Acute hemodynamic effects of biventricular pacing studied during cardiovascular magnetic resonance imaging: the PICARIA Trial

Abstract Background Cardiac resynchronization therapy (CRT) is hampered by a relative high rate of non-response whereby device optimization could aid in improving benefit from CRT. Nonetheless, non-invasive and reproducible clinical tool for currently lacking. Recently introduced cardiovascular magnetic resonance (CMR) compatible CRT devices may allow patient follow-up as biventricular (BIV) pacing can be performed during the CMR exam. However, to date, evaluation acute pump function changes limited. Purpose To assess effects BIV-pacing on change left ventricular (LV) contraction patterns using CMR. Methods Ten patients were included this prospective pilot study. All underwent imaging (1.5T system) prior implantation (baseline), 6 weeks after (CRT-on CRT-off). LV end systolic volume (ESV), diastolic (EDV), ejection fraction (LVEF), measures dyssynchrony dyscoordination (septal rebound stretch (SRSseptal)) assessed cine images. Results before are compared displayed figure. ESV EDV decreased all intrinsic rhythm (CRT-off) (ESV; 161.4±36.3ml vs. 194.9±37.1ml, p<0.01 EDV; 236.2±31.8ml 268.1±42.3ml, p<0.01). A significant improvement LVEF was observed (32.2±8.7% 27.4±5.9%, Both, regional significantly improved CRT-on CRT-off (peakseptal-peaklateral; 57±46ms 183±86ms, SRSseptal; 2.1±2.6% 6.0±3.0%, Conclusions Post-CRT assessing different settings feasible provides important insights cardiac patterns. assessment CMR, potentially combination with pressure measurements, constitute future strategy. Funding Acknowledgement Type funding sources: Private grant(s) and/or Sponsorship. Main source(s): Biotronik (Berlin, Germany)