Positioning of left ventricular pacing lead guided by intracardiac echocardiography with vector velocity imaging during cardiac resynchronization therapy procedure

Rong Bai, Luigi Di Biase, Prasant Mohanty, Aaron B. Hesselson, Ermenegildo De Ruvo, Peter L. Gallagher, Claude S. Elayi, Sanghamitra Mohanty, Javier E. Sanchez, J. David Burkhardt, Rodney Horton, G. Joseph Gallinghouse, Shane M. Bailey, Jason D. Zagrodzky, Robert Canby, Monia Minati, Larry D. Price, C. Lynn Hutchins, Melody A. Muir, Leonardo Calo'Andrea Natale, Gery F. Tomassoni

Research output: Contribution to journalArticle

17 Citations (Scopus)

Abstract

LV Lead Positioning Guided by ICE With Vector Velocity Imaging. Introduction: Intraoperative modality for "real-time" left ventricular (LV) dyssynchrony quantification and optimal resynchronization is not established. This study determined the feasibility, safety, and efficacy of intracardiac echocardiography (ICE), coupled with vector velocity imaging (VVI), to evaluate LV dyssynchrony and to guide LV lead placement at the time of cardiac resynchronization therapy (CRT) implant. Methods: One hundred and four consecutive heart failure patients undergoing ICE-guided (Group 1, N = 50) or conventional (Group 2, N = 54) CRT implant were included in the study. For Group 1 patients, LV dyssynchrony and resynchronization were evaluated by VVI including visual algorithms and the maximum differences in time-to-peak (MD-TTP) radial strain. Based on the findings, the final LV lead site was determined and optimal resynchronization was achieved. CRT responders were defined using standard criteria 6 months after implantation. Results: Both groups underwent CRT implant with no complications. In Group 1, intraprocedural optimal resynchronization by VVI including visual algorithms and MD-TTP was a predictor discriminating CRT response with a sensitivity of 95% and specificity of 89%. Use of ICE/VVI increased number of and predicted CRT responders (82% in Group 1 vs 63% in Group 2; OR = 2.68, 95% CI 1.08-6.65, P = 0.03). Conclusion: ICE can be safely performed during CRT implantation. "Real-time" VVI appears to be helpful in determining the final LV lead position and pacing mode that allow better intraprocedural resynchronization. VVI-optimized acute resynchronization predicts CRT response and this approach is associated with higher number of CRT responders.

Original languageEnglish (US)
Pages (from-to)1034-1041
Number of pages8
JournalJournal of Cardiovascular Electrophysiology
Volume22
Issue number9
DOIs
StatePublished - Sep 2011
Externally publishedYes

Fingerprint

Cardiac Resynchronization Therapy
Echocardiography
Lead
Feasibility Studies
Heart Failure
Safety
Sensitivity and Specificity

Keywords

  • cardiac resynchronization therapy
  • heart failure
  • intracardiac echocardiography
  • strain
  • vector velocity imaging

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Physiology (medical)

Cite this

Positioning of left ventricular pacing lead guided by intracardiac echocardiography with vector velocity imaging during cardiac resynchronization therapy procedure. / Bai, Rong; Di Biase, Luigi; Mohanty, Prasant; Hesselson, Aaron B.; De Ruvo, Ermenegildo; Gallagher, Peter L.; Elayi, Claude S.; Mohanty, Sanghamitra; Sanchez, Javier E.; Burkhardt, J. David; Horton, Rodney; Gallinghouse, G. Joseph; Bailey, Shane M.; Zagrodzky, Jason D.; Canby, Robert; Minati, Monia; Price, Larry D.; Hutchins, C. Lynn; Muir, Melody A.; Calo', Leonardo; Natale, Andrea; Tomassoni, Gery F.

In: Journal of Cardiovascular Electrophysiology, Vol. 22, No. 9, 09.2011, p. 1034-1041.

