Author’s Accepted Manuscript A novel approach for left ventricular lead placement in cardiac resynchronization therapy: Intra-procedural integration of coronary venous electro-anatomic mapping with delayed enhancement cardiac magnetic resonance imaging Uyên Châu Nguyên, Masih Mafi-Rad, Jean-Paul Aben, Martijn W. Smulders, Elien B. Engels, Antonius M.W. van Stipdonk, Justin G.L.M. Luermans, Sebastiaan C.A.M. Bekkers, Frits W. Prinzen, Kevin Vernooy
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S1547-5271(16)30798-6 http://dx.doi.org/10.1016/j.hrthm.2016.09.015 HRTHM6865
To appear in: Heart Rhythm Received date: 2 August 2016 Cite this article as: Uyên Châu Nguyên, Masih Mafi-Rad, Jean-Paul Aben, Martijn W. Smulders, Elien B. Engels, Antonius M.W. van Stipdonk, Justin G.L.M. Luermans, Sebastiaan C.A.M. Bekkers, Frits W. Prinzen and Kevin Vernooy, A novel approach for left ventricular lead placement in cardiac resynchronization therapy: Intra-procedural integration of coronary venous electro-anatomic mapping with delayed enhancement cardiac magnetic resonance imaging, Heart Rhythm, http://dx.doi.org/10.1016/j.hrthm.2016.09.015 This is a PDF file of an unedited manuscript that has been accepted for publication. As a service to our customers we are providing this early version of the manuscript. The manuscript will undergo copyediting, typesetting, and review of the resulting galley proof before it is published in its final citable form. Please note that during the production process errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain.
