Introduction
Methods
Study population
Study design
Cardiac magnetic resonance imaging
Cardiac computed tomography
Image processing
Image fusion
CRT implantation
Statistical analysis
Results
All patients (n = 15) | Target group (n = 6) | Non-target group | |
---|---|---|---|
Male gender (%) | 10 (67) | 3 (50) | 7 (78) |
Age (years) | 68 ± 11 | 67 ± 13 | 69 ± 9 |
Body Mass Index (kg/m2) | 26 ± 5 | 27 ± 6 | 26 ± 4 |
NYHA functional class (n, %) | |||
II | 12 (80) | 5 (83) | 7 (78) |
III | 3 (20) | 1 (17) | 2 (22) |
Left bundle branch block (n, %)a | 11 (73) | 5 (83) | 6 (67) |
QRS duration (ms) | 162 ± 23 | 165 ± 26 | 160 ± 22 |
PR interval (ms) | 188 ± 34 | 164 ± 27† | 203 ± 29† |
LV ejection fraction (%) | 26 ± 5 | 27 ± 6 | 25 ± 5 |
LV end diastolic volume (ml) | 209 [165–250] | 175 [142–216] | 222 [184–327] |
LV end systolic volume (ml) | 149 [123–198] | 128 [96–169] | 162 [135–250] |
Ischemic cardiomyopathy (n, %) | 7 (47) | 2 (33) | 6 (67) |
Scar burden (%) | 18 [13–28] | 30 [15–45] | 18 [7–28] |
LV implantation characteristics
Target group (n = 6) | Non-target group (n = 9) | p-value | |
---|---|---|---|
Distance to target sites | |||
Distance to target (mm) | 8 [0–22] | 26 [17–46] | 0.04 |
Distance to infarct (mm) | 22 [21–23] (n = 2) | 26 [14–51] | 0.51 |
Distance to left phrenic nerve (mm) | 44 [18–54] | 44 [36–n/a] | 0.61 |
Implantation characteristics | |||
Implantation duration (min) | 146 ± 38 | 127 ± 35 | 0.38 |
LV lead implantation duration (min) | 47 ± 18 | 55 ± 28 | 0.57 |
Fluoroscopy time (min) | 36 ± 15 | 28 ± 12 | 0.30 |
Total radiation dose (cGycm2) | 6758 ± 4201 | 8242 ± 6446 | 0.70 |
Pre-procedural 3D-angiogram radiation (cGycm2) | 1188 ± 262 | 1449 ± 452 | 0.41 |
Post-procedural 3D-angiogram radiation (cGycm2) | 1313 ± 333 | 1491 ± 439 | 0.57 |
Radiation dose CRT only (cGycm2) | 5753 ± 3038 | 5303 ± 5847 | 0.91 |
LV lead electrical properties | |||
Paced QRS duration (ms) | 153 ± 22 | 170 ± 22 | 0.18 |
Decrease QRS duration (ms) | − 12 ± 13 | − 9 ± 27 | 0.10 |
Pacing threshold (V) | 0.65 ± 0.39 | 0.58 ± 0.20 | 0.64 |
QLV (ms) | 150 ± 8 | 130 ± 30 | 0.23 |
Ratio QLV/QRS (%) | 85 ± 10 | 81 ± 16 | 0.66 |
Echocardiographic follow up | |||
LV end-systolic volume change (%) | − 30 ± 10 | − 19 ± 19 | 0.28 |
LV ejection fraction change from baseline (%) | 15 ± 5 | 10 ± 12 | 0.30 |