Cardiac resynchronization therapy guided by late gadolinium-enhancement cardiovascular magnetic resonance

2011

Guiding Heart Device Placement with MRI Improves Outcomes

Sample size: 559 publication 10 minutes Evidence: high

Author Information

Author(s): Francisco Leyva, Paul W. X. Foley, Shajil Chalil, Karim Ratib, Russell E. A. Smith, Frits Prinzen, Angelo Auricchio

Primary Institution: Centre for Cardiovascular Sciences, Queen Elizabeth Hospital, University of Birmingham, UK

Hypothesis

Does using late gadolinium-enhancement cardiovascular magnetic resonance (LGE-CMR) to guide left ventricular lead deployment improve long-term outcomes in cardiac resynchronization therapy (CRT)?

Conclusion

Using LGE-CMR to guide LV lead placement away from scarred myocardium leads to better clinical outcomes after CRT.

Supporting Evidence

Patients with leads placed over scarred myocardium had a significantly higher risk of cardiovascular death.
Using LGE-CMR improved the clinical outcomes compared to conventional lead placement methods.
Patients with a scar burden of <10% had better outcomes than those with a higher scar burden.

Takeaway

Doctors used special MRI scans to help place heart devices better, which made patients feel better and live longer. If the device is placed near damaged heart tissue, it can cause more problems.

Methodology

559 patients with heart failure underwent CRT, with lead placements guided by LGE-CMR or not, and outcomes were assessed over a maximum follow-up of 9.1 years.