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European Journal of Nuclear Medicine and Molecular Imaging

Erschienen in:

01.06.2014 | Original Article

Impact of right-ventricular apical pacing on the optimal left-ventricular lead positions measured by phase analysis of SPECT myocardial perfusion imaging

verfasst von: Guang-Uei Hung, Jin-Long Huang, Wan-Yu Lin, Shih-Chung Tsai, Kuo-Yang Wang, Shih-Ann Chen, Michael S. Lloyd, Ji Chen

Erschienen in: European Journal of Nuclear Medicine and Molecular Imaging | Ausgabe 6/2014

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Abstract

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 ^99mTc-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.

Lozano I, Bocchiardo M, Achtelik M, Gaita F, Trappe HJ, Daoud E, et al. Impact of biventricular pacing on mortality in a randomized crossover study of patients with heart failure and ventricular arrhythmias. Pacing Clin Electrophysiol. 2000;23:1711–2.PubMedCrossRef

Cazeau S, Leclercq C, Lavergne T, Walker S, Varma C, Linde C, et al. Effects of multisite biventricular pacing in patients with heart failure and intraventricular conduction delay. N Engl J Med. 2001;344:873–80.PubMedCrossRef

Auricchio A, Stellbrink C, Sack S, Block M, Vogt J, Bakker P, et al. Long-term clinical effect of hemodynamically optimized cardiac resynchronization therapy in patients with heart failure and ventricular conduction delay. J Am Coll Cardiol. 2002;39:2026–33.PubMedCrossRef

Abraham WT, Fisher WG, Smith AL, Delurgio DB, Leon AR, Loh E, et al. Cardiac resynchronization in chronic heart failure. N Engl J Med. 2002;346:1845–53.PubMedCrossRef

Young JB, Abraham WT, Smith AL, Leon AR, Lieberman R, Wilkoff B, et al. Combined cardiac resynchronization and implantable cardioversion defibrillation in advanced chronic heart failure: the MIRACLE ICD Trial. JAMA. 2003;289:2685–94.PubMedCrossRef

Auricchio A, Stellbrink C, Butter C, Sack S, Vogt J, Misier AR, et al. Clinical efficacy of cardiac resynchronization therapy using left ventricular pacing in heart failure patients stratified by severity of ventricular conduction delay. J Am Coll Cardiol. 2003;42:2109–16.PubMedCrossRef

Bristow MR, Saxon LA, Boehmer J, Krueger S, Kass DA, De Marco T, et al. Cardiac-resynchronization therapy with or without an implantable defibrillator in advanced chronic heart failure. N Engl J Med. 2004;350:2140–50.PubMedCrossRef

Cleland JG, Daubert JC, Erdmann E, Freemantle N, Gras D, Kappenberger L, et al. The effect of cardiac resynchronization on morbidity and mortality in heart failure. N Engl J Med. 2005;352:1539–49.PubMedCrossRef

Epstein AE, DiMarco JP, Ellenbogen KA, Estes 3rd NA, Freedman RA, Gettes LS, et al. 2012 ACCF/AHA/HRS focused update incorporated into the ACCF/AHA/HRS 2008 guidelines for device-based therapy of cardiac rhythm abnormalities: a report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines and the Heart Rhythm Society. Circulation. 2013;127:e283–352.PubMedCrossRef

10.

Bax JJ, Bleeker GB, Marwick TH, Molhoek SG, Boersma E, Steendijk P, et al. Left ventricular dyssynchrony predicts response and prognosis after cardiac resynchronization therapy. J Am Coll Cardiol. 2004;44:1834–40.PubMedCrossRef

11.

Yu CM, Fung JW, Zhang Q, Chan CK, Chan YS, Lin H, et al. Tissue Doppler imaging is superior to strain rate imaging and postsystolic shortening on the prediction of reverse remodeling in both ischemic and nonischemic heart failure after cardiac resynchronization therapy. Circulation. 2004;110:66–73.PubMedCrossRef

12.

Yu CM, Zhang Q, Chan YS, Chan CK, Yip GW, Kum LC, et al. Tissue Doppler velocity is superior to displacement and strain mapping in predicting left ventricular reverse remodeling response after cardiac resynchronization therapy. Heart. 2006;92:1452–6.PubMedCentralPubMedCrossRef

13.

Donal E, de Chillou C, Magnin-Poull I, Leclercq C. Imaging in cardiac resynchronization therapy: what does the clinician need? Europace. 2008;10 Suppl 3:iii70–2.PubMed

14.

Ypenburg C, van Bommel RJ, Delgado V, Mollema SA, Bleeker GB, Boersma E, et al. Optimal left ventricular lead position predicts reverse remodeling and survival after cardiac resynchronization therapy. J Am Coll Cardiol. 2008;52:1402–9.PubMedCrossRef

15.

Murphy RT, Sigurdsson G, Mulamalla S, Agler D, Popovic ZB, Starling RC, et al. Tissue synchronization imaging and optimal left ventricular pacing site in cardiac resynchronization therapy. Am J Cardiol. 2006;97:1615–21.PubMedCrossRef

16.

Khan FZ, Virdee MS, Palmer CR, Pugh PJ, O’Halloran D, Elsik M, et al. Targeted left ventricular lead placement to guide cardiac resynchronization therapy: the TARGET study: a randomized, controlled trial. J Am Coll Cardiol. 2012;59:1509–18.PubMedCrossRef

17.

