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Additional info for Computer Assisted Optimisation of Non-Pharmacological Treatment of Congestive Heart Failure and Supraventricular Arrhyth

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2 Atrial and Ventricular Anatomy The hearts muscle (myocardium) contracts due to an electrical excitation of each myocardial cell (cardiomyocyte). First, the atria contract simultaneously, then - after a short delay, the ventricles contract. For the cardiomyocytes to contract simultaneously, each myocyte has to be excited rather simultaneouly. A special network of fast conducting cells spreads across the ventricles so that they also are stimulated at the same time. The atrial structure has developed so that the regions of the left and right atrium are stimulated closely together.

These four valves are situated in the so called valve plane (see fig. 2). As part of the fibrous skeleton of the heart, the valve plane separates the atria from the ventricles not only structurally but also electromechanically. Still, the excitation of the atria causes the ventricles to be excited through the atrio - ventricular node (see fig. 2) in the physiological case which causes the contraction of the hearts main chambers. 2 Atrial and Ventricular Anatomy The hearts muscle (myocardium) contracts due to an electrical excitation of each myocardial cell (cardiomyocyte).

Although the mechanism differs from the previously described, the symptoms of diastolic heart failure are very similar to those of a dilated, poorly contracting heart [140]. 6 Ventricular Dyssynchrony Bundle branch blocks will delay contraction between the two venticles (interventricular delay) but a diseased myocardium (dilated cardiomyopathy and scar from a myocardial infarction) with slowing conduction, will result in LV electromechanical dysfunction (intraventricular delay). Interventricular or intraventricular electrical delays are frequent in the HF population with the intraventricular delay being a greater predictor of mortality [80, 235].

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