MRI assessment of pacing induced ventricular dyssynchrony in an isolated human heart

Michael D. Eggen, Michael G. Bateman, Christopher D. Rolfes, Stephen A. Howard, Cory M. Swingen, Paul A. Iaizzo

Research output: Contribution to journalArticlepeer-review

6 Scopus citations

Abstract

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.

Original languageEnglish (US)
Pages (from-to)466-469
Number of pages4
JournalJournal of Magnetic Resonance Imaging
Volume31
Issue number2
DOIs
StatePublished - Feb 2010

Keywords

  • Cardiac pacing
  • Dyssynchrony
  • Magnetic resonance imaging
  • Myocardial contraction
  • Myocardial strain

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