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MRI assessment of pacing induced ventricular dyssynchrony in an isolated human heart
Author(s) -
Eggen Michael D.,
Bateman Michael G.,
Rolfes Christopher D.,
Howard Stephen A.,
Swingen Cory M.,
Iaizzo Paul A.
Publication year - 2010
Publication title -
journal of magnetic resonance imaging
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.563
H-Index - 160
eISSN - 1522-2586
pISSN - 1053-1807
DOI - 10.1002/jmri.22050
Subject(s) - ventricle , interventricular septum , medicine , cardiac resynchronization therapy , cardiology , lateral wall , perfusion , heart failure , mechanical engineering , ejection fraction , engineering
This study demonstrates the capabilities of MRI in the assessment of cardiac pacing induced ventricular dyssynchrony, and the findings support the need for employing more physiological pacing. A human donor heart deemed non‐viable for transplantation, was reanimated using an MR compatible, four‐chamber working perfusion system. The heart was imaged using a 1.5T MR scanner while being paced from the right ventricular apex (RVA) via an epicardial placed lead. Four‐chamber, short‐axis, and tagged short‐axis cines were acquired in order to track wall motion and intramyocardial strain during pacing. The results of this study revealed that the activation patterns of the left ventricle (LV) during RVA pacing demonstrated intraventricular dyssynchrony; as the left ventricular mechanical activation proceeded from the septum and anterior wall to the lateral wall, with the posterior wall being activated last. As such, the time difference to peak contraction between the septum and lateral wall was ∼125 msec. Likewise, interventricular dyssynchrony was demonstrated from the four‐chamber cine as the time difference between the peak LV and RV free wall motion was 180 msec. With the ongoing development of MR safe and MR compatible pacing systems, we can expect MRI to be added to the list of imaging modalities used to optimize cardiac resynchronization therapy (CRT) and/or alternate site pacing. J. Magn. Reson. Imaging 2010; 31: 466–469. © 2010 Wiley‐Liss, Inc.