Effects of cardiac growth on electrical dyssynchrony in the single ventricle patient

Single ventricle patients, including those with hypoplastic left heart syndrome (HLHS), typically undergo three palliative heart surgeries culminating in the Fontan procedure. HLHS is associated with high rates of morbidity and mortality, and many patients develop arrhythmias, electrical dyssynchron...

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Bibliographic Details
Published in:Computer methods in biomechanics and biomedical engineering 2024-06, Vol.27 (8), p.1011-1027
Main Authors: Tikenoğulları, O. Z., Peirlinck, M., Chubb, H., Dubin, A. M., Kuhl, E., Marsden, A. L.
Format: Article
Language:English
Subjects:
cardiac electrophysiology
Computer Simulation
congenital heart disease
Customization
dyssynchrony
Electrophysiology
Enlargement
Finite Element Analysis
Finite element method
growth and remodeling
Heart
Heart surgery
Heart Ventricles - physiopathology
Humans
Hypoplastic left heart syndrome
Hypoplastic Left Heart Syndrome - physiopathology
Hypoplastic Left Heart Syndrome - surgery
Models, Cardiovascular
Morbidity
Patients
Ventricle
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Summary:Single ventricle patients, including those with hypoplastic left heart syndrome (HLHS), typically undergo three palliative heart surgeries culminating in the Fontan procedure. HLHS is associated with high rates of morbidity and mortality, and many patients develop arrhythmias, electrical dyssynchrony, and eventually ventricular failure. However, the correlation between ventricular enlargement and electrical dysfunction in HLHS physiology remains poorly understood. Here we characterize the relationship between growth and electrophysiology in HLHS using computational modeling. We integrate a personalized finite element model, a volumetric growth model, and a personalized electrophysiology model to perform controlled in silico experiments. We show that right ventricle enlargement negatively affects QRS duration and interventricular dyssynchrony. Conversely, left ventricle enlargement can partially compensate for this dyssynchrony. These findings have potential implications on our understanding of the origins of electrical dyssynchrony and, ultimately, the treatment of HLHS patients.
ISSN:1025-5842
1476-8259
DOI:10.1080/10255842.2023.2222203