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- Title
Insights from Novel Noninvasive CT and ECG Imaging Modalities on Electromechanical Myocardial Activation in a Canine Model of Ischemic Dyssynchronous Heart Failure.
- Authors
DAWOUD, FADY; SCHULERI, KARL H.; SPRAGG, DAVID D.; HORÁČEK, B. MILAN; BERGER, RONALD D.; HALPERIN, HENRY R.; LARDO, ALBERT C.
- Abstract
CT ECGI Electromechanical Imaging Introduction The interplay between electrical activation and mechanical contraction patterns is hypothesized to be central to reduced effectiveness of cardiac resynchronization therapy (CRT). Furthermore, complex scar substrates render CRT less effective. We used novel cardiac computed tomography (CT) and noninvasive electrocardiographic imaging (ECGI) techniques in an ischemic dyssynchronous heart failure (DHF) animal model to evaluate electrical and mechanical coupling of cardiac function, tissue viability, and venous accessibility of target pacing regions. Methods and Results Ischemic DHF was induced in 6 dogs using coronary occlusion, left bundle ablation and tachy RV pacing. Full body ECG was recorded during native rhythm followed by volumetric first-pass and delayed enhancement CT. Regional electrical activation were computed and overlaid with segmented venous anatomy and scar regions. Reconstructed electrical activation maps show consistency with LBBB starting on the RV and spreading in a 'U-shaped' pattern to the LV. Previously reported lines of slow conduction are seen parallel to anterior or inferior interventricular grooves. Mechanical contraction showed large septal to lateral wall delay (80 ± 38 milliseconds vs. 123 ± 31 milliseconds, P = 0.0001). All animals showed electromechanical correlation except dog 5 with largest scar burden. Electromechanical decoupling was largest in basal lateral LV segments. Conclusion We demonstrated a promising application of CT in combination with ECGI to gain insight into electromechanical function in ischemic dyssynchronous heart failure that can provide useful information to study regional substrate of CRT candidates.
- Subjects
ANIMAL experimentation; CARDIAC pacing; COMPUTED tomography; DIGITAL diagnostic imaging; DOGS; ELECTROCARDIOGRAPHY; HEART failure
- Publication
Journal of Cardiovascular Electrophysiology, 2016, Vol 27, Issue 12, p1454
- ISSN
1045-3873
- Publication type
Article
- DOI
10.1111/jce.13091