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urpose. . The aim of the research was to study the possibility of using the myocardium SPECT with 99mTc-MIBI and myocardium scintigraphy with 123Imetaiodobenzylguanidine (123I-MIBG) in order to optimize the location choice of the cardioverter defibrillator (ICD) defibrillating electrode (DE) in patients with coronary artery diseases (CAD). Materials and methods. The study included 80 patients (men 68, women 12, aged 65.0 ± 7.3 years) with CAD, who had indications for ICD implantation. Patients were divided into 3 groups. The first group consisted of 26 patients who underwent SPECT with 99mTc-MIBI at rest, and the implantation of DE of ICD was performed taking into account the scintigraphic results. The second group consisted of 27 patients who underwent myocardial scintigraphy with 123I-MIBG and ICD implantation was performed taking into account the results of this study. The third group included 27 patients to whom DE was implanted only on the basis of generally accepted electrophysiological criteria. The groups were compared by electrophysiological indices of the efficiency of the DE implantation at the 1st, 7th and 31st days after the operation. Results. Significant differences were found for the majority of electrophysiological indices on the 1st, 7th and 31st days after the operation between 1 and 3 groups. In addition, in the first group, the degree of perfusion impairment in the septal segment (scores) in patients to whom the DE was implanted into the apical position was closely correlated with the threshold of electrical stimulation (PES) on the 1st (p<0.05, R = 0.725), the 7th (p <0.05, R = 0.805) and the 31st day (p <0.05, R = 0.922). In the same group, in patients to whom DE was implanted into a septal position, the degree of perfusion defects in the apical segment correlated with PES at the 7th ( p <0.05, R = 0.660) and 31st (for p <0.05 R = 0,843) day. There were no significant differences in the majority of the electrophysiological indices on the 1st, 7th and 31st days after the operation between the 2nd and 3rd groups. In patients to whom the DE was implanted into the apical position, the score of the 123I-MIBG accumulation defects in the septal segment correlated only with the index of the ventricular signal amplitude on the first day (p <0.05, R = 0.523). However, in the same group, in patients to whom the DE was implanted into the septal position, no significant correlations between electrophysiological indices and the score of 123I-MIBG accumulation defects were found. Conclusion. Myocardial SPECT with 99mTc-MIBI with detailed evaluation of perfusion defects in the apical and septal segments of the heart ventricles allows optimizing the choice of the site of DE implantation in patients with CAD. The use of the 123I-MIBG scintigraphy for choosing the place of DE implantation did not result at significant improvement of electrophysiological parameters in the examined category of patients.

russian electronic journal of radiology

THE POSSIBILITIES OF MYOCARDIUM SCINTIGRAPHY WITH 99MTC-MIBI AND 123I-MIBG FOR OPTIMIZATION OF THE ICD DEFIBRILLANT ELECTRODE LOCATION IN PATIENTS WITH CAD: THE COMPARATIVE STUDY