Heart Failure Clinical Trial
Official title:
Use of 3-D Blood Pool Scintigraphy to Guide Left Ventricular Pacing Lead Placement in Patients Requiring Cardiac Resynchronization Therapy (MUGA-CRT)
The purpose of this study is to determine whether multiple gated acquisition (MUGA) guided lead placement improves clinical outcomes for patients needing cardiac resynchronization therapy (CRT) compared to traditional posterolateral left ventricular lead placement.
Heart failure (HF) has a prevalence of five million individuals in the United States.
Approximately 25-30% of patients with HF due to left ventricular (LV) systolic dysfunction
have prolonged QRS. Prolonged QRS duration (>120ms) on ECG in HF patients is associated with
increased morbidity and mortality.
Delayed electrical activation of the LV translates to temporal delay in ventricular
contraction. This is referred to as mechanical dyssynchrony. Patients with advanced HF, low
ejection fraction (EF) of less than 35% and QRS of more than 120ms are indicated for cardiac
resynchronization therapy (CRT). While most patients undergoing CRT implantation show
dramatic improvement in HF symptoms, 30-40% of the HF patients undergoing CRT placement do
not show a clinical response. The site of placement of the LV lead has been shown to be an
important determinant of the effects of CRT.
Measurement of left ventricular ejection fraction (LVEF) is performed using non-invasive
measures such as the MUGA. By using the available information on left ventricular systolic
function the investigators plan on investigating the effects of MUGA-guided versus
traditional LV lead placement for CRT.
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