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Background In patients with heart failure (HF) and left bundle branch block (LBBB) cardiac resynchronization therapy (CRT) improves left ventricular (LV) function and leads to reverse LV remodeling. A major concern with CRT remains that using current clinical indicators and implementation methods, 30-40% of patients are nonresponders. CRT response is highly dependent on the presence of delayed mechanical activation and absence of scar at the LV lead implantation site [1]. The aims of this study were to establish the correlation between mechanical activation time measured by cine DENSE MRI and electrical activation time (QLV) at the LV lead implantation site, and to characterize the heterogeneity of the location of the site of the latest mechanically activated segment in patients with HF-LBBB. Furthermore, we evaluated the frequency in which CRT leads are placed in suboptimal regions.

Cine DENSE MRI of mechanical activation in heart failure patients referred for cardiac resynchronization therapy