Interactive visualization for scar transmurality in cardiac resynchronization therapy

Sabrina Reiml*, Daniel Toth, Maria Panayiotou, Bernhard Fahn, Rashed Karim, Jonathan M. Behar, Christopher A. Rinaldi, Reza Razavi, Kawal S. Rhode, Alexander Brost, Peter Mountney

*Corresponding author for this work

Research output: Chapter in Book/Report/Conference proceedingPoster abstractpeer-review

3 Citations (Scopus)


Heart failure is a serious disease affecting about 23 million people worldwide. Cardiac resynchronization therapy is used to treat patients suffering from symptomatic heart failure. However, 30% to 50% of patients have limited clinical benefit. One of the main causes is suboptimal placement of the left ventricular lead. Pacing in areas of myocardial scar correlates with poor clinical outcomes. Therefore precise knowledge of the individual patient's scar characteristics is critical for delivering tailored treatments capable of improving response rates. Current research methods for scar assessment either map information to an alternative non-anatomical coordinate system or they use the image coordinate system but lose critical information about scar extent and scar distribution. This paper proposes two interactive methods for visualizing relevant scar information. A 2-D slice based approach with a scar mask overlaid on a 16 segment heart model and a 3-D layered mesh visualization which allows physicians to scroll through layers of scar from endocardium to epicardium. These complementary methods enable physicians to evaluate scar location and transmurality during planning and guidance. Six physicians evaluated the proposed system by identifying target regions for lead placement. With the proposed method more target regions could be identified.

Original languageEnglish
Title of host publicationProgress in Biomedical Optics and Imaging - Proceedings of SPIE
ISBN (Print)9781510600218
Publication statusPublished - 18 Mar 2016
EventMedical Imaging 2016: Image-Guided Procedures, Robotic Interventions, and Modeling - San Diego, United States
Duration: 28 Feb 20161 Mar 2016


ConferenceMedical Imaging 2016: Image-Guided Procedures, Robotic Interventions, and Modeling
Country/TerritoryUnited States
CitySan Diego


  • Cardiac Resynchronization Therapy
  • Cardiology
  • Device Implantation
  • Electrophysiology
  • Scar
  • Transmurality
  • Visualization


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