Vol. 23 No. 4 (2019)
CASE REPORTS

New opportunities for assessing the optimal positioning of a multipolar left ventricular electrode for resynchronization therapy

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  • A. Romanov,
  • E. Morzhanaev,
  • I. Mikheenko,
  • A. Ponomarenko,
  • A. Filippenko,
  • N. Nikitin,
  • S. Minin,
  • D. Losik,
  • S. Mironenko
A. Romanov
Meshalkin National Medical Research Center, Novosibirsk
E. Morzhanaev
Meshalkin National Medical Research Center, Novosibirsk
Bio
I. Mikheenko
Meshalkin National Medical Research Center, Novosibirsk
A. Ponomarenko
Meshalkin National Medical Research Center, Novosibirsk
A. Filippenko
Meshalkin National Medical Research Center, Novosibirsk
N. Nikitin
Meshalkin National Medical Research Center, Novosibirsk
S. Minin
Meshalkin National Medical Research Center, Novosibirsk
D. Losik
Meshalkin National Medical Research Center, Novosibirsk
S. Mironenko
Meshalkin National Medical Research Center, Novosibirsk
DOI: https://doi.org/10.21688/1681-3472-2019-4-84-90

Published 2019-12-27

Keywords

  • heart failure,
  • multipolar electrode,
  • myocardial perfusion scintigraphy,
  • cardiac resynchronization therapy

How to Cite

Romanov, A., Morzhanaev, E., Mikheenko, I., Ponomarenko, A., Filippenko, A., Nikitin, N., Minin, S., Losik, D., & Mironenko, S. (2019). New opportunities for assessing the optimal positioning of a multipolar left ventricular electrode for resynchronization therapy. Patologiya Krovoobrashcheniya I Kardiokhirurgiya, 23(4), 84–90. https://doi.org/10.21688/1681-3472-2019-4-84-90

Copyright (c) 2019 Romanov A. B., Morzhanaev E. A., Mikheenko I. L., Ponomarenko A. V., Filippenko A. G., Nikitin N. A., Minin S. M., Losik D. V., Mironenko S. P.

Creative Commons License

This work is licensed under a Creative Commons Attribution 4.0 International License.

Abstract

Heart failure and left bundle branch block is a common disease in the modern world. Cardiac resynchronization therapy is used to correct this condition, but some patients have no positive clinical effect from its use. One of the reasons for the lack of response to therapy is not the optimal position of the left ventricular electrode. In this clinical case we presented the experience of using myocardial perfusion scintigraphy to determine the optimal position of the left ventricular electrode.
A 60-year-old patient, who was admitted to the center with symptoms of heart failure and signs of complete left bundle branch block, underwent an implantation of the cardiac resynchronization system. Both intraoperative data and the data of preliminary myocardial scintigraphy were used to select the site of implantation of the left ventricular electrode. A significant improvement in the patient’s condition, evaluated after 6 months after the implantation of the device, allowed us to conclude that the use of myocardial perfusion scintigraphy with standard methods of ultrasound diagnosis can increase the efficiency of implantation of cardiac resynchronization devices and a response to the therapy.

Received 2 October 2019. Revised 20 December 2019. Accepted 23 December 2019.

Funding: The work is supported by a grant of the President of the Russian Federation for young scientists No. МД-2893.2018.7.

Conflict of interest: Authors declare no conflict of interest.

