Key result
Using average LV models derived from 33 heart failure patients for CRT lead placement guidance yielded a clinically acceptable probability of correct coronary vein selection in 15 candidates.
Why the study?
Does guidance using mean anatomical models from ultrasound and fluoroscopy fusion provide comparable coronary vein selection to patient-specific models in CRT candidates?
Does guidance using mean anatomical models from ultrasound and fluoroscopy fusion provide comparable coronary vein selection to patient-specific models in CRT candidates?
Using average anatomical models derived from ultrasound and fluoroscopy fusion may provide a clinically acceptable alternative to patient-specific models for guiding LV lead placement in CRT.
May simplify CRT guidance with average models; leaves open prospective validation versus patient-specific approaches.
Recent studies show that the response rate to cardiac resynchronization therapy (CRT) could be improved if the left ventricle (LV) is paced at the site of the latest mechanical activation, but away from the myocardial scar. A prototype system for CRT lead placement guidance that combines LV functional information from ultrasound with live x-ray fluoroscopy was developed. Two mean anatomical models, each containing LV epi-, LV endo- and right ventricle endocardial surfaces, were computed from a database of 33 heart failure patients as a substitute for a patient-specific model. The sphericity index was used to divide the observed population into two groups. The distance between the mean and the patient-specific models was determined using a signed distance field metric (reported in mm). The average error values for LV epicardium were [Formula: see text] and for LV endocardium were [Formula: see text]. The validity of using average LV models for a CRT procedure was tested by simulating coronary vein selection in a group of 15 CRT candidates. The probability of selecting the same coronary branch, when basing the selection on the average model compared to a patient-specific model, was estimated to be [Formula: see text]. This was found to be clinically acceptable.
No takes yet. Share an insight, caveat, or question.
Babić et al. (2015) studied Heart failure (n=48). Parametric ultrasound and fluoroscopy image fusion using average LV models vs. Patient-specific model was evaluated on Probability of selecting the same coronary branch. Using average LV models derived from 33 heart failure patients for CRT lead placement guidance yielded a clinically acceptable probability of correct coronary vein selection in 15 candidates.
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: