Computational Simulation of Biventricular Pacing in an Asymptomatic Human Heart

Cardiac resynchronization therapy (CRT) through biventricular stimulation was first used in the early 1990s as a treatment option for patients with systolic heart failure, intraventricular conduction delay, and other cardiac arrhythmias [1]. CRT, also known as biventricular pacing (BiVP), is an alternative to right ventricular stimulation, which induces dyssynchronous ventricular contraction. In BiVP, three pacing leads are usually placed on the myocardium of the right atrium, the right ventricle, and the left ventricle in the distal cardiac vein. Because there are no standardized loci for lead placement in BiVP, physicians rely on trial and error when inserting pacemaker leads and use electrocardiograms (ECG) to determine the effectiveness of the BiVP lead placement. The ECG measures the electrical conduction, contraction pacing, and projections of the anatomy of the myocardium. Abnormalities in the sinusoidal waves of the ECG reveal problems. Therefore, the ECG can depict a quantitative representation of the effectiveness of biventricular pacing lead placement.