A novel approach for left ventricular lead placement in cardiac
resynchronization
therapy:
intraprocedural
integration of coronary venous electroanatomic mapping with delayed enhancement cardiac magnetic resonance imaging ² ²ǡ ǡ
ǡͳ Ǧǡ ǡʹ Ǧ ǡ
ǡ͵ Ǥ ǡ ǡʹ Ǥ ǡ
ǡͳ ǤǤ ǡ ǡʹ ǤǤǤ ǡǡǡʹǤǤǤǡǡǡʹ Ǥǡǡͳ ǡǡʹ 1DepartmentofPhysiology,CardiovascularResearchInstituteMaastricht, 2Departmentof
Cardiology, Maastricht University Medical Center, 3Pie Medical Imaging, Maastricht, the Netherlands Correspondenceto: ² ²ǡ ǡ
ǡ Ǧ ͳǡ ʹͲͲǡ Ǥ ǣΪ͵ͳǦͶ͵Ǧ͵ͺͺͳʹͲͲǢ ǣΪ͵ͳǦͶ͵Ǧ ͵ͺͺͶͳǤǣ
ʹ̷Ǥ
Shorttitle:
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Wordcount:Ͷͻ͵ʹ Conflict of interest: ǤǤǤ
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Abstract Background:
ȋȌ
ȋȌ Ǥ Objective:
Ǧ
ȋȌ
ȋǦȌ
Ǥ Methods:
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ǤǦǦ
Ǥ Ǧ
Ǧ
ǦǤ
ȋ Ȍ Ǥ Results: Ǧ
ͺǤͻάʹǤͺ
ͶǤάͳǤͳ ȋάȌǤ
ʹΫͳͻ ȋͷΫͳͳ͵Ψ Ȍ
Ǥ
Ǥ
Ǥ
Ǧ
ȋǤͳά͵ǤͶͷ Ǥ ͺǤͳͺάͶǤͲʹȋά ȌǡpδͲǤͲͲͳȌǡ
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ȋǦͲǤͳͳǡpδͲǤͲͲͳȌǡǤ Conclusion:
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Keywords ǡ
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ǡ
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ʹ
Introduction
ȋȌǡ Ǥͳ
ȋȌ Ǥʹ
Ǥ͵ ǡ
ǤͶ ǡ
Ǥͷ ǡ
Ǥ
Ǧ
ȋȌ
Ǥ
ȋǦȌ
Ǥ Ǧ
͵
Ǥ
ȋͳȌǦ
͵
ǦǦ
ǡȋʹȌ ͵Ǧ
ǡȋ͵Ȍ
ǡ ͶȌ
ȋ Ȍ
Ǥ
Methods Studypopulation
Ȁ
Ǧ
Ǧ
Ǥ
Ǥ
͵
Cardiacmagneticresonanceimagingandanalysis
Ǧ ͳǤͷȀ͵ǤͲǦ ȋ Ȁ Ȁ
ǡ Ȍ
Ǥ
ǡ Ǧ
Ǧ
ȋ
Ǧͺǡ
ǦͳͲǡȀʹǤͻǦͶǤ͵ȀͳǤͷǦ ͳǤǡ ͷͲǦͺͲιǡ ͵ʹͲǦ͵ͺͶǡ ʹͷǦͷͲέʹͷǦͷͲȌ ǣ
Ǧ
ǡ Ǧ
ǡ Ǧ
ǡ Ǧ
Ǥ ǡ ʹ
ȋȀͶǤͲǦǤͳȀͳǤʹǦ͵ǤͲǡ
ǦͳͲǡ ͳͲǦʹͷιǡ ͵ͲͲǦ͵ͺͶǡ ʹͶͲǦͷέʹͶͲǦͷȌǡ ͳͲ ͲǤͳͷȀ ȋ
ǡ
ȌǤ Ǧ
ȋ ͵ǤͶǡ
