TY - JOUR
T1 - Mechanical Activation Computation from Fluoroscopy for Guided Cardiac Resynchronization Therapy
AU - Thomas, Emily
AU - Toth, Daniel
AU - Kurzendorfer, Tanja
AU - Rhode, Kawal
AU - Mountney, Peter
PY - 2018/10/29
Y1 - 2018/10/29
N2 - Congestive heart failure is associated with significant morbidity and mortality, as first line treatments are not always effective in improving symptoms and quality of life. Furthermore, 30-50% of patients who are treated with cardiac resynchronization therapy (CRT), a minimally invasive intervention, do not respond when assessed by objective criteria such as cardiac remodeling. Positioning of the left ventricular lead in the latest activating myocardial region is associated with the best outcome. Cardiac magnetic resonance (CMR) imaging can detect scar tissue and interventricular dyssynchrony; improving the outcome of CRT. However, MR is currently not standard modality for CRT due to its cost and limited availability. This paper explores a novel method to exploit interventional X-ray fluoroscopy set up in CRT procedures to gain information on mechanical activation of the myocardium by tracking the movement of vessels overlying to left ventricular myocardium. Fluoroscopic images were labelled, to track branch movement and determine the motion along the main principal component associated with cardiac motion, to optimize lead placement in CRT. A comparison between MR- and fluoroscopy-derived mechanical activation was performed on 9 datasets, showing more than 66% agreement in 8 cases.
AB - Congestive heart failure is associated with significant morbidity and mortality, as first line treatments are not always effective in improving symptoms and quality of life. Furthermore, 30-50% of patients who are treated with cardiac resynchronization therapy (CRT), a minimally invasive intervention, do not respond when assessed by objective criteria such as cardiac remodeling. Positioning of the left ventricular lead in the latest activating myocardial region is associated with the best outcome. Cardiac magnetic resonance (CMR) imaging can detect scar tissue and interventricular dyssynchrony; improving the outcome of CRT. However, MR is currently not standard modality for CRT due to its cost and limited availability. This paper explores a novel method to exploit interventional X-ray fluoroscopy set up in CRT procedures to gain information on mechanical activation of the myocardium by tracking the movement of vessels overlying to left ventricular myocardium. Fluoroscopic images were labelled, to track branch movement and determine the motion along the main principal component associated with cardiac motion, to optimize lead placement in CRT. A comparison between MR- and fluoroscopy-derived mechanical activation was performed on 9 datasets, showing more than 66% agreement in 8 cases.
U2 - 10.1109/EMBC.2018.8512434
DO - 10.1109/EMBC.2018.8512434
M3 - Article
C2 - 30440466
SN - 1557-170X
VL - 2018
SP - 592
EP - 595
JO - Conference proceedings : ... Annual International Conference of the IEEE Engineering in Medicine and Biology Society. IEEE Engineering in Medicine and Biology Society. Conference
JF - Conference proceedings : ... Annual International Conference of the IEEE Engineering in Medicine and Biology Society. IEEE Engineering in Medicine and Biology Society. Conference
ER -