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Author Notes:

Corresponding Author: Adrian Lam, ayplam@gatech.edu, 201 Dowman Dr, Atlanta, GA 30322, Work: 404-712-4464, Fax: 404-712-4464.

Subjects:

Research Funding:

This work was supported by the National Center for Advancing Translational Sciences from the National Institutes of Health (UL1TR000454) and grant R21 HL109979 from the National Institutes of Health and a grant-in-aid from the American Heart Association.

Adrian Lam was supported by the American Heart Association (AHA# 12PRE11030006).

Keywords:

  • Science & Technology
  • Life Sciences & Biomedicine
  • Cardiac & Cardiovascular Systems
  • Cardiovascular System & Cardiology
  • Coronary vein
  • CRT
  • MRI
  • X-ray venography
  • CARDIAC-RESYNCHRONIZATION THERAPY
  • VENTRICULAR LEAD POSITION
  • MYOCARDIAL SCAR
  • HEART-FAILURE

Performance of 3D, navigator echo-gated, contrast-enhanced, magnetic resonance coronary vein imaging in patients undergoing CRT

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Journal Title:

Journal of Interventional Cardiac Electrophysiology

Volume:

Volume 41, Number 2

Publisher:

, Pages 155-160

Type of Work:

Article | Post-print: After Peer Review

Abstract:

Materials and methods: Nineteen (19) patients undergoing cardiac resynchronization therapy (CRT) received a cardiac MRI at 1.5T 1 week before treatment. Coronary vein images were acquired using a 3D, navigator- and ECG-gated, contrast-enhanced, inversion-recovery, fast low-angle shot (FLASH) sequence. X-ray venography was performed during the CRT procedure to image the coronary venous anatomy and the LV lead location. MRI coronary vein images were graded on a 0–3 scale (0 = nonexistent, 1 = poor, 2 = good, 3 = excellent). MRI and X-ray venogram images were also graded using a binary visible/not visible scheme to compare the visibility of the coronary veins.Results: The mean visibility scores for the coronary sinus, the posterior interventricular, the posterior vein of the left ventricle, the left marginal vein, and the anterior interventricular were 3.0 ± 0.2, 2.3 ± 0.7, 1.6 ± 1.1, 1.9 ± 0.8 and 2.4 ± 0.9, respectively. When compared to X-ray venography, MRI was capable of visualizing 90 % of veins and all of the veins used for LV lead implantation. The vein used for LV lead implantation had an average vein image quality score of 1.9 on MRI images.Conclusions: Contrast-enhanced MRI was capable of visualizing 90% of the coronary venous anatomy and was able visualize the vein used for LV lead implantation in all patients.Purpose: The aims of this study were to evaluate the ability of contrast-enhanced MRI to visualize the coronary veins with validation by the gold standard, X-ray venography, and to determine whether MRI can visualize the coronary vein branch used for left ventricular (LV) lead implantation.

Copyright information:

© 2014, Springer Science+Business Media New York.

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