ǡ
ȌǤ
Ǥ
Ǧ
Ǧ
Ǧ
ǡ Ǧ Ǧ ǡ ͳǡ
ȋȌ
͵
Ǥ
Ǧ
ǦǦ
ǦǦǤͺ
Ǧ Ǧ
ͻǦ
Ǥ
Ǧ
͵
ǡ ͳǡ
ʹͲͳ͵ ȋǡ
ǡȌ
ȋǤ
ǡǤǡȌǤ
Electroanatomicmapping Ǧ
Ǥ
Ǥǡ
͵
Ǥ
ͳǤ
Ͷ
Ǧ
ȋȌǤ
ȋȌǡ
ǡ Ǥ
ȋǤ
Ȍ
Ǥ
Ǥ
ͳǦ
Ǥͻ
Imageintegration
ǡ Ǧ
Ǧ ͵
Ǥ ǡ
ǡǡ
ǦǤǡ
Ǧ
ǡ
ǤͳͲ ͵ Ǧ ͳ
Ǧ ͳǤ
Leftventricularleadplacement Ǧǡ
Ǥ
ȋ
εͲΨȌǡ
ǡ
ǡ εͻͷεͷͲΨǡ
Ǥͳͳ
Ǧ Ǥ Ǥ
Ǥ
ͷ
Integrationaccuracyevaluation Ǧ
Ǧ
Ǧ Ǧ ʹǤ Ǧ Ǧ
Ã
ǦǤ
ÃǤ
Ǧ
ÃǦ
ʹǤ
Ǧ Ǧ
ǡ ʹǡ
Ǥ
Electrogramanalyses ǦǦ
Ǥ
ǡ
ǦǦ
ͳǦ ȋ ͻǦ
ȌǤ
Ǧ Ǥ
Ǧ
ͲΨ
εͲΨǤ
Statisticalanalysis
ͳͻǤͲ ȋ
Ǥǡ
ǡ ȌǤ ά ά
Ȁ
Ǥ
Ȃ ǡǦǡ
Ǥ
pδͲǤͲͷǢǦ
Ǥ
Results Patientcharacteristics
Ȁ
Ǧ
Ǧ
Ǥ
ͳǤ Ǧ ʹǤ
CRTimplantation de novo Ǥ
Ǥ
Ǥ
Ǥ
Electroanatomicmapping Ǧ
Ǥ ʹͲάͶ
ͳͻά Ǥ ͳͺ ͵
ǡ
ͻʹΨǤ
͵Ǥ ̵ Ǥάʹ͵Ǥʹ
Ǥ
ʹΫͳͻȋͷΫͳͳ͵ΨȌǡ͵ǡ
͵Ǥ
Imageintegration
͵
Ǧ Ǧ
ʹͷάͷ Ǥ
ͳͲάͷ ͺǤͻάʹǤͺ
Ǥ
ͶǤάͳǤͳ͵Ǥ͵άͲǤͻǡʹͷǤ͵άǤ͵ Ǥ
Leftventricularleadplacement ͵
ǡ
ǡ Ǥ
͵ǡ
Ǥǡ
ǡ
ͶǤ ǢǤͺ Ͷǡ
ǡǤͳͺ
Ǥ ǡ
Ǥ ǡ
ȋnαʹǡǤͷ ǤȌ ͳǡ
ȋnαʹǡ ǤͳͲ ǤͳͳȌ Ͷǡ
ȋnαʹǡǤͳʹ ǤͳͷȌ ͶǤ
Electrogramvoltages ͳͲͳͷ ̵Ǧ
ȋn=ͷͲͶȌ
ȋnαͷͳͳȌǤ ͺǤͳͺάͶǤͲʹ ȋά Ȍ Ǧ
Ǥͳά͵ǤͶͷ
ȋȂ ǦpζͲǤͲͲͳȌǤ
Ǧ
ȋ
ǦͲǤͳͳǡ pδͲǤͲͲͳȌǤ
Ǧ
Ǥ
ǡ ͷǤ Ǧ
ȋǦ pζͲǤͲͲͳȌ ǡ
Ǥ
Discussion ǡ
Ǧ
Ǧ
Ǧ
Ǥ Ǧǡ
Ǧ
̶̶
Ǥ Ǧǡ
Ǥ
ͶǤάͳǤͳ
Ǥͳʹ
Ǧ
Ǥ
ǡǦ
Ǥ
ͺ
Leftventricularleadplacement
Ǧ
ͳͶͶ Ǥ͵
ʹͷ ͵ʹ ǡ ǡ
Ǥ
Ǥ
ǡ
ǡ
Ǥ
ǡ
ͷͷͻ
ǡ
ǡ
Ǥʹ
Ǥ
Imageguidedcardiacresynchronizationtherapy Ǧ
Ǥ
Ǧ
Ǧ
ʹ Ǥͳ͵ ʹʹͲ ͳǣͳ Ǥ ǡ
ȋͲΨ Ǥ ͷͷΨǡ pα ͲǤͲ͵ͳȌǤ
Ǥ
Ǥ
Ǥ
ǡ
ǡ
ǤǦ
Ǧ
ȋͷΨȌǤ
ȋͻΨȌ ȋʹͶΨȌǤǦ
ȋʹͻΨ Ǥ Ψ
Ȍǡ
Ǥͳ͵ ǡ ǡ
Ǧ
ǡ
ǡ
͵ͻ ǤͳͶǤ ͻ
ǡ
ǡ
Ǥ
Ǧ
Ǧ
Ǧ
Ǧ
δͷͲΨ
Ǥͳͷ
δͷͲΨ
ͳͷȀʹͲ Ǥ
ǡ ͻʹΨ
Ǥ ͷͲΨ Ǧǡ
Ǥ
Ǧ
ǡ
Ǧ
Ǥ Ǧ
Ǧ
Ǧ ǦǤ
Clinicalimplications Ǧ
Ǥǡ Ǧǡ
Ǥ
Ǥ
ǡ
Ǧ ǡ ǡ
Ǥ Ǧ
ǡ
Ǥ
Ǥǡͳ
ǡ
Ǧ ǡ Ǧ
ǡ
Ǥ
ͳͲ
Ǧǡ
ǡ
Ǥǡ
Ǧ Ǥ
ǦȋǦȌǤ
Limitations Ǧ
Ǥ
ǡ ̶̶
Ǥ
ǡ
Ǥǡͳ
Ǧ
Ǧ ̵ ǦǤ ǡ
Ǥ
Conclusion Ǧ
Ǧ
Ǧ Ǧ Ǥ Ǧ
Ǧ
ǤǦ
ǡ
Ǧ
Ǥ
Acknowledgement
Ǥ
Ǥ
References 1.
ͳͳ
ǡ ǤǦ
ǣ Ǥ
ǣ
ʹͲͳͳǢͷǣͷʹͳǦͷʹǤ
2.
3.
4.
5.
6.
7.
8.
9.
10. 11.
