Optimal Coronary Sinus Lead Implantation Using Intracardiac Impedography and Magnetic Resonance Imaging
| Status: | Completed |
|---|---|
| Conditions: | Cardiology |
| Therapuetic Areas: | Cardiology / Vascular Diseases |
| Healthy: | No |
| Age Range: | Any |
| Updated: | 7/16/2013 |
| Start Date: | June 2010 |
| End Date: | December 2014 |
| Contact: | Michael S. Lloyd, MD |
| Email: | mlloyd2@emory.edu |
| Phone: | 4047124070 |
Real-Time Intracardiac Impedograms of Left Ventricular Leads to Locate Sites of Latest Mechanical Delay in Cardiac Resynchronization Therapy
Despite the dramatic effect of cardiac resynchronization therapy (CRT) on survival and
morbidity in people with congestive heart failure, 50-70% of eligible patients do not
respond to this intervention. There is retrospective evidence that placement of the left
ventricular (LV) lead at the region of latest mechanical delay markedly improves response to
CRT. However, there is no feasible way to gauge dyssynchrony at LV lead sites during CRT
implantation. Impedance recordings from pacing lead tips allow for real-time assessment of
mechanical motion and may represent a useful intraoperative tool to guide optimum placement
of the LV lead during CRT implantation. This pilot trial will assess the use of
intraoperative impedograms in humans to measure regional dyssynchrony at potential LV lead
locations during CRT implantation.
This is a clinical trial using intracardiac impedance signals (impedograms) to assess
regional dyssynchrony at various sites of left ventricular (LV) lead placement in humans
undergoing CRT device implantation. This study will test the following hypotheses during the
funding period:
1. LV lead impedograms as an implant tool to place leads at sites of latest mechanical
delay are feasible and correlate with other means of assessing dyssynchrony.
2. LV lead impedograms vary significantly depending on LV lead location.
3. There are several characteristics of LV lead impedograms that correlate with mechanical
phenomena of the heart.
Inclusion Criteria:
- Patients with NYHA class III or IV heart failure
- LVEF ≤ 30%
- QRS duration ≥ 120 ms
- Candidate for CRT implantation
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Emory University Hospital As the largest health care system in Georgia and the only health...
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