Computational Models Predict CRT Response via Myocardial Work Metrics
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Solution Overview
Problem
Current methods for diagnosing and predicting the response to cardiac resynchronization therapy (CRT) in patients with dyssynchronous heart failure (DHF) lack specificity and sensitivity, as existing metrics do not effectively correlate with patient outcomes, and there is a need for improved methods to optimize therapeutic parameters such as pacing lead locations and ventriculo-ventricular delays.
Innovation Solution
The development of patient-specific computational models that measure and analyze regional myocardial work distribution indices, such as the coefficient of variation of external work density (COVW) and myocardial negative work density fraction (MNWF), to predict the severity of dyssynchrony and potential response to CRT, allowing for personalized therapeutic settings and improved clinical outcomes.
Engineering Contradictions & Design Principles
Engineering Contradiction Analysis
1Measurement precision
If traditional diagnostic metrics (echocardiography, electrocardiography, cardiac catheterization) are used to classify CRT responders and non-responders, then the classification can be obtained, but the specificity and sensitivity are insufficient and correlation with patient outcomes is poor
Solution Approach 1:
The patent replaces traditional mechanical and electrical diagnostic measurements (echocardiography, electrocardiography, catheterization) with a computational modeling approach that uses patient-specific anatomical models and simulated electrical activation patterns to predict mechanical dyssynchrony and CRT response. This substitution enables more precise and reliable predictions by integrating multiple data sources into a unified computational framework.
Solution Approach 2:
The patent creates a composite diagnostic approach by integrating multiple types of clinical data (anatomical imaging, electrical activation patterns, hemodynamic parameters) into a single patient-specific computational model. This composite methodology combines the strengths of different diagnostic modalities to achieve superior predictive accuracy compared to any single metric alone.
2Measurement precision
If patient-specific computational models with regional myocardial work analysis are implemented, then prediction accuracy and therapeutic optimization are improved, but the device complexity and computational requirements increase
Solution Approach 1:
The patent performs preliminary computational modeling and simulation during the pre-procedural planning phase, before the actual CRT device implantation. By calculating patient-specific dyssynchrony metrics and optimizing pacing parameters in advance using computational models, the complex analytical work is completed beforehand, allowing for straightforward device programming and implantation without requiring complex real-time computational resources during the procedure.
Data Source
AI summary
In alternative embodiments, provided are compositions, medical devices or products of manufacture, systems, diagnostic tools, and methods, including computer implemented methods, for predicting the response of patients with dyssynchronous heart failure (DHF) to cardiac resynchronization therapy (CRT), comprising: measuring or determining the fraction of the LV/septum performing negative work (MNW); and measuring or determining the coefficient of variation of external work density (COVW), wherein the MNW fraction performing negative work and coefficient of variation COVW (sd/mean) correlated strongly with observed reduction in end-systolic volume after CRT. In alternative embodiments, provided are products comprising a remote communication device for remotely and operably interacting with a programmable implantable cardioverter-defibrillator (ICD) or CRT-D including a defibrillator in case defibrillation is needed, an implantable defibrillator, a dual-chamber defibrillator or a single-chamber defibrillator, or a CRT-P where there is no defibrillator but the CRT-P has a pacing system alone without the defibrillator.