Research output: Contribution to journalArticle

Bai, R, Di Biase, L, Mohanty, P, Hesselson, AB, De Ruvo, E, Gallagher, PL, Elayi, CS, Mohanty, S, Sanchez, JE, Burkhardt, JD, Horton, R, Gallinghouse, GJ, Bailey, SM, Zagrodzky, JD, Canby, R, Minati, M, Price, LD, Hutchins, CL, Muir, MA, Calo', L, Natale, A & Tomassoni, GF 2011, 'Positioning of left ventricular pacing lead guided by intracardiac echocardiography with vector velocity imaging during cardiac resynchronization therapy procedure', Journal of Cardiovascular Electrophysiology, vol. 22, no. 9, pp. 1034-1041. https://doi.org/10.1111/j.1540-8167.2011.02052.x
Bai, Rong ; Di Biase, Luigi ; Mohanty, Prasant ; Hesselson, Aaron B. ; De Ruvo, Ermenegildo ; Gallagher, Peter L. ; Elayi, Claude S. ; Mohanty, Sanghamitra ; Sanchez, Javier E. ; Burkhardt, J. David ; Horton, Rodney ; Gallinghouse, G. Joseph ; Bailey, Shane M. ; Zagrodzky, Jason D. ; Canby, Robert ; Minati, Monia ; Price, Larry D. ; Hutchins, C. Lynn ; Muir, Melody A. ; Calo', Leonardo ; Natale, Andrea ; Tomassoni, Gery F. / Positioning of left ventricular pacing lead guided by intracardiac echocardiography with vector velocity imaging during cardiac resynchronization therapy procedure. In: Journal of Cardiovascular Electrophysiology. 2011 ; Vol. 22, No. 9. pp. 1034-1041.
@article{7e01e8c3dec344ca8f4c4acbf594236b,
title = "Positioning of left ventricular pacing lead guided by intracardiac echocardiography with vector velocity imaging during cardiac resynchronization therapy procedure",
abstract = "LV Lead Positioning Guided by ICE With Vector Velocity Imaging. Introduction: Intraoperative modality for {"}real-time{"} left ventricular (LV) dyssynchrony quantification and optimal resynchronization is not established. This study determined the feasibility, safety, and efficacy of intracardiac echocardiography (ICE), coupled with vector velocity imaging (VVI), to evaluate LV dyssynchrony and to guide LV lead placement at the time of cardiac resynchronization therapy (CRT) implant. Methods: One hundred and four consecutive heart failure patients undergoing ICE-guided (Group 1, N = 50) or conventional (Group 2, N = 54) CRT implant were included in the study. For Group 1 patients, LV dyssynchrony and resynchronization were evaluated by VVI including visual algorithms and the maximum differences in time-to-peak (MD-TTP) radial strain. Based on the findings, the final LV lead site was determined and optimal resynchronization was achieved. CRT responders were defined using standard criteria 6 months after implantation. Results: Both groups underwent CRT implant with no complications. In Group 1, intraprocedural optimal resynchronization by VVI including visual algorithms and MD-TTP was a predictor discriminating CRT response with a sensitivity of 95{\%} and specificity of 89{\%}. Use of ICE/VVI increased number of and predicted CRT responders (82{\%} in Group 1 vs 63{\%} in Group 2; OR = 2.68, 95{\%} CI 1.08-6.65, P = 0.03). Conclusion: ICE can be safely performed during CRT implantation. {"}Real-time{"} VVI appears to be helpful in determining the final LV lead position and pacing mode that allow better intraprocedural resynchronization. VVI-optimized acute resynchronization predicts CRT response and this approach is associated with higher number of CRT responders.",
keywords = "cardiac resynchronization therapy, heart failure, intracardiac echocardiography, strain, vector velocity imaging",
author = "Rong Bai and {Di Biase}, Luigi and Prasant Mohanty and Hesselson, {Aaron B.} and {De Ruvo}, Ermenegildo and Gallagher, {Peter L.} and Elayi, {Claude S.} and Sanghamitra Mohanty and Sanchez, {Javier E.} and Burkhardt, {J. David} and Rodney Horton and Gallinghouse, {G. Joseph} and Bailey, {Shane M.} and Zagrodzky, {Jason D.} and Robert Canby and Monia Minati and Price, {Larry D.} and Hutchins, {C. Lynn} and Muir, {Melody A.} and Leonardo Calo' and Andrea Natale and Tomassoni, {Gery F.}",
year = "2011",
month = "9",
doi = "10.1111/j.1540-8167.2011.02052.x",
language = "English (US)",
volume = "22",
pages = "1034--1041",
journal = "Journal of Cardiovascular Electrophysiology",
issn = "1045-3873",
publisher = "Wiley-Blackwell",
number = "9",

}

TY - JOUR

T1 - Positioning of left ventricular pacing lead guided by intracardiac echocardiography with vector velocity imaging during cardiac resynchronization therapy procedure

AU - Bai, Rong

AU - Di Biase, Luigi

AU - Mohanty, Prasant

AU - Hesselson, Aaron B.

AU - De Ruvo, Ermenegildo

AU - Gallagher, Peter L.

AU - Elayi, Claude S.

