Abstract
Background Cardiac resynchronization therapy (CRT) improves outcomes in many heart failure patients, yet 1 in 3 patients do not positively respond. A “U-shaped” left ventricular (LV) activation pattern (type II), suggestive of electrical conduction block, can be characterized by cardiovascular magnetic resonance (CMR) and has been associated with improved CRT response compared to a more homogenous (type I) activation pattern. In other studies, targeting the LV pacing lead to the latest site of LV activation has been associated with improved response. We hypothesized that patients with CMR derived type II ventricular activation pattern and a concordant LV lead placement would have superior CRT response.
Highlights
Cardiac resynchronization therapy (CRT) improves outcomes in many heart failure patients, yet 1 in 3 patients do not positively respond
We hypothesized that patients with cardiovascular magnetic resonance (CMR) derived type II ventricular activation pattern and a concordant left ventricular (LV) lead placement would have superior CRT response
Endocardial borders were traced on short-axis cine images and radial displacement curves (RDCs) were generated and mapped to an American Heart Association (AHA) 17-segment model
Summary
Cardiac resynchronization therapy (CRT) improves outcomes in many heart failure patients, yet 1 in 3 patients do not positively respond. A “U-shaped” left ventricular (LV) activation pattern (type II), suggestive of electrical conduction block, can be characterized by cardiovascular magnetic resonance (CMR) and has been associated with improved CRT response compared to a more homogenous (type I) activation pattern. In other studies, targeting the LV pacing lead to the latest site of LV activation has been associated with improved response. We hypothesized that patients with CMR derived type II ventricular activation pattern and a concordant LV lead placement would have superior CRT response
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