Chalil S, Foley PW, Muyhaldeen SA, Patel KC, Yousef ZR, Smith RE, et al. Late gadolinium enhancement-cardiovascular magnetic resonance as a predictor of response to cardiac resynchronization therapy in patients with ischemic cardiomyopathy. Europace. 2007;9:1031–7.PubMedCrossRef

18.

Leyva F. Cardiac resynchronization therapy guided by cardiac magnetic resonance. J Cardiovasc Magn Reson. 2010;12:64.PubMedCentralPubMedCrossRef

19.

Boogers MJ, Chen J, van Bommel RJ, Borleffs CJ, Dibbets-Schneider P, van derHeil B, et al. Optimal left ventricular lead position assessed with phase analysis on gated myocardial perfusion SPECT. Eur J Nucl Med Mol Imaging. 2011;38:230–8.PubMedCentralPubMedCrossRef

20.

Friehling M, Chen J, Saba S, Bazaz R, Schwartzman D, Adelstein EC, et al. A prospective pilot study to evaluate the relationship between acute change in left ventricular synchrony after cardiac resynchronization therapy and patient outcome using a single-injection gated SPECT protocol. Circ Cardiovasc Imaging. 2011;4:532–9.PubMedCentralPubMedCrossRef

21.

Hawkins NM, Petrie MC, MacDonald MR, Hogg KJ, McMurray JV. Selecting patients for cardiac resynchronization therapy: electrical or mechanical dyssynchrony? Eur Heart J. 2006;27:1270–81.PubMedCrossRef

22.

Chen J, Garcia EV, Folks RD, Cooke CD, Faber TL, Tauxe EL, et al. Onset of left ventricular mechanical contraction as determined by phase analysis of ECG-gated myocardial perfusion SPECT imaging: development of a diagnostic tool for assessment of cardiac mechanical dyssynchrony. J Nucl Cardiol. 2005;12:687–95.PubMedCrossRef

23.

Singh JP, Klein HU, Huang DT, Reek S, Kuniss M, Quesada A, et al. Left ventricular lead position and clinical outcome in the multicenter automatic defibrillator implantation trial – cardiac resynchronization therapy (MADIT-CRT) trial. Circulation. 2011;123:1159–66.PubMedCrossRef

24.

Saba S, Marek J, Schwartzman D, Jain S, Adelstein E, White P, et al. Echocardiography-guided left ventricular lead placement for cardiac resynchronization therapy: results of the Speckle Tracking Assisted Resynchronization Therapy for Electrode Region trial. Circ Heart Fail. 2013;6:427–34.PubMedCrossRef

25.

Ludwig DR, Tanaka H, Friehling M, Gorcsan 3rd J, Schwartzman D. Further deterioration of LV ejection fraction and mechanical synchrony during RV apical pacing in patients with heart failure and LBBB. J Cardiovasc Transl Res. 2013;6:425–9.PubMedCrossRef

26.

Chung ES, Leon AR, Tavazzi L, Sun JP, Nihoyannopoulos P, Merlino J, et al. Results of the Predictors of Response to CRT (PROSPECT) trial. Circulation. 2008;117:2608–16.PubMedCrossRef

27.

Trimble MA, Velazquez EJ, Adams GL, Honeycutt EF, Pagnanelli RA, Barnhart HX, et al. Repeatability and reproducibility of phase analysis of gated single-photon emission computed tomography myocardial perfusion imaging used to quantify cardiac dyssynchrony. Nucl Med Commun. 2008;29:374–81.PubMedCentralPubMedCrossRef

28.

Lin X, Xu H, Zhao X, Folks RD, Garcia EV, Soman P, et al. Repeatability of left ventricular dyssynchrony and function parameters in serial gated myocardial perfusion SPECT studies. J Nucl Cardiol. 2010;17:811–6.PubMedCentralPubMedCrossRef

29.

White JA, Yee R, Yuan X, Krahn A, Skanes A, Parker M, et al. Delayed enhancement magnetic resonance imaging predicts response to cardiac resynchronization therapy in patients with intraventricular dyssynchrony. J Am Coll Cardiol. 2006;48:1953–60.PubMedCrossRef

30.

Adelstein EC, Saba S. Scar burden by myocardial perfusion imaging predicts echocardiographic response to cardiac resynchronization therapy in ischemic cardiomyopathy. Am Heart J. 2007;153:105–12.PubMedCrossRef

31.

Kristiansen HM, Vollan G, Hovstad T, Keilegavlen H, Faerestrand S. A randomized study of haemodynamic effects and left ventricular dyssynchrony in right ventricular apical vs. high posterior septal pacing in cardiac resynchronization therapy. Eur J Heart Fail. 2012;14:506–16.PubMedCrossRef

Titel: Impact of right-ventricular apical pacing on the optimal left-ventricular lead positions measured by phase analysis of SPECT myocardial perfusion imaging
verfasst von: Guang-Uei Hung
Jin-Long Huang
Wan-Yu Lin
Shih-Chung Tsai
Kuo-Yang Wang
Shih-Ann Chen
Michael S. Lloyd
Ji Chen
Publikationsdatum: 01.06.2014
Verlag: Springer Berlin Heidelberg
Erschienen in: European Journal of Nuclear Medicine and Molecular Imaging / Ausgabe 6/2014
Print ISSN: 1619-7070
Elektronische ISSN: 1619-7089
DOI: https://doi.org/10.1007/s00259-014-2693-y

Springer Medizin

Abstract

Purpose

Methods

Results

Conclusion

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