Mechanical contraction to guide CRT left-ventricular lead placement instead of electrical activation in myocardial infarction with left ventricular dysfunction: An experimental study based on non-invasive gated myocardial perfusion imaging and invasive electroanatomic mapping

2019 ◽  
Vol 27 (2) ◽  
pp. 419-430 ◽  
Author(s):  
Jianfeng Wang ◽  
Yuetao Wang ◽  
Minfu Yang ◽  
Shan Shao ◽  
Yi Tian ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Experimental Study ◽  
Ventricular Dysfunction ◽  
Left Ventricular ◽  
Electrical Activation ◽  
Non Invasive ◽  
Lead Placement ◽  
Ventricular Lead ◽  
Gated Myocardial Perfusion Imaging ◽  
Left Ventricular Lead Placement

Abstract 687: Cardiac Imaging with Multi-Slice Computed Tomography and Echocardiography to Guide Left Ventricular Lead Placement in Resynchronization Therapy. The CAMERA Trial

Circulation ◽  
2008 ◽  
Vol 118 (suppl_18) ◽  
Author(s):  
Ronan Curtin ◽  
Richard A Grimm ◽  
Giuseppe Saracino ◽  
Jeff Hsing ◽  
Tingfei Hu ◽  
...  
Keyword(s):  
Left Ventricular ◽  
Left Ventricular Lead ◽  
Left Ventricular Dyssynchrony ◽  
Coronary Veins ◽  
Ventricular Dyssynchrony ◽  
Non Invasive ◽  
Lead Placement ◽  
Ventricular Lead ◽  
Left Ventricular Lead Placement ◽  
Minute Walk

Cardiac resynchronization (CRT) is associated with reverse ventricular remodeling and improved clinical outcomes, but is not successful in all patients. We looked at the feasibility of combined non-invasive imaging of the coronary veins and assessment of left ventricular dyssynchrony prior to pacemaker implantation and whether this combination would improve procedural success and patient outcome. Heart failure patients with standard indications for CRT were randomized to cardiac Multi-Detector CT (MDCT) plus Doppler echocardiographic assessment of left ventricular dyssynchrony versus conventional management prior to CRT. Co-registration of MDCT and tissue synchronization imaging data using a novel software program was performed and the results were used to optimize left ventricular lead placement for patients in the non-invasive imaging arm. 21 patients were enrolled with 9 patients randomized to the contemporary non-invasive imaging strategy and 12 patients randomized to the control group. MDCT correctly identified 19 of 24 (79%) coronary venous branches ≥ 2 mm in diameter when compared to invasive coronary venography. Patients in the non-invasive imaging group had a significant improvement in the 6 minute walk time on 6 month follow up (76.1 ± 48.4 meters vs 20.0 ± 64.8 meters, p = 0.04). Improvements in NYHA functional class and LV remodeling at 6 months were not significantly different in the non-invasive imaging and control arms. Left ventricular lead placement was successful in all patients, however more patients in the non-invasive imaging arm demonstrated LV lead placement in the most delayed or adjacent myocardial segment (8 of 9 vs 6 of 12, p = 0.09). Those patients with “optimal” lead placement showed a trend towards improved 6 minute walk times and improvement in left ventricular function 6 months after biventricular pacing. An imaging-guided strategy with coregistration of MDCT coronary venous anatomy and delayed myocardial segments by tissue Doppler echocardiography prior to CRT is feasible and may improve patient outcomes by facilitating optimal LV lead placement.

Initial experience with remote magnetic navigation for left ventricular lead placement

2009 ◽  
Vol 64 (4) ◽  
pp. 467-475 ◽  
Author(s):  
K. Mischke ◽  
C. Knackstedt ◽  
M. Schmid ◽  
N. Hatam ◽  
M. Becker ◽  
...  
Keyword(s):  
Left Ventricular ◽  
Left Ventricular Lead ◽  
Initial Experience ◽  
Magnetic Navigation ◽  
Remote Magnetic Navigation ◽  
Lead Placement ◽  
Ventricular Lead ◽  
Left Ventricular Lead Placement

scholarly journals 152 Real-time cardiac MR anatomy and dyssynchrony overlay to guide left ventricular lead placement in CRT

Heart ◽  
2011 ◽  
Vol 97 (Suppl 1) ◽  
pp. A84-A85
Author(s):  
A. Shetty ◽  
S. Duckett ◽  
M. Ginks ◽  
Y. Ma ◽  
M. Sohal ◽  
...  
Keyword(s):  
Real Time ◽  
Left Ventricular ◽  
Left Ventricular Lead ◽  
Cardiac Mr ◽  
Lead Placement ◽  
Ventricular Lead ◽  
Left Ventricular Lead Placement
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