Optimal site selection & image fusion guidance technology to facilitate cardiac resynchronisation therapy.

Optimal site selection & image fusion guidance technology to facilitate cardiac resynchronisation therapy. Expert Rev Med Devices. 2018 Jul 18;: Authors: Sieniewicz BJ, Gould J, Porter B, Sidhu BS, Behar JM, Claridge S, Niederer S, Rinaldi CA Abstract INTRODUCTION: Cardiac resynchronisation therapy (CRT) has emerged as one of the few effective treatments for heart failure. However, up to 50% of patients derive no benefit. Suboptimal LV lead position is a potential cause of poor outcomes whilst targeted lead deployment has been associated with enhanced response rates. Image-fusion guidance systems represent a novel approach to CRT delivery, allowing physicians to both accurately track and target a specific location during LV lead deployment. Areas Covered: This review will provide a comprehensive evaluation of how to define the optimal pacing site. We will evaluate the evidence for delivering targeted LV stimulation at sites displaying favourable viability or advantageous mechanical or electrical properties. Finally, we will evaluate several emerging image-fusion guidance systems which aim to facilitate optimal site selection during CRT. Expert Commentary: Targeted LV lead deployment is associated with reductions in morbidity and mortality. Assessment of tissue characterisation and electrical latency are critical and can be achieved in a number of ways. Ultimately, the constraints of CS anatomy have forced the exploration of novel...
Source: Expert Review of Medical Devices - Category: Medical Devices Tags: Expert Rev Med Devices Source Type: research