New opportunities for assessing the optimal positioning of a multipolar left ventricular electrode for resynchronization therapy

Abstract

<p>Heart failure and left bundle branch block is a common disease in the modern world. Cardiac resynchronization therapy is used to correct this condition, but some patients have no positive clinical effect from its use. One of the reasons for the lack of response to therapy is not the optimal position of the left ventricular electrode. In this clinical case we presented the experience of using myocardial perfusion scintigraphy to determine the optimal position of the left ventricular electrode.<br />A 60-year-old patient, who was admitted to the center with symptoms of heart failure and signs of complete left bundle branch block, underwent an implantation of the cardiac resynchronization system. Both intraoperative data and the data of preliminary myocardial scintigraphy were used to select the site of implantation of the left ventricular electrode. A significant improvement in the patient’s condition, evaluated after 6 months after the implantation of the device, allowed us to conclude that the use of myocardial perfusion scintigraphy with standard methods of ultrasound diagnosis can increase the efficiency of implantation of cardiac resynchronization devices and a response to the therapy.</p><p>Received 2 October 2019. Revised 20 December 2019. Accepted 23 December 2019.</p><p><strong>Funding:</strong> The work is supported by a grant of the President of the Russian Federation for young scientists No. МД-2893.2018.7.</p><p><strong>Conflict of interest:</strong> Authors declare no conflict of interest.</p>

Radionuclide imaging for feasibility of target left ventricular lead placement in patients with heart failure scheduled for cardiac resynchronization therapy

“…Тем не менее, несмотря на поиск оптимальных кандидатов на СРТ, доля пациентов, у которых данная терапия не приводит к улучшению клинико-функционального состояния, может достигать 40% [3,4]. В настоящее время проводится поиск методик, которые позволят повысить эффективность отбора пациентов, что в свою очередь улучшит ответ на СРТ [5,6]. Среди методов предоперационного отбора появляются данные об использовании методов радионуклидной визуализации, которые до сих пор не имеют серьезной альтернативы в комплексной оценке миокардиальной перфузии [7] и симпатической активности [8] миокарда ЛЖ.…”