Single-beat noninvasive imaging of ventricular endocardial and epicardial activation in patients undergoing CRT.

<h4>Background</h4>Little is known about the effect of cardiac resynchronization therapy (CRT) on endo- and epicardial ventricular activation. Noninvasive imaging of cardiac electrophysiology (NICE) is a novel imaging tool for visualization of both epi- and endocardial ventricular electr...

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Autores principales:	Thomas Berger, Bernhard Pfeifer, Friedrich F Hanser, Florian Hintringer, Gerald Fischer, Michael Netzer, Thomas Trieb, Markus Stuehlinger, Wolfgang Dichtl, Christian Baumgartner, Otmar Pachinger, Michael Seger
Formato:	article
Lenguaje:	EN
Publicado:	Public Library of Science (PLoS) 2011
Materias:	Medicine R Science Q
Acceso en línea:	https://doaj.org/article/e4c8f3b30be94cc1a8d2bd37ffa3e086
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spelling	oai:doaj.org-article:e4c8f3b30be94cc1a8d2bd37ffa3e0862021-11-18T06:59:44ZSingle-beat noninvasive imaging of ventricular endocardial and epicardial activation in patients undergoing CRT.1932-620310.1371/journal.pone.0016255https://doaj.org/article/e4c8f3b30be94cc1a8d2bd37ffa3e0862011-01-01T00:00:00Zhttps://www.ncbi.nlm.nih.gov/pmc/articles/pmid/21298045/pdf/?tool=EBIhttps://doaj.org/toc/1932-6203<h4>Background</h4>Little is known about the effect of cardiac resynchronization therapy (CRT) on endo- and epicardial ventricular activation. Noninvasive imaging of cardiac electrophysiology (NICE) is a novel imaging tool for visualization of both epi- and endocardial ventricular electrical activation.<h4>Methodology/principal findings</h4>NICE was performed in ten patients with congestive heart failure (CHF) undergoing CRT and in ten patients without structural heart disease (control group). NICE is a fusion of data from high-resolution ECG mapping with a model of the patient's individual cardiothoracic anatomy created from magnetic resonance imaging. Beat-to-beat endocardial and epicardial ventricular activation sequences were computed during native rhythm as well as during ventricular pacing using a bidomain theory-based heart model to solve the related inverse problem. During right ventricular (RV) pacing control patients showed a deterioration of the ventricular activation sequence similar to the intrinsic activation pattern of CHF patients. Left ventricular propagation velocities were significantly decreased in CHF patients as compared to the control group (1.6±0.4 versus 2.1±0.5 m/sec; p<0.05). CHF patients showed right-to-left septal activation with the latest activation epicardially in the lateral wall of the left ventricle. Biventricular pacing resulted in a resynchronization of the ventricular activation sequence and in a marked decrease of total LV activation duration as compared to intrinsic conduction and RV pacing (129±16 versus 157±28 and 173±25 ms; both p<0.05).<h4>Conclusions/significance</h4>Endocardial and epicardial ventricular activation can be visualized noninvasively by NICE. Identification of individual ventricular activation properties may help identify responders to CRT and to further improve response to CRT by facilitating a patient-specific lead placement and device programming.Thomas BergerBernhard PfeiferFriedrich F HanserFlorian HintringerGerald FischerMichael NetzerThomas TriebMarkus StuehlingerWolfgang DichtlChristian BaumgartnerOtmar PachingerMichael SegerPublic Library of Science (PLoS)articleMedicineRScienceQENPLoS ONE, Vol 6, Iss 1, p e16255 (2011)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine R Science Q
spellingShingle	Medicine R Science Q Thomas Berger Bernhard Pfeifer Friedrich F Hanser Florian Hintringer Gerald Fischer Michael Netzer Thomas Trieb Markus Stuehlinger Wolfgang Dichtl Christian Baumgartner Otmar Pachinger Michael Seger Single-beat noninvasive imaging of ventricular endocardial and epicardial activation in patients undergoing CRT.
description	<h4>Background</h4>Little is known about the effect of cardiac resynchronization therapy (CRT) on endo- and epicardial ventricular activation. Noninvasive imaging of cardiac electrophysiology (NICE) is a novel imaging tool for visualization of both epi- and endocardial ventricular electrical activation.<h4>Methodology/principal findings</h4>NICE was performed in ten patients with congestive heart failure (CHF) undergoing CRT and in ten patients without structural heart disease (control group). NICE is a fusion of data from high-resolution ECG mapping with a model of the patient's individual cardiothoracic anatomy created from magnetic resonance imaging. Beat-to-beat endocardial and epicardial ventricular activation sequences were computed during native rhythm as well as during ventricular pacing using a bidomain theory-based heart model to solve the related inverse problem. During right ventricular (RV) pacing control patients showed a deterioration of the ventricular activation sequence similar to the intrinsic activation pattern of CHF patients. Left ventricular propagation velocities were significantly decreased in CHF patients as compared to the control group (1.6±0.4 versus 2.1±0.5 m/sec; p<0.05). CHF patients showed right-to-left septal activation with the latest activation epicardially in the lateral wall of the left ventricle. Biventricular pacing resulted in a resynchronization of the ventricular activation sequence and in a marked decrease of total LV activation duration as compared to intrinsic conduction and RV pacing (129±16 versus 157±28 and 173±25 ms; both p<0.05).<h4>Conclusions/significance</h4>Endocardial and epicardial ventricular activation can be visualized noninvasively by NICE. Identification of individual ventricular activation properties may help identify responders to CRT and to further improve response to CRT by facilitating a patient-specific lead placement and device programming.
format	article
author	Thomas Berger Bernhard Pfeifer Friedrich F Hanser Florian Hintringer Gerald Fischer Michael Netzer Thomas Trieb Markus Stuehlinger Wolfgang Dichtl Christian Baumgartner Otmar Pachinger Michael Seger
author_facet	Thomas Berger Bernhard Pfeifer Friedrich F Hanser Florian Hintringer Gerald Fischer Michael Netzer Thomas Trieb Markus Stuehlinger Wolfgang Dichtl Christian Baumgartner Otmar Pachinger Michael Seger
author_sort	Thomas Berger
title	Single-beat noninvasive imaging of ventricular endocardial and epicardial activation in patients undergoing CRT.
title_short	Single-beat noninvasive imaging of ventricular endocardial and epicardial activation in patients undergoing CRT.
title_full	Single-beat noninvasive imaging of ventricular endocardial and epicardial activation in patients undergoing CRT.
title_fullStr	Single-beat noninvasive imaging of ventricular endocardial and epicardial activation in patients undergoing CRT.
title_full_unstemmed	Single-beat noninvasive imaging of ventricular endocardial and epicardial activation in patients undergoing CRT.
title_sort	single-beat noninvasive imaging of ventricular endocardial and epicardial activation in patients undergoing crt.
publisher	Public Library of Science (PLoS)
publishDate	2011
url	https://doaj.org/article/e4c8f3b30be94cc1a8d2bd37ffa3e086
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Single-beat noninvasive imaging of ventricular endocardial and epicardial activation in patients undergoing CRT.

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