57. New Image Integration Technologies for Optimization of Cardiac Resynchronization Therapy

  1. Mohammad Shenasa MD2,
  2. Gerhard Hindricks MD3,
  3. Martin Borggrefe MD4,
  4. Günter Breithardt MD5 and
  5. Mark E. Josephson MD6
  1. Charlotte Eitel and
  2. Christopher Piorkowski

Published Online: 18 DEC 2012

DOI: 10.1002/9781118481585.ch57

Cardiac Mapping, Fourth Edition

Cardiac Mapping, Fourth Edition

How to Cite

Eitel, C. and Piorkowski, C. (2013) New Image Integration Technologies for Optimization of Cardiac Resynchronization Therapy, in Cardiac Mapping, Fourth Edition (eds M. Shenasa, G. Hindricks, M. Borggrefe, G. Breithardt and M. E. Josephson), Wiley-Blackwell, Oxford, UK. doi: 10.1002/9781118481585.ch57

Editor Information

  1. 2

    Attending Physician, Department of Cardiovascular Services, O'Connor Hospital, Heart & Rhythm Medical Group, San Jose, California, USA

  2. 3

    Professor of Medicine (Cardiology), University Leipzig, Heart Center, Director, Department of Electrophysiology, Leipzig, Germany

  3. 4

    Professor of Medicine (Cardiology), Head, Department of Cardiology, Angiology and Pneumology, University Medical Center, Mannheim Medical Faculty Mannheim, University of Heidelberg, Mannheim, Germany

  4. 5

    Professor Emeritus of Medicine and Cardiology, Department of Cardiology and Angiology, Hospital of the University of Münster, Münster, Germany

  5. 6

    Chief, Cardiovascular Medicine Division, Director, Harvard-Thorndike Electrophysiology Institute and Arrhythmia Service, Beth Israel Deaconess Medical Center, Herman C. Dana Professor of Medicine, Harvard Medical School, Boston, Massachusetts, USA

Author Information

  1. University of Leipzig Heart Center, Leipzig, Germany

Publication History

  1. Published Online: 18 DEC 2012
  2. Published Print: 10 JAN 2013

ISBN Information

Print ISBN: 9780470670460

Online ISBN: 9781118481585

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Keywords:

  • cardiac resynchronization therapy;
  • LV lead placement;
  • dyssynchrony;
  • imaging;
  • non-responder;
  • CRT optimization;
  • implantation;
  • devices

Summary

Cardiac resynchronization therapy (CRT) is an effective therapy in patients with heart failure and delayed ventricular conduction. Unfortunately, one-third of patients undergoing CRT for current guideline-recommended indications do not derive a significant benefit from it. Non-response to CRT may relate to scar burden, the amount of electrical and mechanical dyssynchrony, left ventricular (LV) lead placement and other factors. Identification of optimal pacing sites requires combination and integration of information on electrical and mechanical dyssynchrony, anatomical information on coronary sinus (CS) anatomy and tissue characterization leading to an optimal pacing site at the latest activated viable segment that is provided with an appropriate CS target vein. This chapter gives an overview of current imaging methodologies and integration technologies for definition of LV target sites with their strengths and weaknesses.