ArticleEuropace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology2023
Virtual pacing of a patient's digital twin to predict left ventricular reverse remodelling after cardiac resynchronization therapy.
Article in 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, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 21 papers.
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Who cites it
21 citing papers in PubMed, 29 citations in OpenAlex.
- Mechanical-medical convergence in heart failure: Artificial intelligence, finite-element modeling, and 3D printing for diagnosis and prognosis.Bioengineering & translational medicine · 2026Review
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- From Precision to Personalized: Catalyzing AI-Enabled Innovation in Drug Development.Clinical and translational science · 2026Article
- The Potential of Digital Twins for Pediatric Rare Diseases.CPT: pharmacometrics & systems pharmacology · 2026Review
- Synthetic artificial intelligence in cardiology: from generative models to clinical applications.European heart journal open · 2026Review
- Multi-Level Perception Systems in Fusion of Lifeforms: Classification, Challenges and Future Conceptions.Sensors (Basel, Switzerland) · 2026Review
- The Integral Role of Cardiac Imaging in the Electrophysiology Field.The Journal of innovations in cardiac rhythm management · 2025Review
- Artificial Intelligence in Cardiac Electrophysiology: A Clinically Oriented Review with Engineering Primers.Bioengineering (Basel, Switzerland) · 2025Review
- A scoping review of human digital twins in healthcare applications and usage patterns.NPJ digital medicine · 2025Article
- Digital Cardiovascular Twins, AI Agents, and Sensor Data: A Narrative Review from System Architecture to Proactive Heart Health.Sensors (Basel, Switzerland) · 2025Review
- An in silico guide for ventriculo-ventricular delay programming for left bundle branch-optimized cardiac resynchronization therapy.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 · 2025Article
- Numerical accuracy of closed-loop steady state in a zero-dimensional cardiovascular model.Philosophical transactions. Series A, Mathematical, physical, and engineering sciences · 2025Article
- Impact of myocardial phenotype on optimal atrioventricular delay settings during biventricular and left bundle branch pacing at rest and during exercise: insights from a virtual patient study.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 · 2025Article
- Multipoint Left Ventricular Pacing as Alternative Approach in Cases of Biventricular Pacing Failure.Journal of clinical medicine · 2025Review
- Digital Twins for Clinical and Operational Decision-Making: Scoping Review.Journal of medical Internet research · 2025Article
- Optimizing outcomes from cardiac resynchronization therapy: what do recent data and insights say?Expert review of cardiovascular therapy · 2024Review
- From bits to bedside: entering the age of digital twins in cardiac electrophysiology.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 · 2024Review
- Cardiovascular care with digital twin technology in the era of generative artificial intelligence.European heart journal · 2024Review
- Digital twins for cardiac electrophysiology: state of the art and future challenges.Herzschrittmachertherapie & Elektrophysiologie · 2024Review
- Concepts of Cardiac Dyssynchrony and Dynamic Approach.Diagnostics (Basel, Switzerland) · 2024Review
Corrections and comments
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Authors and funding
12 authors at 3 institutions in 1 country.
Funding
Abstract
aimsIdentifying heart failure (HF) patients who will benefit from cardiac resynchronization therapy (CRT) remains challenging. We evaluated whether virtual pacing in a digital twin (DT) of the patient's heart could be used to predict the degree of left ventricular (LV) reverse remodelling post-CRT. METHODS AND
resultsForty-five HF patients with wide QRS complex (≥130 ms) and reduced LV ejection fraction (≤35%) receiving CRT were retrospectively enrolled. Echocardiography was performed before (baseline) and 6 months after CRT implantation to obtain LV volumes and 18-segment longitudinal strain. A previously developed algorithm was used to generate 45 DTs by personalizing the CircAdapt model to each patient's baseline measurements. From each DT, baseline septal-to-lateral myocardial work difference (MWLW-S,DT) and maximum rate of LV systolic pressure rise (dP/dtmax,DT) were derived. Biventricular pacing was then simulated using patient-specific atrioventricular delay and lead location. Virtual pacing-induced changes ΔMWLW-S,DT and ΔdP/dtmax,DT were correlated with real-world LV end-systolic volume change at 6-month follow-up (ΔLVESV). The DT's baseline MWLW-S,DT and virtual pacing-induced ΔMWLW-S,DT were both significantly associated with the real patient's reverse remodelling ΔLVESV (r = -0.60, P < 0.001 and r = 0.62, P < 0.001, respectively), while correlation between ΔdP/dtmax,DT and ΔLVESV was considerably weaker (r = -0.34, P = 0.02).
conclusionOur results suggest that the reduction of septal-to-lateral work imbalance by virtual pacing in the DT can predict real-world post-CRT LV reverse remodelling. This DT approach could prove to be an additional tool in selecting HF patients for CRT and has the potential to provide valuable insights in optimization of CRT delivery.
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