Cardiac resynchronization therapy (CRT) using a bi-ventricular pacemaker is an important treatment option for patients with drug-refractory heart failure and evidence of ventricular dyssynchrony. However, using current selection criteria and implantation techniques, 30-40% of patients undergoing CRT are non-responsive to the treatment. Because CRT is invasive, costly, has significant associated risks, and requires lifelong need of pacing device, there is a clear need for better methods to optimize the treatment. Multiple factors influence patient response to CRT including poor selection criteria and/or non-optimal device implementation. In the implementation of CRT, the position of the left ventricular (LV) pacing lead has a significant role in determining patient response. The overall goals of this project are: 1) to develop an MRI- based methodology to plan and locate the LV pacing lead in the area of latest contraction and 2) test the methodology on a group of patients undergoing CRT.

Public Health Relevance

We propose to develop methodology to use magnetic resonance imaging (MRI) to plan left ventricular lead placement in patients undergoing cardiac resynchronization therapy (CRT) using a bi-ventricular pacemaker. The project involves development and validation of software for the display of regional ventricular dyssynchrony and myocardial scar burden by MRI. The MRI based methodology will then be evaluated in a series of patients to test its ability to improve outcomes by improving lead placement.

Agency
National Institute of Health (NIH)
Institute
National Heart, Lung, and Blood Institute (NHLBI)
Type
Exploratory/Developmental Grants (R21)
Project #
5R21HL109979-02
Application #
8442235
Study Section
Bioengineering, Technology and Surgical Sciences Study Section (BTSS)
Program Officer
Boineau, Robin
Project Start
2012-04-01
Project End
2014-03-31
Budget Start
2013-04-01
Budget End
2014-03-31
Support Year
2
Fiscal Year
2013
Total Cost
$169,727
Indirect Cost
$50,727
Name
Emory University
Department
Radiation-Diagnostic/Oncology
Type
Schools of Medicine
DUNS #
066469933
City
Atlanta
State
GA
Country
United States
Zip Code
30322
Lam, Adrian; Mora-Vieira, Luis F; Hoskins, Michael et al. (2014) Performance of 3D, navigator echo-gated, contrast-enhanced, magnetic resonance coronary vein imaging in patients undergoing CRT. J Interv Card Electrophysiol 41:155-60