Integration of Electrical, Structural, and Anatomical imaging for the guidance of Cardiac Resynchronization Therapy

U.C. Nguyen*, M.J.M. Cluitmans, C. Mihl, J.J.G. Luermans, B.L.J.H. Kietselaer, S.C.A.M. Bekkers, S. Gommers, P.G.A. Volders, F.W. Prinzen, K. Vernooy

*Corresponding author for this work

Research output: Chapter in Book/Report/Conference proceedingConference article in proceedingAcademicpeer-review

Abstract

Background: Placing the left ventricular (LV) lead at a site of late electrical activation remote from scar is desired for cardiac resynchronization therapy (CRT) response.Objective: The purpose of this study was to integrate electrocardiographic imaging (ECGi) with computed tomography (CT) derived coronary venous anatomy and delayed enhancement cardiac magnetic resonance imaging (DE-CMR) derived scar to reconstruct a pre-procedural roadmap for LV lead guidance in CRT.Methods: Three CRT candidates with focal scar defined by DE-CMR were prospectively included. Intrinsic body surface potentials measurements (BSPM) were carried out. Inverse reconstruction using the CT heart-torso geometry were used for ECGi. Meshes of the CT coronary veins, epicardium with ECGi activation times, and DE-CMR scar were integrated.Results: The ECGi-CT-CMR roadmap was used for CRT implantation in 2/3 patients. Placing the LV lead remote from scar was accomplished in 2/2 patients. Target veins from the ECGi-CT-CMR roadmap were located in a region of 80-105 ms electrical delay.Conclusion: ECGi-CT-CMR roadmaps can be used during CRT implantation to guide LV lead placement to a coronary vein remote from scar in a region of late electrical activation, possibly improving CRT.
Original languageEnglish
Title of host publication2017 COMPUTING IN CARDIOLOGY (CINC)
PublisherIEEE Computer Society
Pages1-4
Number of pages4
Volume44
DOIs
Publication statusPublished - 2017
Event44th Computing in Cardiology Conference - Rennes, France
Duration: 24 Sept 201727 Sept 2017
https://www.cinc.org/2017/ProgramBook/2017CinCProgramBook2.pdf

Publication series

SeriesComputing in Cardiology Conference
Volume44
ISSN2325-8861

Conference

Conference44th Computing in Cardiology Conference
Abbreviated titleCinC
Country/TerritoryFrance
CityRennes
Period24/09/1727/09/17
Internet address

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