Feasibility of Left Ventricle Lead Implantation in Cardiac Resynchronization Therapy Guided by Gated SPECT and Ventricular Remodeling.

Autor:	Nascimento EAD; Universidade Federal Fluminense - Serviço de Cardiologia, Hospital Universitário Antônio Pedro e Pós-Graduação em Ciências Cardiovasculares, Niterói, RJ - Brasil.; Instituto Estadual de Cardiologia Aloysio de Castro - Departamento de Arritmias Cardíacas, Rio de Janeiro, RJ - Brasil., Fernandes FA; Universidade Federal Fluminense - Departamento de Radiologia - Universidade Federal Fluminense e Pós-Graduação em Ciências Cardiovasculares, Niterói, RJ - Brasil., Mira PAC; Universidade Federal Fluminense - Laboratório de Ciências do Exercício, Niterói, RJ - Brasil., He Z; Department of Applied Computing, Michigan Technological University, Houghton - MI - EUA., Zhou W; Department of Applied Computing, Michigan Technological University, Houghton - MI - EUA., Mesquita CT; Universidade Federal Fluminense - Departamento de Radiologia - Universidade Federal Fluminense e Pós-Graduação em Ciências Cardiovasculares, Niterói, RJ - Brasil.
Jazyk:	English; Portuguese
Zdroj:	Arquivos brasileiros de cardiologia [Arq Bras Cardiol] 2023 Mar; Vol. 120 (3), pp. e20220077.
DOI:	10.36660/abc.20220077
Abstrakt:	Background: Cardiac resynchronization therapy (CRT) may benefit patients with advanced heart failure (HF). Abnormal eccentricity index by gated SPECT is related to structural and functional alterations of the left ventricle (LV). Objective: The aim of this study is to evaluate the feasibility of LV lead implantation guided by phase analysis and its relationship to ventricular remodeling. Methods: Eighteen patients with indication for CRT underwent myocardial scintigraphy for implant orientation, and eccentricity and ventricular shape parameters were evaluated. P < 0.05 was adopted as statistical significance. Results: At baseline, most patients were classified as NYHA 3 (n = 12). After CRT, 11 out of 18 patients were reclassified to a lower degree of functional limitation. In addition, patients' quality of life was improved post-CRT. Significant reductions were observed in QRS duration, PR interval, end-diastolic shape index, end-systolic shape index, stroke volume, and myocardial mass post-CRT. The CRT LV lead was positioned concordant, adjacent, and discordant in 11 (61.1%), 5 (27.8%), and 2 (11.1%) patients, respectively. End-systolic and end-diastolic eccentricity demonstrated reverse remodeling post-CRT. Conclusions: LV lead implantation in CRT guided by gated SPECT scintigraphy is feasible. The placement of the electrode concordant or adjacent to the last segment to contract was a determinant of reverse remodeling.
Databáze:	MEDLINE
Externí odkaz:	Zobrazit plný text záznamu