PURPOSE: The use of SPECT phase analysis to optimize left-ventricular (LV) lead positions for cardiac resynchronization therapy (CRT) was performed at baseline, but CRT works as simultaneous right ventricular (RV) and LV pacing. The aim of this study was to assess the impact of RV apical (RVA) pacing on optimal LV lead positions measured by SPECT phase analysis. METHODS: This study prospectively enrolled 46 patients. Two SPECT myocardial perfusion scans were acquired under sinus rhythm with complete left bundle branch block and RVA pacing, respectively, following a single injection of (99m)Tc-sestamibi. LV dyssynchrony parameters and optimal LV lead positions were measured by the phase analysis technique and then compared between the two scans. RESULTS: The LV dyssynchrony parameters were significantly larger with RVA pacing than with sinus rhythm (p ~0.01). In 39 of the 46 patients, the optimal LV lead positions were the same between RVA pacing and sinus rhythm (kappa = 0.861). In 6 of the remaining 7 patients, the optimal LV lead positions were along the same radial direction, but RVA pacing shifted the optimal LV lead positions toward the base. CONCLUSION: The optimal LV lead positions measured by SPECT phase analysis were consistent, no matter whether the SPECT images were acquired under sinus rhythm or RVA pacing. In some patients, RVA pacing shifted the optimal LV lead positions toward the base. This study supports the use of baseline SPECT myocardial perfusion imaging to optimize LV lead positions to increase CRT efficacy.
PURPOSE: The use of SPECT phase analysis to optimize left-ventricular (LV) lead positions for cardiac resynchronization therapy (CRT) was performed at baseline, but CRT works as simultaneous right ventricular (RV) and LV pacing. The aim of this study was to assess the impact of RV apical (RVA) pacing on optimal LV lead positions measured by SPECT phase analysis. METHODS: This study prospectively enrolled 46 patients. Two SPECT myocardial perfusion scans were acquired under sinus rhythm with complete left bundle branch block and RVA pacing, respectively, following a single injection of (99m)Tc-sestamibi. LV dyssynchrony parameters and optimal LV lead positions were measured by the phase analysis technique and then compared between the two scans. RESULTS: The LV dyssynchrony parameters were significantly larger with RVA pacing than with sinus rhythm (p ~0.01). In 39 of the 46 patients, the optimal LV lead positions were the same between RVA pacing and sinus rhythm (kappa = 0.861). In 6 of the remaining 7 patients, the optimal LV lead positions were along the same radial direction, but RVA pacing shifted the optimal LV lead positions toward the base. CONCLUSION: The optimal LV lead positions measured by SPECT phase analysis were consistent, no matter whether the SPECT images were acquired under sinus rhythm or RVA pacing. In some patients, RVA pacing shifted the optimal LV lead positions toward the base. This study supports the use of baseline SPECT myocardial perfusion imaging to optimize LV lead positions to increase CRT efficacy.
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Authors: James A White; Raymond Yee; Xiaping Yuan; Andrew Krahn; Allan Skanes; Michele Parker; George Klein; Maria Drangova Journal: J Am Coll Cardiol Date: 2006-10-31 Impact factor: 24.094
Authors: C-M Yu; Q Zhang; Y-S Chan; C-K Chan; G W K Yip; L C C Kum; E B Wu; P-W Lee; Y-Y Lam; S Chan; J W-H Fung Journal: Heart Date: 2006-04-18 Impact factor: 5.994
Authors: I Lozano; M Bocchiardo; M Achtelik; F Gaita; H J Trappe; E Daoud; J Hummel; C Duby; P Yong Journal: Pacing Clin Electrophysiol Date: 2000-11 Impact factor: 1.976
Authors: Mati Friehling; Ji Chen; Samir Saba; Raveen Bazaz; David Schwartzman; Evan C Adelstein; Ernest Garcia; William Follansbee; Prem Soman Journal: Circ Cardiovasc Imaging Date: 2011-07-19 Impact factor: 7.792
Authors: John G F Cleland; Jean-Claude Daubert; Erland Erdmann; Nick Freemantle; Daniel Gras; Lukas Kappenberger; Luigi Tavazzi Journal: N Engl J Med Date: 2005-03-07 Impact factor: 91.245
Authors: Nathaniel M Hawkins; Mark C Petrie; Michael R MacDonald; Kerry J Hogg; John J V McMurray Journal: Eur Heart J Date: 2006-03-09 Impact factor: 29.983