ͳʹ
ǡ ǡ ǡ ǡ ǡ ǡ
Ǥ
Ǧ
Ǥ
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ʹͲͳͳǢͳ͵ǣʹͻǤ ǡ ǡǡǡ
ǡǡǡ Ǥǡ
ǡ
Ǥ ʹͲͳ͵Ǣ͵ͶǣʹʹͷʹǦʹʹʹǤ ǡǡ ǡǤ
Ǥ
ʹͲͳ͵ǢǣͷͶʹǦͷͷͲǤ ǡ ǡǡ
ǡ ǡǡ Ǥ
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ʹͲͳͶǢͳͶǣʹǦͺǤ ǡ ǡ ǡ ǡ ǡ ǡ Ǥ
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ǡǡ
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ʹͲͳͷǢͳǣͺͶǦͻ͵Ǥ
ǡ ǡ ǡ Ǥ ʹͲͳ͵
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ȋȌǤ
ȋȌǤ
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ʹͲͳ͵ǢͳͷǣͳͲͲǦͳͳͳͺǤ ǡ ǡ ǡ ǡ ǡ
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ʹͳʹͲͲͶǢͶͶǣʹ͵ͺ͵Ǧʹ͵ͺͻǤ ǡ ǡ ǡ
ǡ ǡ ǡ ǡ ǡǡǤ
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ʹͻʹͲͲʹǢͳͲͷǣͷ͵ͻǦ ͷͶʹǤ Ǥ
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15.
16.
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ǣ Ǧ Ǥ ʹͲͳͳǢ͵ʹǣͳͲͶǦͳͳͶǤ ǡǡǡ ǡ̵ǡǡǡǡ ǡ Ǥ
ǣ ǣ ǡ
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ʹͶʹͲͳʹǢͷͻǣͳͷͲͻǦͳͷͳͺǤ ǡ ǡ ǡ ǡ ǡ Ǥ
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ʹͲͳͶǢͶͳǣͳͶǦͳͷ͵Ǥ
Table1
Ǥ ȋȌ ȋȀʹȌ
ȋ Ȁ Ȍ
ȋΨȌ ȋȌ ȋȌ ȋȌ
ͳ͵
ͳͺ ͻǤʹάͺǤͲ ͳȋͺͻȌ ʹͺάͶ ͳȋͻͶȌ ͳȋȌ ͳʹȋȌȀȋ͵͵Ȍ ʹͶǤͶάǤͶ ʹͻǤͺάͺʹǤͷ ʹʹͺάͶǤͻ ͻǤͲάͳͺǤ ͳȋͻͶȌ ͳȋȌ
ȋȌ
Ǧ
ǦȀ
ͳͷǤͶάʹ͵Ǥͺ ͳʹȋȌ ȋ͵͵Ȍ ͳͳȋͳȌ ȋ͵ͻȌ ͳȋͻͶȌ ͶȋʹʹȌ ͳͷȋͺ͵Ȍ ȋ͵ͻȌ ͳͷȋͺ͵Ȍ ͳͶȋͺȌ
άnȋΨȌǤ αǦ
Ǧǡ αǦ Ǧ
Ǧ
ǡ αǦ Ǧǡ α
ǡ αǦ
ǡ αǦ
ǡ α
ǡ α
ǡ α
ǡ α
ǡ α
ǡαǤ
ͳͶ