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References

  1. Cleland J.G.F., Daubert J.C., Erdmann E., Freemantle N., Gras D., Kappenberger L., Tavazzi L.; Cardiac Resynchronization-Heart Failure (CARE-HF) Study Investigators. The Effect of cardiac resynchronization on morbidity and mortality in heart failure. ACC Current Journal Review. 2005;352(15):20. PMID: 15753115. http://dx.doi.org/10.1016/j.accreview.2005.05.046
  2. Zareba W., Klein H., Cygankiewicz I., Jackson Hall W., McNitt S., Brown M., Cannom D., Daubert J.P., Eldar M., Gold M.R., Goldberger J.J., Goldenberg I., Lichstein E., Pitschner H., Rashtian M., Solomon S., Viskin S., Wang P., Moss A.J. Effectiveness of cardiac resynchronization therapy by QRS morphology in the multicenter automatic defibrillator implantation trial–cardiac resynchronization therapy (MADIT-CRT). Circulation. 2011;123(10):1061-72. PMID: 21357819. https://dx.doi.org/10.1161/CIRCULATIONAHA.110.960898
  3. Ponikowski P., Voors A.A., Anker S.D., Bueno H., Cleland J.G.F., Coats A.J.S., Falk V., González-Juanatey J.R., Harjola V.-P., Jankowska E.A., Jessup M., Linde C., Nihoyannopoulos P., Parissis J.T., Pieske B., Riley J.P., Rosano G.M.C., Ruilope L.M., Ruschitzka F., Rutten F.H., van der Meer P., ESC Scientific Document Group. 2016 ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure: The Task Force for the diagnosis and treatment of acute and chronic heart failure of the European Society of Cardiology (ESC) Developed with the special contribution of the Heart Failure Association (HFA) of the ESC. Eur Heart J. 2016;37(27):2129-200. PMID: 27206819. https://dx.doi.org/10.1093/eurheartj/ehw128
  4. Bax J.J., Ansalone G., Breithardt O.A., Derumeaux G., Leclercq C., Schalij M.J., Sogaard P., St John Sutton M., Nihoyannopoulos P. Echocardiographic evaluation of cardiac resynchronization therapy: ready for routine clinical use? A critical appraisal. J Am Coll Cardiol. 2004;44(1):1-9. PMID: 15234396. https://dx.doi.org/10.1016/j.jacc.2004.02.055
  5. Yu C.-M., Bleeker G.B., Fung J.W.-H., Schalij M.J., Zhang Q., van der Wall E.E., Chan Y.-S., Kong S.-L., Bax J.J. Left ventricular reverse remodeling but not clinical improvement predicts long-term survival after cardiac resynchronization therapy. Circulation. 2005;112:1580-6. PMID: 16144994. https://dx.doi.org/10.1161/CIRCULATIONAHA.105.538272
  6. Notabartolo D., Merlino J.D., Smith A.L., DeLurgio D.B., Vera F.V., Easley K.A., Martin R.P., León A.R. Usefulness of the peak velocity difference by tissue Doppler imaging technique as an effective predictor of response to cardiac resynchronization therapy. Am J Cardiol. 2004;94(6):817-20. PMID: 15374800. https://dx.doi.org/10.1016/j.amjcard.2004.05.072
  7. Burri H., Sunthorn H., Somsen A., Zaza S., Fleury E., Shah D., Righetti A. Optimizing sequential biventricular pacing using radionuclide ventriculography. Heart Rhythm. 2005;2(9):960-5. PMID: 16171751. https://dx.doi.org/10.1016/j.hrthm.2005.05.017
  8. Национальное руководство по радионуклидной диагностике. под редакцией Ю.Б. Лишманова, В.И. Чернова. Т. 1. Новосибирск: Изд-во STT, 2010. 290 c. [National guide on radionuclide diagnostics. Lishmanov Y.B., Chernov V.I., editors. Novosibirsk: STT LLC, 2010. 290 p. (In Russ.)]
  9. Sweeney M.O. Programming and follow-up of CRT and CRTD Devices. In: Barold S.S., Ritter P., editors. Devices for cardiac resynchronization. Boston: Springer, 2008. p. 317-423. http://dx.doi.org/10.1007/978-0-387-71167-6_21
  10. van Bommel R.J., Bax J.J., Abraham W.T., Chung E.S., Pires L.A., Tavazzi L., Zimetbaum P.J., Gerritse B., Kristiansen N., Ghio S. Characteristics of heart failure patients associated with good and poor response to cardiac resynchronization therapy: a PROSPECT (Predictors of Response to CRT) sub-analysis. Eur Heart J. 2009;30(20):2470-7. PMID: 19717847. http://dx.doi.org/10.1093/eurheartj/ehp368
  11. Bodin A., Bisson A., Andre C., Pierre B., Fauchier L., Babuty D., Clementy N. Multisite pacing via a quadripolar lead for cardiac resynchronization therapy. J Interv Card Electrophysiol. 2019;56(1):117-25. PMID: 31321658. http://dx.doi.org/10.1007/s10840-019-00592-1
  12. Bleeker G.B., Kaandorp T.A.M., Lamb H.J., Boersma E., Steendijk P., de Roos A., van der Wall E.E., Schalij M.J., Bax J.J. Effect of posterolateral scar tissue on clinical and echocardiographic improvement after cardiac resynchronization therapy. Circulation. 2006;113(7):969-76. PMID: 16476852. http://dx.doi.org/10.1161/circulationaha.105.543678
  13. Hummel J.P., Lindner J.R., Belcik J.T., Ferguson J.D., Mangrum J.M., Bergin J.D., Haines D.E., Lake D.E., DiMarco J.P., Mounsey J.P. Extent of myocardial viability predicts response to biventricular pacing in ischemic cardiomyopathy. Heart Rhythm. 2005;2(11):1211-7. PMID: 16253911. http://dx.doi.org/10.1016/j.hrthm.2005.07.027
  14. Yao W., Xiwen Z., Jiangang Z. Impact of left ventricular scar burden and cardiac synchrony on CRT efficacy: a single-centre retrospective observational study. Heart. 2011;97:A176.