Skip to main content
Springer Nature Link
Log in

3D dynamic position assessment of the coronary sinus lead in cardiac resynchronization therapy

  • Original Article
  • Published:
Medical & Biological Engineering & Computing Aims and scope Submit manuscript

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.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Subscribe and save

Springer+ Basic
$34.99 /Month
  • Get 10 units per month
  • Download Article/Chapter or eBook
  • 1 Unit = 1 Article or 1 Chapter
  • Cancel anytime
Subscribe now

Buy Now

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3
Fig. 4
Fig. 5
Fig. 6
Fig. 7
Fig. 8

Similar content being viewed by others

References

  1. Abraham WT (2002) Cardiac resynchronization in chronic heart failure. N Engl J Med 346:1845–1853

    Article  PubMed  Google Scholar 

  2. Barron JL, Fleet DJ, Beauchemin SS (1994) Performance of optical flow techniques. Int J Comput Vis 12(1):43–77

    Article  Google Scholar 

  3. Becker M (2010) Analysis of LV lead position in cardiac resynchronization therapy using different imaging modalities. JACC Cardiovasc Imaging 3(5):472–481

    Article  PubMed  Google Scholar 

  4. Bogaard MD, Doevendans PA, Leenders GE, Loh P, Hauer RNW, van Wessel H, Meine M (2010) Can optimization of pacing settings compensate for a non-optimal left ventricular pacing site? Europace 12(9):1262–1269

    Article  PubMed  Google Scholar 

  5. Bristow MR (2004) Cardiac-resynchronization therapy with or without an implantable defibrillator in advanced chronic heart failure. N Engl J Med 350:2140–2150

    Article  PubMed  CAS  Google Scholar 

  6. Bulava A et al (2005) Postmortem anatomy of the coronary sinus pacing lead. Pacing Clin Electrophysiol 28:736–739

    Article  PubMed  Google Scholar 

  7. Bulava A (2007) Single-centre experience with coronary sinus lead stability and long-term pacing parameters. Europace 9:523–527

    Article  PubMed  Google Scholar 

  8. Camus T (1997) Real-time quantized optical flow. J Real Time Imaging 3:71–86

    Article  Google Scholar 

  9. Cleland JGF (2005) The effect of cardiac resynchronization on morbidity and mortality in heart failure. N Engl J Med 352:1539–1549

    Article  PubMed  CAS  Google Scholar 

  10. Figueroa PJ (2003) A flexible software for tracking of markers used in human motion analysis. Comput Methods Programs Biomed 72(2):155–165

    Article  PubMed  Google Scholar 

  11. Galvin B (1998) Recovering motion fields: an evaluation of eight optical flow algorithms. In: Proceedings of British Machine Vision Conference, BMVA Press, pp 195–204

  12. Golemati S et al (2003) Carotid artery wall motion estimated from B-mode ultrasound using region tracking and block matching. Ultrasound Med Biol 29(3):387–399

    Article  PubMed  Google Scholar 

  13. Gorscan J (2008) Echocardiographic assessment of ventricular dyssynchrony. Curr Cardiol Rep 10(3):211–217

    Article  Google Scholar 

  14. Gras D (2007) Implantation of cardiac resynchronization therapy systems in CARE-HF trial: procedural success rate and safety. Europace 9:516–522

    Article  PubMed  CAS  Google Scholar 

  15. Kasravi B et al (2005) Coronary sinus lead extraction in the era of cardiac resynchronization therapy: single center experience. Pacing Clin Electrophysiol 28:51–53

    Article  PubMed  Google Scholar 

  16. Khan ZF (2009) Left ventricular lead placement in cardiac resynchronization therapy: where and how? Europace 11:554–561

    Article  PubMed  Google Scholar 

  17. Kumar P (2010) Assessment of the post-implant final left ventricular lead position: a comparative study between radiographic and angiographic modalities. J Interv Cardiac Electrophysiol 29(1):17–22

    Article  Google Scholar 

  18. Leon AR (2005) Safety of transvenous cardiac resynchronization system implantation in patients with chronic heart failure: combined results of over 2,000 patients from a multicenter study program. J Am Coll Cardiol 46:2348–2356

    Article  PubMed  Google Scholar 

  19. McAlister FA (2007) Cardiac resynchronization therapy for patients with left ventricular systolic dysfunction: a systematic review. JAMA 297(22):2502–2514

    Article  PubMed  CAS  Google Scholar 

  20. Stoitsis J, Golemati S, Dimopoulos AK, Nikita KS (2005) Analysis and quantification of arterial wall motion from B-mode ultrasound images—comparison of block-matching and optical flow. In: IEEE engineering in medicine and biology society, IEEE press, pp 1758–1761

  21. Tang WH (2008) Relation of mechanical dyssynchrony with underlying cardiac structure and performance in chronic systolic heart failure: implications on clinical response to cardiac resynchronization. Europace 10:1370–1374

    Article  PubMed  Google Scholar 

  22. Valstar ER (2001) Digital Roentgen stereophotogrammetry: development, validation, and clinical application. Ph.D. Thesis, Leiden University

  23. Veronesi F et al (2006) Tracking of left ventricular long axis from real-time three-dimensional echocardiography using optical flow techniques. IEEE Trans Inf Technol Biomed 10:174–181

    Article  PubMed  CAS  Google Scholar 

  24. Veronesi F et al (2009) A study of functional anatomy of aortic-mitral valve coupling using 3D matrix transesophageal echocardiography. Circ Cardiovasc Imaging 2(1):24–31

    Article  PubMed  Google Scholar 

  25. Yu CM et al (2005) LV reverse remodeling but not clinical improvement predicts long-term survival after cardiac resynchronization therapy. Circulation 112:1580–1586

    Article  PubMed  Google Scholar 

Download references

Acknowledgment

We would like to thank Roberta Mosconi and Federico Veronesi for contributing to this study and Riccardo Pepoli, Giorgio Bevilacqua, and Anna Galli for image acquisition.

Author information

Authors and Affiliations

  1. Department of Electronics, Computer Science and Systems, University of Bologna, Cesena, Italy

    Cristiana Corsi, Dario Turco, Claudio Lamberti & Stefano Severi

  2. Cardiovascular Department, Santa Maria delle Croci Hospital, Ravenna, Italy

    Corrado Tomasi & Massimo Margheri

Authors
  1. Cristiana Corsi
    View author publications

    You can also search for this author inPubMed Google Scholar

  2. Corrado Tomasi
    View author publications

    You can also search for this author inPubMed Google Scholar

  3. Dario Turco
    View author publications

    You can also search for this author inPubMed Google Scholar

  4. Massimo Margheri
    View author publications

    You can also search for this author inPubMed Google Scholar

  5. Claudio Lamberti
    View author publications

    You can also search for this author inPubMed Google Scholar

  6. Stefano Severi
    View author publications

    You can also search for this author inPubMed Google Scholar

Corresponding author

Correspondence to Cristiana Corsi.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Corsi, C., Tomasi, C., Turco, D. et al. 3D dynamic position assessment of the coronary sinus lead in cardiac resynchronization therapy. Med Biol Eng Comput 49, 901–908 (2011). https://doi.org/10.1007/s11517-011-0794-3

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s11517-011-0794-3

Keywords