Table2 Ǧ Ǥ ͳ ʹ ͵ Ͷ ͷ ͺ ͻ ͳͲ ͳͳ ͳʹ ͳ͵ ͳͶ ͳͷ ͳ ͳ ͳͺ
ȋȌ
ȋΨȌ ͳʹͳ ͳͲʹ ͳͷ ͳͶͳ Ͷ ʹ͵Ͳ ͳͶ ͳʹͺ ͳ͵ ʹͶ ͻ ͳ ʹͲ ͳͶ ͳͺ ͳͲͳ ͳ ͳ͵ͺ ͳ ͳ͵ ʹͷ ͳͳͺ ͻ ʹʹ ͳʹ ͳͶͷ ͵ ͳͻͺ ͳͲ ͳͷ ͳ ʹͳ͵ ʹͶ ͳͺͲ ʹͲ
Ȁ Ȁ Ȁ Ȁ Ȁ Ǧ Ȁ Ȁ Ȁ Ȁ Ȁ Ȁ Ȁ Ǧ Ȁ Ȁ Ȁ Ȁ Ȁ Ȁ Ȁ Ȁ Ȁ Ȁ Ȁ Ȁ Ȁ Ȁ Ȁ ȀȀ Ȁ Ȁ Ȁ Ȁ Ȁ Ȁ
Ȁ Ȁ Ȁ Ȁ Ȁ Ȁ Ȁ Ȁ Ȁ ȀȀȀ ȀȀȀ ȀȀ Ȁ Ȁ Ȁ Ȁ ȀȀ Ȁ Ȁ Ȁ Ȁ Ȁ Ȁ Ȁ Ȁ Ȁ Ȁ Ȁ Ȁ Ȁ Ȁ Ȁ
Ǧ Ȁ ȀȀ Ȁ Ȁ Ȁ Ȁ
Ǧ Ǧ Ǧ Ǧ Ǧ Ǧ Ǧ Ǧ Ǧ Ǧ Ǧ Ǧ Ǧ Ǧ
αǡ α
ǡ αǡ αǡ Ǧ α
ǡ αǡ αǡ αǡαǡα
ǡαǤ
ͳͷ
Table3
Ǧ
Ǥ
ȋΨȌ
ͳ ǡ ǡ ʹ ǡ ͵ ǡǡ Ͷ ǡǡ ͷ ǡǡ ǡǡ ǡʹ ǡ ͺ ǡǡ ʹ ͻ ǡǡ ͳ ǡǡ Ͳ ͳ ǡǡ ͳ ǡ ͳ ǡ ǡ ʹ ͳ ǡǡ ͵ ͳ ǡ ǡ Ͷ ͳ ǡǡ ͷ ǡ ͳ ǡǡ ǡ ͳ ǡǡ ͳ ǡǡ ͺ
Ǧ Ǧ Ǧ Ǧ Ǧ Ǧ Ǧ Ǧ Ǧ Ǧ Ǧ Ǧ Ǧ Ǧ Ǧ Ǧ Ǧ Ǧ
ͳͶ͵ȋͻʹȌ ͳͻȋͳͳ͵Ȍ ͳʹͳȋʹȌ ͳͶȋͺ͵Ȍ ͳȋͺͻȌ ͳͷʹȋͻͳȌ ͳͳͻȋͺͳȌ ͳ͵ͲȋͺͳȌ ͳͲȋͷȌ ͻͷȋʹȌ ͺȋȌ ͻͲȋͶȌ ʹȋͷȌ ͳͺȋͳͳ͵Ȍ ͳͲͷȋȌ ͳͳȋͻʹȌ ͳͺͺȋͻͻȌ
ǡ ǡ
Ǧ Ǧ
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ȋȌ Ǧ
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Ȁ Ǧ
ͳͺȋͻͻȌ
Ǧ
ǣʹ
α ǡ α ǡ Ǧα
ǡα
Ǧ
ǡ αǡ α ǡα
ǡα
ǡαǤ
ͳ
Figure1
ͳ
Figure2
ͳͺ
Figure3
ͳͻ
Figure4
ʹͲ
Figure5
Figure1 ǤͷǤǦȋȌ
Ǧ
͵ȋȌǤȋȌ Ǧ Ǧ
ȋȌǤ Ǧ ȋȌ
Ǥ ǡ
ȋȌ
Ǥ α ǡ α ǡ α
ǡ Ǧα
ǡα
Ǧ
ǡ αǡ α ǡ α ǡ α
ǡ α ǡ α ǡα
Ǥ Figure2
Ǥ ͵
ǡ
Ǧ ȋȌǤ
ÃȋȌǤ ͵ͲȋȌǤ ʹͳ
Figure3
ȋȌǤ
Ǥ
ǡ
Ǥ αǡ
αǡ
αǡ
αǡ
αǡ
αǡαǡαǤ
ȋȌǤ Ǧ
ǡ Ǥ α
Ǥ Figure4
ǦǤ
Ǧ
Ǥ ǤȋȌ
ȋȌ
Ǥ Ǥͺ ȋȌ
ȋ ʹȌǤ ǤͳͲ ȋȌ
Ǥ ǤͳʹȋȌ
Ǥ
ͳǤ Figure5 Ǧ
Ǥ
Ǥ PǦ ȂǤαǤ
ʹʹ
TV Ring
HBP lead
MVR
Selective His Bundle Pacing
TV Ring
HBP lead
MVR
HIS BUNDLE PACING IN A PATIENT WITH MVR AND TV RING
Graphical Abstract