CRT Lead Placement Planning using MRI

使用 MRI 进行 CRT 导线放置规划

• 批准号: 8303846
• 负责人: JOHN N OSHINSKI
• 金额: $ 21.29万
• 依托单位: EMORY UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2012
• 资助国家: 美国
• 起止时间: 2012-04-01 至 2014-03-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8303846
• 关键词: Address; Anatomy; Area; Cardiac; Cicatrix; Computer software; Contracts; Controlled Clinical Trials; Coronary; Data; Development; Devices; Evaluation; Evaluation Methodology; Goals; Heart failure; Image; Implant; International; Lead; Left; Location; Magnetic Resonance Imaging; Maps; Mechanics; Methodology; Methods; Myocardial; Myocardium; Outcome; Pacemakers; Patient Selection; Patients; Performance; Pharmaceutical Preparations; Physiological; Placebo Control; Positioning Attribute; Procedures; Prospective Studies; Refractory; Retrospective Studies; Risk; Role; Selection Criteria; Series; Software Validation; Structure of left gastric vein; Techniques; Testing; Time; Tissues; Venous; Ventricular; Work; base; candidate selection; clinical practice; implantation; improved; research clinical testing; response; software development; success; tool

DESCRIPTION (provided by applicant): Cardiac resynchronization therapy (CRT) using a bi-ventricular pacemaker is an important treatment option for patients with drug-refractory heart failure and evidence of ventricular dyssynchrony. However, using current selection criteria and implantation techniques, 30-40% of patients undergoing CRT are non-responsive to the treatment. Because CRT is invasive, costly, has significant associated risks, and requires lifelong need of pacing device, there is a clear need for better methods to optimize the treatment. Multiple factors influence patient response to CRT including poor selection criteria and/or non-optimal device implementation. In the implementation of CRT, the position of the left ventricular (LV) pacing lead has a significant role in determining patient response. The overall goals of this project are: 1) to develop an MRI- based methodology to plan and locate the LV pacing lead in the area of latest contraction and 2) test the methodology on a group of patients undergoing CRT. PUBLIC HEALTH RELEVANCE: We propose to develop methodology to use magnetic resonance imaging (MRI) to plan left ventricular lead placement in patients undergoing cardiac resynchronization therapy (CRT) using a bi-ventricular pacemaker. The project involves development and validation of software for the display of regional ventricular dyssynchrony and myocardial scar burden by MRI. The MRI based methodology will then be evaluated in a series of patients to test its ability to improve outcomes by improving lead placement.

描述（由申请人提供）：使用双心室起搏器的心脏起搏治疗（CRT）是药物难治性心力衰竭和心室不同步证据患者的重要治疗选择。然而，使用当前的选择标准和植入技术，30-40%接受CRT的患者对治疗无反应。由于CRT是侵入性的、昂贵的、具有显著的相关风险，并且需要终身需要起搏装置，因此显然需要更好的方法来优化治疗。多种因素影响患者对CRT的反应，包括不良选择标准和/或非最佳器械实施。在CRT的实施中，左心室（LV）起搏导线的位置在确定患者反应方面具有重要作用。本项目的总体目标是：1）开发一种基于MRI的方法，以计划和定位最近收缩区域中的LV起搏电极导线; 2）在一组接受CRT的患者中测试该方法。 公共卫生相关性：我们建议开发一种方法，使用磁共振成像（MRI）计划使用双心室起搏器接受心脏起搏治疗（CRT）的患者的左心室电极导线放置。该项目涉及通过MRI显示局部心室不同步和心肌瘢痕负荷的软件开发和验证。然后将在一系列患者中评价基于MRI的方法，以测试其通过改善电极导线放置来改善结局的能力。