Cardiac resynchronization therapy (CRT) is an effective treatment for chronic symptomatic systolic heart failure with cardiac dyssynchrony, but about one-third of patients do not respond favourably to the therapy. We hypothesized that acute modifications of the coronary sinus electrode tip movements, induced by biventricular pacing, may be related to resynchronization process and consequently to CRT response. In 13 patients submitted to CRT implant, a previously validated method for coronary sinus lead 3D tracking throughout cardiac cycles was applied at the device implant, before and immediately after the turning-on of pacing. Several parameters describing the 3D position of coronary sinus lead and its trajectory throughout the cardiac cycle in these two time instants, were computed and compared between echo-responder patients and non-responders. Significant differences in these parameters indicated a more circular and smooth trajectory as an immediate result of the CRT turning-on in the echo-responder group. Preliminary data showed that 3D trajectories could describe features of resynchronization start-up in CRT recipients and may help to understand the reasons of therapy failure in non-responder patients.

Prediction of CRT response by means 3D trajectory assessment of the coronary sinus lead

CORSI, CRISTIANA;TURCO, DARIO;SEVERI, STEFANO
2012

Abstract

Cardiac resynchronization therapy (CRT) is an effective treatment for chronic symptomatic systolic heart failure with cardiac dyssynchrony, but about one-third of patients do not respond favourably to the therapy. We hypothesized that acute modifications of the coronary sinus electrode tip movements, induced by biventricular pacing, may be related to resynchronization process and consequently to CRT response. In 13 patients submitted to CRT implant, a previously validated method for coronary sinus lead 3D tracking throughout cardiac cycles was applied at the device implant, before and immediately after the turning-on of pacing. Several parameters describing the 3D position of coronary sinus lead and its trajectory throughout the cardiac cycle in these two time instants, were computed and compared between echo-responder patients and non-responders. Significant differences in these parameters indicated a more circular and smooth trajectory as an immediate result of the CRT turning-on in the echo-responder group. Preliminary data showed that 3D trajectories could describe features of resynchronization start-up in CRT recipients and may help to understand the reasons of therapy failure in non-responder patients.
2012
Congresso Nazionale di Bioingegneria 2012 Atti
68
69
C. Corsi; D. Turco; C. Tomasi; I. Rubino; R. Pepoli; M. Margheri; S. Severi
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/11585/125832
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