How to get the optimal defibrillation lead parameters using myocardial perfusion scintigraphy in patients with coronary artery disease

The conventional criteria for a defibrillation lead (DL) implantation don’t take into account presence of scar or deep ischemia in the myocardium. This may impair a proper functioning of the DL. We sought to optimize the DL implantation placement using rest myocardial perfusion scintigraphy (MPS), w...

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Bibliographic Details
Published in:The International Journal of Cardiovascular Imaging 2021-11, Vol.37 (11), p.3323-3333
Main Authors: Atabekov, Tariel A., Batalov, Roman E., Sazonova, Svetlana I., Krivolapov, Sergey N., Khlynin, Mikhail S., Mishkina, Anna I., Zavadovsky, Konstantin V., Curnis, Antonio, Popov, Sergey V.
Format: Article
Language:English
Subjects:
Cardiac Imaging
Cardiology
Cardiovascular disease
Coronary artery
Coronary artery disease
Coronary vessels
Heart diseases
Imaging
Implantation
Interrogation
Ischemia
Medicine
Medicine & Public Health
Myocardium
Optimization
Original Paper
Parameters
Patients
Perfusion
Radiology
Scars
Scintigraphy
Segments
Vein & artery diseases
Ventricle
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Summary:The conventional criteria for a defibrillation lead (DL) implantation don’t take into account presence of scar or deep ischemia in the myocardium. This may impair a proper functioning of the DL. We sought to optimize the DL implantation placement using rest myocardial perfusion scintigraphy (MPS), which allow detecting areas of myocardial hypoperfusion (MH). To study the influence of MH and scarring, detected by MPS, on the DL parameters in patients with coronary artery disease (CAD). 69 patients (male—65, age 64.8 ± 7.7 years) with CAD and indications for ICD implantation were enrolled. Two days before ICD implantation all patients underwent MPS at rest. Then patients were divided in 2 groups. In the 1st group DL was implanted considering MPS results: to the septal position, if the most significant MH were detected in the apical segments, and to the apical position, if MH were in the septal segments. In the 2nd group DL was implanted using the conventional approach without considering MPS results. Clinical 12 months follow-up was performed with ICD interrogation. Patients of both groups were comparable by clinical and scintigraphic parameters. In the same time, in the 1st group pacing threshold was lower (p 
ISSN:1569-5794
1573-0743
1875-8312
DOI:10.1007/s10554-021-02308-x