Title
3D dynamic position assessment of the coronary sinus lead in cardiac resynchronization therapy.
Abstract
Although cardiac resynchronization therapy (CRT) is an effective treatment for chronic systolic heart failure with dyssynchrony, about one-third of patients do not respond favorably. The interaction between the pacing lead and the coronary sinus (CS) branches is of paramount importance for an effective resynchronization. Minor changes in lead position overtime could interfere with CRT mechanics, without affecting even biophysical parameters or ECG morphology. Although late post-implant CS lead dislodgement rate is consistent, lead movements have been little investigated and only with bi-dimensional methods. The aim of this study was (1) to develop a method for quantifying CS lead position in the 3D domain throughout the cardiac cycle and (2) to test it by comparing the CS lead position at implant and at follow-up, using chest fluoroscopy. Method performance, its accuracy and reproducibility were qualitatively and quantitatively assessed. Intra- and inter-observer percent discordance between trajectories were also computed. The accuracy of the procedure resulted in 0.3 ± 0.1 mm and its resolution was 0.5 mm. Intra- and inter-observer discordances were 2.2 ± 1.5 and 5.5 ± 3.6 mm, respectively. The proposed method for measuring the CS lead dynamic placement in 3D space seems accurate and reproducible. Investigating CS lead 3D dynamics could provide further insights into CRT mechanics.
Year
DOI
Venue
2011
10.1007/s11517-011-0794-3
Med. Biol. Engineering and Computing
Keywords
Field
DocType
mechanics. keywords biomedical x-ray imaging � cardiac resynchronization therapyregion matching � coronary sinus lead tracking,dynamic positioning
Reproducibility,Implant,Internal medicine,Cardiology,Lead Dislodgement,Fluoroscopy,Cardiac cycle,Chronic systolic heart failure,Cardiac resynchronization therapy,Coronary sinus,Medicine
Journal
Volume
Issue
ISSN
49
8
1741-0444
Citations 
PageRank 
References 
2
0.64
5
Authors
6
Name
Order
Citations
PageRank
Cristiana Corsi14914.59
Corrado Tomasi221.32
Dario Turco321.32
Massimo Margheri420.64
Claudio Lamberti5485.25
Stefano Severi62819.47