- Poster presentation
- Open Access
Clinical feasibility of targeted cardiac resynchronization lead delivery using a 3D MRI cardiac model
© Stirrat et al; licensee BioMed Central Ltd. 2012
- Published: 1 February 2012
- Right Ventricular
- Cardiac Resynchronization Therapy
- Delay Enhancement
- Leave Ventricular Lead
- Pace Site
Cardiac resynchronization therapy (CRT) aims to reduce dyssynchronous contraction through simultaneous pacing of the right ventricular (RV) septum and left ventricular (LV) lateral wall. Up to 40% of patients do not respond, largely attributed to lack of dysynchrony and/or transmural scar at pacing sites. In this pilot study we tested the feasibility of guiding LV and RV leads to “optimal” segmental targets using a MRI-based 3D surface rendered cardiac model.
Mean age and LVEF was 68.5 ±6.7 years and 25.6 ±10.8%, with a mean NYHA class of 2.9 ± 0.6. “Optimal” LV and RV pacing sites differed from conventional pacing sites (basal posterolateral segment and RV apex) in 9 and 4 patients, respectively. All patients successfully underwent CRT device implantation with a mean fluoroscopy time of 23 ± 10.9 minutes. Post-device CT imaging showed LV and RV leads to be successfully delivered to the “optimal” or immediately adjacent segment in 90% and 90% of patients, respectively. The only documented complication was a small pericardial effusion not requiring drainage in a patient that was prescribed conventional lead positioning by the model.
In this pilot study we demonstrate that a targeted approach to CRT lead placement using an MRI-based cardiac model is clinically feasible. A prospective clinical trial evaluating the clinical benefit of this approach is planned.
J.A.W is a clinician scientist with the Heart and Stroke Foundation of Ontario, Canada. This research was supported by the Heart and Stroke Foundation grant # NA6488 (PI: J.A.W.) and by the Canada Foundation of Innovation (CFI) Leaders Opportunity Fund.
This article is published under license to BioMed Central Ltd. This is an open access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.