Student: Marina Strocchi
1st supervisor: Steven Niederer, King’s College London
2nd supervisor: Martin Bishop, King’s College London
Clinical supervisor: Aldo Rinaldi, King’s College London
Heart failure (HF) is a lethal syndrome representing a common ‘final pathway’ for sufferers of a multitude of cardiac diseases. One in five people will suffer from HF during their life time and once diagnosed ~40% of patients die within one year. Cardiac resynchronisation therapy (CRT), where pacing the left and right ventricles re-coordinates cardiac electrical activation to produce a synchronous and efficient contraction, has emerged as one of the few effective and safe treatments for HF. However, at present 30% of patients fail to respond clinically through improved quality of life, exercise capacity and New York Heart Association (NYHA) functional classification of HF and up to 40% show no beneficial reverse remodelling, with a less than 15% decrease in end systolic volume.
Previously, we have used personalised computer models of individual patient’s hearts to investigate the conditions under which multi-polar CRT pacing leads will be most effective, the physiological mechanisms that underpin improved response with endocardial pacing and if pacing lead location or patient physiology is the principle determine of patient response to CRT. In this study we will develop a virtual cohort of models of the ventricles and atria of patients to link left ventricular function with pressure measurements from remote recordings across the heart (right atria, left atria and right ventricles) and great vessels (aorta and pulmonary artery) allowing us to investigate how CRT pacing lead timings can be optimised from indirect measurements.
This project aims to extend the biophysical model to include the four chambers of the heart and the major vessels in order to assess how variations in CRT pacing sites and relative timings effect LV hemodynamics and pressure measurements across the heart. The final goal is to create a predictive model to guide or predict optimal CRT setting based-on remote pressure measurements.
This movie shows the creation of a patient specific model of the heart and simulation of the electrical activation. This is an interdisciplinary project working on the translation of computer simulation technologies into clinical applications. Candidates will need to work with clinicians, engineers and representatives from industry.