Key result
Image-guided left ventricular lead placement using multimodality imaging and image fusion techniques provides effective guidance to potentially increase response rates in cardiac resynchronization therapy.
Why the study?
A considerable proportion of patients do not respond to cardiac resynchronization therapy, and tailored left ventricular lead positioning instead of empiric implantation may increase response rates.
Does image-guided left ventricular lead placement improve response rates in patients with advanced heart failure undergoing cardiac resynchronization therapy?
Does image-guided left ventricular lead placement improve response rates in patients with advanced heart failure undergoing cardiac resynchronization therapy?
Image-guided LV lead placement using multimodality imaging and fusion techniques shows promise for improving CRT response rates by targeting late mechanically activated segments and avoiding scar, though significant technical and logistical barriers limit routine clinical adoption.
May support targeted LV lead placement in CRT; leaves open confirmation of response gains in prospective trials.
Cardiac resynchronization therapy is an effective and widely accessible treatment for patients with advanced, drug-refractory heart failure. It has been shown to reverse maladaptive ventricular remodeling, increase exercise capacity, and lower hospitalization and mortality rates. However, there still exists a considerable proportion of patients who do not respond favorably to the therapy. Tailored left ventricular (LV) lead positioning instead of empiric implantation is thought to have the greatest potential to increase response rates. In our paper, we focus on the rationale for guided LV lead implantation and provide a review of the non-invasive imaging modalities applicable for navigation during LV lead implantation, with special attention to the latest achievements in the field of multimodality imaging and image fusion techniques. Current limitations and future perspectives of the concept are discussed as well.
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Hájek et al. (2019) conducted a review in Heart failure requiring cardiac resynchronization therapy. Image-guided left ventricular lead placement vs. Empiric implantation was evaluated. Image-guided left ventricular lead placement using multimodality imaging and image fusion techniques provides effective guidance to potentially increase response rates in cardiac resynchronization therapy.
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