Medical & Biological Engineering & Computing

, Volume 45, Issue 9, pp 845–854 | Cite as

Computer model for the optimization of AV and VV delay in cardiac resynchronization therapy

  • Matthias Reumann
  • Dima Farina
  • Raz Miri
  • Stephan Lurz
  • Brigitte Osswald
  • Olaf Dössel
Original Article


An optimal electrode position, atrio-ventricular (AV) and interventricular (VV) delay in cardiac resynchronization therapy (CRT) improves its success. An optimization strategy does not yet exist. A computer model of the Visible Man and a patient heart was used to simulate an atrio-ventricular and a left bundle branch block with 0%, 20% and 40% reduction in interventricular conduction velocity, respectively. The minimum error between physiological excitation and pathology/therapy was automatically computed for 12 different electrode positions. AV and VV delay timing was adjusted accordingly. The results show the importance of individually adjusting the electrode position as well as the timing delays to the patient’s anatomy and pathology, which is in accordance with current clinical studies. The presented methods and strategy offer the opportunity to carry out non-invasive, automatic optimization of CRT preoperatively. The model is subject to validation in future clinical studies.


Heart failure Cardiac resynchronization therapy Pacing Optimization Computer models 



The authors would like to acknowledge the data acquisition of the patient data set by the University of Würzburg, which was carried out in a research project funded by the German Research Foundation DFG (No. DO 637/6-1).


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Copyright information

© International Federation for Medical and Biological Engineering 2007

Authors and Affiliations

  • Matthias Reumann
    • 1
  • Dima Farina
    • 2
  • Raz Miri
    • 2
  • Stephan Lurz
    • 2
  • Brigitte Osswald
    • 3
  • Olaf Dössel
    • 2
  1. 1.Computational Biology CenterIBM TJ Watson Research CenterYorktown HeightsUSA
  2. 2.Institute of Biomedical EngineeringUniversität Karlsruhe (TH)KarlsruheGermany
  3. 3.Department of Cardiac SurgeryUniversity of HeidelbergHeidelbergGermany

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