Pacing, Arrhythmias, and Cardiac Electrophysiology : Journal of the Working Groups on Cardiac Pacing, Arrhythmias, and Cardiac Cellular Electrophysiology of the European Society of Cardiology·Simon G DuckettC Aldo Rinaldi
Jul 26, 2012·Progress in Biophysics and Molecular Biology·Seiryo SugiuraToshiaki Hisada
Nov 2, 2012·Science Translational Medicine·Raimond L WinslowMichael I Miller
Jan 29, 2013·European Heart Journal·Cheuk-Man Yu, David L Hayes
Mar 7, 2013·Pacing and Clinical Electrophysiology : PACE·Jun-Ichi OkadaSeiryo Sugiura
Jun 27, 2013·Europace : European Pacing, Arrhythmias, and Cardiac Electrophysiology : Journal of the Working Groups on Cardiac Pacing, Arrhythmias, and Cardiac Cellular Electrophysiology of the European Society of Cardiology·UNKNOWN European Society of Cardiology (ESC)Panos E Vardas
Aug 31, 2013·Circulation Research·Jonathan A Kirk, David A Kass
May 16, 2017·Journal of Molecular and Cellular Cardiology·Jun-Ichi OkadaSeiryo Sugiura

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Citations

Sep 10, 2019·The Korean Journal of Physiology & Pharmacology : Official Journal of the Korean Physiological Society and the Korean Society of Pharmacology·Jun-Ichi OkadaToshiaki Hisada

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