Key result
CMR-guided targeting increases successful LV lead placement in target areas by ~128% versus conventional implantation.
Why the study?
To evaluate the efficacy of on-screen image guidance for left ventricular pacing electrode implantation accuracy and its impact on left ventricular end-systolic volume reduction after CRT.
Does CMR-guided on-screen targeting improve LVPE implantation accuracy and LVESV reduction in heart failure patients undergoing CRT?
Population
131 heart failure patients (80% with Class I CRT indication) across 7 hospitals in the Netherlands
Comparison
Image-guided implantation with on-screen guidance vs conventional implantation
Design
Multicenter randomized trial
Follow-up
6 months
Authors
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Image guidance may aid precise LV lead placement in scarred myocardium; leaves open routine adoption pending confirmatory trials.
RCT (n=127)
Open-label with blinded echocardiogram analysis
Stratified randomization by ischemic cardiomyopathy (ICM)
Yes
Does CMR-guided on-screen targeting improve LVPE implantation accuracy and LVESV reduction in heart failure patients undergoing CRT?
Absolute Event Rate: 66.7% vs 29.2%
p-value: p=<0.001
CMR-guided on-screen targeting significantly improves the accuracy of left ventricular lead placement in the target area and reduces placement in scarred areas during CRT implantation.
Gerrits et al. (2025) conducted an RCT in Heart failure with indication for cardiac resynchronization therapy (n=127). CMR-guided on-screen targeting vs. Conventional implantation was evaluated on Successful left ventricular pacing electrode (LVPE) placement in the target area (p=<0.001). CMR-guided on-screen targeting significantly increased the successful placement of the left ventricular pacing electrode in the target area to 66.7% compared to 29.2% with conventional implantation.
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