Cardiac magnetic resonance-derived anatomy, scar, and dyssynchrony fused with fluoroscopy to guide LV lead placement in cardiac resynchronization therapy: a comparison with acute haemodynamic measures and echocardiographic reverse remodelling
- Shetty, Anoop K.
- Duckett, Simon G.
- Ginks, Matthew R.
- Ma, YingLiang
- Sohal, Manav
- Bostock, Julian
- Kapetanakis, Stamatis
- Singh, Jagmeet P.
- Rhode, Kawal S.
- Wright, Matthew
- O'Neill, Mark D.
- Gill, Jaswinder S.
- Carr-White, Gerald
- Razavi, Reza
- Rinaldi, Christopher Aldo
DOIAbstract
Aims Left ventricular (LV) lead positioning for cardiac resynchronization therapy (CRT) is largely empirical and operator-dependent. Our aim was to determine whether cardiac magnetic resonance (CMR)-guided CRT may improve the acute and the chronic response. Methods and results CMR-derived anatomical models and dyssynchrony maps were created for 20 patients. The CMR targets (three latest activated segments with <50% scar) were overlaid on to live fluoroscopy. Acute haemodynamic response (AHR) to LV pacing was assessed using an intra-ventricular pressure wire. Chronic CRT response (end-systolic volume reduction ≥15%) was assessed 6 months post-implantation. All patients underwent successful CMR-guided LV lead placement. A CMR target segment w...
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