PO-02-019 PREDICTION OF RESPONSE TO CARDIAC RESYNCHRONIZATION THERAPY USING IN SILICO HEART MODELS: COMPARISON OF IN SILICO AND REAL-WORLD CRT OUTCOMES

Abstract

Cardiac resynchronization therapy (CRT) is a treatment option for patients with heart failure and left ventricular (LV) dyssynchrony. However, one-third of the patients are a CRT non-responder. We predicted CRT outcomes using in silico CRT simulation model and compared the in silico CRT outcomes with real-world CRT outcomes. Three-dimensional (3D) heart geometries of 11 patients (age, 64.0 ± 10.7 years, 4 men) with CRT were constructed from cardiac computed tomography. Finite element method was used to simulate the electrical wave propagation and mechanics in the heart. We coupled the cardiac electrical excitation and mechanical contraction with vascular hemodynamics by using the lumped parameter model. We predicted LV end-diastolic and end-systolic volume (LVEDV and LVESV) and ejection fraction (LVEF) after CRT implantation using the in silico CRT simulation model. A CRT responder was defined as absolute increase in LVEF ≥ 5%. We compared the in silico CRT outcomes with real-world CRT outcomes Two patients were in silico CRT responders and these 2 patients were real-world CRT responders. Nine patients were in silico CRT non-responders. Among these 9 patients, 8 patients were real-world CRT non-responders and 1 patient was real-world CRT responder. The in silico CRT outcomes agreed with real-world CRT outcomes in 10 out of 11 patients. The positive and negative predictive values and the accuracy of the response of in silico CRT model were 100%, 88.9%, and 90.9%, respectively. The in silico CRT simulation model is feasible for prediction of real-world CRT outcomes.