Abstract:
Heart failure is associated with substantial mortality and morbidity and remains the most common diagnosis in older patients. Based on experimental electrophysiologic stu...Show MoreMetadata
Abstract:
Heart failure is associated with substantial mortality and morbidity and remains the most common diagnosis in older patients. Based on experimental electrophysiologic studies, cardiac resynchronization therapy (CRT) for heart failure results in a maximum resynchronization effect when applied to the most delayed left ventricular (LV) site. Current clinical practice is to identify the optimal site using separate visualisation of scar and activation information. These must be mentally mapped into 3D, which is challenging and time-consuming for the electrophysiologist. The aim of this work is to improve patient planning for CRT by mapping propagation of mechanical activation from cardiac magnetic resonance (CMR) onto a three-dimensional plus time (3D+t) model map to assist the cardiologist in determining the optimal LV pacing site. Automatic motion analysis of the 16-segment patient-specific LV anatomical model, automatically segmented from cine MR data, was done and regional volume change curves as a function of the cardiac cycle along with intraventricular dyssynchrony indices were extracted. The regional volume information computed was then mapped onto all phases of the 3D+t CMR data, which provides a 3D+t mechanical activation map over the whole cardiac cycle. This workflow was tested on 7 patients and 3 healthy volunteers. This mapping of the regional change of volume across the LV during ventricular pacing could facilitate the selection of the optimum pacing segment at the planning stage of the procedure, and consequently decrease the number of inadequate responders to CRT.
Published in: 2016 38th Annual International Conference of the IEEE Engineering in Medicine and Biology Society (EMBC)
Date of Conference: 16-20 August 2016
Date Added to IEEE Xplore: 18 October 2016
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PubMed ID: 28269193