Background: The study aimed to evaluate impact of electrical and mechanical dissynchrony assessed by surface ECG based imaging technology combined with CT scan and echocardiography on the benefit of cardiac resynchronization therapy (CRT).
Methods: We applied noninvasive mapping using 240-lead ECG combined with CT scan based anatomy (Amycard, RUS) to 6 patients undergoing CRT. Patients had EF=35%, QRS duration of at least 120 ms, NYHA class III-IV. Atrioventricular and intrventricular intervals were optimized by echocardiography and electrocardiographic imaging guidance.
Results: : In all this cases we found an optimal coronary vein to position LV electrode in the latest electrically-activated area. During the average follow-up period of 6 months in all patients EF increased on 35, 6% from initial, end diastolic and end systolic volumes decreased significantly, NYHA class improved to I-II.
Conclusions: Initial experience with noninvasive 3D mapping system combined with CT scan shows its clinical utility, feasibility to provide noninvasive characterization of coronary vein anatomy, epicardial activation sequence and precise determination of the latest activated region, and leads to maximization of the hemodynamic improvement after CRT.