November 14, 2013European Heart Journal - Cardiovascular Imaging
Combined preoperative information using a bullseye plot from speckle tracking echocardiography, cardiac CT scan, and MRI scan: targeted left ventricular lead implantation in patients receiving cardiac resynchronization therapy
Key result
Integrated bullseye model identifies optimal LV lead placement in ~95% of patients, linked to improved LVEF.
- n=39
Why the study?
Does a composite bullseye plot integrating echocardiography, CT, and MRI facilitate optimal targeted left ventricular lead implantation in patients receiving CRT?
Population
39 patients eligible for cardiac resynchronization therapy, mean age 69 ± 9.7 years, 77% male, 82% with…
Design
Cohort
Follow-up
6 months
Authors
Discussion
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Implication
May support targeted CRT lead placement; hypothesis-generating and requires randomized confirmation before practice change.
Study Design
Type
Observational (n=39)
Structured PICO
Does a composite bullseye plot integrating echocardiography, CT, and MRI facilitate optimal targeted left ventricular lead implantation in patients receiving CRT?
P
Population
39 patients (mean age 69, 77% male) with heart failure eligible for cardiac resynchronization therapy, evaluated for optimal left ventricular lead placement and followed for 6 months.
E
Exposure
Targeted left ventricular lead implantation guided by a composite bullseye plot integrating speckle tracking echocardiography (for mechanical delay), cardiac CT (for venous anatomy), and cardiac MRI (for viability).
O
Outcome
Feasibility of optimal left ventricle lead placement and changes in left ventricular end systolic volume and ejection fraction at 6 months.surrogate
Integrating echocardiography, cardiac CT, and MRI into a combined bullseye plot is feasible and facilitates optimal targeted left ventricular lead placement in CRT patients, leading to improved LV function at 6 months.
Cite This Study
Bakos et al. (2013) conducted an observational in Heart failure eligible for cardiac resynchronization therapy (n=39). Integrated bullseye model combining echocardiography, cardiac CT, and MRI was evaluated on Optimal left ventricular lead placement (matching vein in the segment with the latest mechanical delay or immediately adjacent segments). An integrated bullseye model combining echocardiography, CT, and MRI identified an optimal LV lead placement site in 95% of patients, leading to improved LV ejection fraction at 6 months (P<0.01).