AU - Mohanty, Sanghamitra

AU - Sanchez, Javier E.

AU - Burkhardt, J. David

AU - Horton, Rodney

AU - Gallinghouse, G. Joseph

AU - Bailey, Shane M.

AU - Zagrodzky, Jason D.

AU - Canby, Robert

AU - Minati, Monia

AU - Price, Larry D.

AU - Hutchins, C. Lynn

AU - Muir, Melody A.

AU - Calo', Leonardo

AU - Natale, Andrea

AU - Tomassoni, Gery F.

PY - 2011/9

Y1 - 2011/9

N2 - LV Lead Positioning Guided by ICE With Vector Velocity Imaging. Introduction: Intraoperative modality for "real-time" left ventricular (LV) dyssynchrony quantification and optimal resynchronization is not established. This study determined the feasibility, safety, and efficacy of intracardiac echocardiography (ICE), coupled with vector velocity imaging (VVI), to evaluate LV dyssynchrony and to guide LV lead placement at the time of cardiac resynchronization therapy (CRT) implant. Methods: One hundred and four consecutive heart failure patients undergoing ICE-guided (Group 1, N = 50) or conventional (Group 2, N = 54) CRT implant were included in the study. For Group 1 patients, LV dyssynchrony and resynchronization were evaluated by VVI including visual algorithms and the maximum differences in time-to-peak (MD-TTP) radial strain. Based on the findings, the final LV lead site was determined and optimal resynchronization was achieved. CRT responders were defined using standard criteria 6 months after implantation. Results: Both groups underwent CRT implant with no complications. In Group 1, intraprocedural optimal resynchronization by VVI including visual algorithms and MD-TTP was a predictor discriminating CRT response with a sensitivity of 95% and specificity of 89%. Use of ICE/VVI increased number of and predicted CRT responders (82% in Group 1 vs 63% in Group 2; OR = 2.68, 95% CI 1.08-6.65, P = 0.03). Conclusion: ICE can be safely performed during CRT implantation. "Real-time" VVI appears to be helpful in determining the final LV lead position and pacing mode that allow better intraprocedural resynchronization. VVI-optimized acute resynchronization predicts CRT response and this approach is associated with higher number of CRT responders.

AB - LV Lead Positioning Guided by ICE With Vector Velocity Imaging. Introduction: Intraoperative modality for "real-time" left ventricular (LV) dyssynchrony quantification and optimal resynchronization is not established. This study determined the feasibility, safety, and efficacy of intracardiac echocardiography (ICE), coupled with vector velocity imaging (VVI), to evaluate LV dyssynchrony and to guide LV lead placement at the time of cardiac resynchronization therapy (CRT) implant. Methods: One hundred and four consecutive heart failure patients undergoing ICE-guided (Group 1, N = 50) or conventional (Group 2, N = 54) CRT implant were included in the study. For Group 1 patients, LV dyssynchrony and resynchronization were evaluated by VVI including visual algorithms and the maximum differences in time-to-peak (MD-TTP) radial strain. Based on the findings, the final LV lead site was determined and optimal resynchronization was achieved. CRT responders were defined using standard criteria 6 months after implantation. Results: Both groups underwent CRT implant with no complications. In Group 1, intraprocedural optimal resynchronization by VVI including visual algorithms and MD-TTP was a predictor discriminating CRT response with a sensitivity of 95% and specificity of 89%. Use of ICE/VVI increased number of and predicted CRT responders (82% in Group 1 vs 63% in Group 2; OR = 2.68, 95% CI 1.08-6.65, P = 0.03). Conclusion: ICE can be safely performed during CRT implantation. "Real-time" VVI appears to be helpful in determining the final LV lead position and pacing mode that allow better intraprocedural resynchronization. VVI-optimized acute resynchronization predicts CRT response and this approach is associated with higher number of CRT responders.

KW - cardiac resynchronization therapy

KW - heart failure

KW - intracardiac echocardiography

KW - strain

KW - vector velocity imaging

UR - http://www.scopus.com/inward/record.url?scp=80052825189&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=80052825189&partnerID=8YFLogxK

U2 - 10.1111/j.1540-8167.2011.02052.x

DO - 10.1111/j.1540-8167.2011.02052.x

M3 - Article

C2 - 21457384

AN - SCOPUS:80052825189

VL - 22

SP - 1034

EP - 1041

JO - Journal of Cardiovascular Electrophysiology

JF - Journal of Cardiovascular Electrophysiology

SN - 1045-3873

IS - 9

ER -