SPECT-Guided LV Lead Placement for Incremental CRT Efficacy

Zou, Jiangang; Hua, Wei; Su, Yangang; Xu, Geng; Zhen, Liangrong; Yan, Ji; Yu, Bo; Liu, Xinbing; Xue, Xiaolin; Jin, Can; Ji, Fan; Guo, Tao; Yang, Lixia; Dong, Yugang; Chen, Lin; Gu, Xianglin; Zhu, Li; Hu, Zuo‐Ying; Fan, Xiaohan; Hou, Xiaofeng; Shan, Qijun; Yang, Bing; Zhang, Qian; Wang, Yao; Gu, Kai; Qiu, Yuanhao; Wu, Hongping; Tang, Lijun; Zhao, Zhigang; Wei, Yongyue; Chen, Feng; Chen, Ji; Cao, Kejiang

doi:10.1016/j.jcmg.2019.07.009

Cited by 12 publications

(11 citation statements)

References 4 publications

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“…In contrast, Salden et al [ 20 ] assessed Real-time image-guided LV lead placement by fusion of fluoroscopy images with CMR images. The GUIDECRT trial by Zou et al [ 21 ] validated the improvement of CRT efficacy guided by SPECT. Mele et al [ 22 ] investigated the feasibility of LV lead placement directed by parametric two-dimensional STE with polar plots of the amplitude and timing of LV longitudinal strain.…”

Section: Resultsmentioning

confidence: 99%

“…One RCT reported the generation process of adequate random sequence and the allocation concealment [ 16 ]; therefore, it was regarded as high quality. Another three RCT studies were deemed moderate quality [ 17 , 19 , 21 ]. Based on the Newcastle–Ottawa Scale for risk-stratifying observational study biases, three studies received eight stars [ 15 , 18 , 20 ], and one study received seven stars [ 22 ].…”

Section: Resultsmentioning

confidence: 99%

“…Seven studies reported direct comparison of responses between image-guided CRT and standard CRT placements [ 15 – 19 , 21 , 22 ]. All seven studies showed that participants undergoing image-guided CRT had significantly higher CRT response rates.…”

Section: Resultsmentioning

confidence: 99%

“…Eight studies compared the changes from baseline to post-treatment LVESV in the image-guided group with the changes in the standard group [ 15 – 22 ]. Six studies [ 15 – 18 , 20 , 21 ] demonstrated that the decrease of LVESV was more prominent in the image-guided group. Pooled data illustrated the comparative results from this inter-group meta-analysis (WMD, − 12.46[95% CI, − 18.89 to − 6.03]; p < 0.01, Fig.…”

Section: Resultsmentioning

confidence: 99%

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Comparative efficacy of image-guided techniques in cardiac resynchronization therapy: a meta-analysis

Hassea

et al. 2021

BMC Cardiovasc Disord

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Background Several studies have illustrated the use of echocardiography, magnetic resonance imaging, and nuclear imaging to optimize left ventricular (LV) lead placement to enhance the response of cardiac resynchronization therapy (CRT) in heart failure patients. We aimed to conduct a meta-analysis to determine the incremental efficacy of image-guided CRT over standard CRT. Methods We searched PubMed, Cochrane library, and EMBASE to identify relevant studies. The outcome measures of cardiac function and clinical outcomes were CRT response, concordance of the LV lead to the latest sites of contraction (concordance of LV), heart failure (HF) hospitalization, mortality rates, changes of left ventricular ejection fraction (LVEF), and left ventricular end-systolic volume (LVESV). Results The study population comprised 1075 patients from eight studies. 544 patients underwent image-guided CRT implantation and 531 underwent routine implantation without imaging guidance. The image-guided group had a significantly higher CRT response and more on-target LV lead placement than the control group (RR, 1.33 [95% CI, 1.21 to 1.47]; p < 0.01 and RR, 1.39 [95% CI, 1.01 to 1.92]; p < 0.05, respectively). The reduction of LVESV in the image-guided group was significantly greater than that in the control group (weighted mean difference, − 12.46 [95% CI, − 18.89 to − 6.03]; p < 0.01). The improvement in LVEF was significantly higher in the image-guided group (weighted mean difference, 3.25 [95% CI, 1.80 to 4.70]; p < 0.01). Pooled data demonstrated no significant difference in HF hospitalization and mortality rates between two groups (RR, 0.89 [95% CI, 0.16 to 5.08]; p = 0.90, RR, 0.69 [95% CI, 0.37 to 1.29]; p = 0.24, respectively). Conclusions This meta-analysis indicates that image-guided CRT is correlated with improved CRT volumetric response and cardiac function in heart failure patients but not with lower hospitalization or mortality rate.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

See 2 more Smart Citations

Comparative efficacy of image-guided techniques in cardiac resynchronization therapy: a meta-analysis

Hassea

et al. 2021

BMC Cardiovasc Disord

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“…Several studies have tried to find parameters or factors that could significantly improve CRT efficacy. The use of SPECT images to assess LV latest activation was shown in [10] to improve the rate of placing LV on target and ultimately produced a positive improvement in CRT response. Other studies have used machine learning approaches to predict mortality in patients with coronary artery disease.…”

Section: Related Workmentioning

confidence: 99%