{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,12,19]],"date-time":"2025-12-19T09:38:16Z","timestamp":1766137096279,"version":"3.41.2"},"reference-count":18,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"21","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["JAHA"],"published-print":{"date-parts":[[2018,11,6]]},"abstract":"<jats:sec xml:lang=\"en\">\n            <jats:title>Background<\/jats:title>\n            <jats:p xml:lang=\"en\">\n              The efficacy of cardiac resynchronization therapy may be reduced in the event of pacing within myocardial fibrosis. We aimed to develop a method to determine the anatomical relationships between the left ventricular (\n              <jats:styled-content style=\"fixed-case\">LV<\/jats:styled-content>\n              ) lead and myocardial fibrosis.\n            <\/jats:p>\n          <\/jats:sec>\n          <jats:sec xml:lang=\"en\">\n            <jats:title>Methods and Results<\/jats:title>\n            <jats:p xml:lang=\"en\">\n              In consecutive patients indicated for cardiac resynchronization therapy, cardiovascular magnetic resonance imaging with late gadolinium enhancement assessment was performed before implantation. After implantation, an injected computed tomography scanner (\n              <jats:styled-content style=\"fixed-case\">CT<\/jats:styled-content>\n              scan) was performed. The 2 imaging techniques were fused to assess the\n              <jats:styled-content style=\"fixed-case\">LV<\/jats:styled-content>\n              lead position relative to myocardial scar. A total of 68 patients were included. Myocardial scar was found in 29 (43%) and was localized in lateral segments in 14 (21%). Scar was significantly associated with male sex, ischemic cardiomyopathy, a Selvester score adapted to left bundle branch block (\n              <jats:styled-content style=\"fixed-case\">LBBB<\/jats:styled-content>\n              Selvester), and Selvester criteria for localizing lateral fibrosis (V2 S\/S\u2032 ratio). Image fusion was feasible in all patients. Position within myocardial scar was confirmed for 6 electrodes in 3 patients. Prolonged\n              <jats:styled-content style=\"fixed-case\">QRS<\/jats:styled-content>\n              duration during\n              <jats:styled-content style=\"fixed-case\">LV<\/jats:styled-content>\n              pacing \u2265139% predicted electrode positioning within scar tissue (sensitivity, 83%; specificity, 91%;\n              <jats:italic>P<\/jats:italic>\n              =0.002).\n            <\/jats:p>\n          <\/jats:sec>\n          <jats:sec xml:lang=\"en\">\n            <jats:title>Conclusions<\/jats:title>\n            <jats:p xml:lang=\"en\">\n              In cardiac resynchronization therapy patients, fusion between preimplantation cardiovascular magnetic resonance and a postimplantation injected computed tomography scan is a feasible technique. Prolongation of the\n              <jats:styled-content style=\"fixed-case\">QRS<\/jats:styled-content>\n              duration during\n              <jats:styled-content style=\"fixed-case\">LV<\/jats:styled-content>\n              pacing predicts pacing within myocardial scar. Accurate location of\n              <jats:styled-content style=\"fixed-case\">LV<\/jats:styled-content>\n              lead pacing electrodes on the epicardial surface relative to myocardial scar, either by imaging or\n              <jats:styled-content style=\"fixed-case\">ECG<\/jats:styled-content>\n              analyses, may help improve cardiac resynchronization therapy response in selected patients.\n            <\/jats:p>\n          <\/jats:sec>","DOI":"10.1161\/jaha.118.009502","type":"journal-article","created":{"date-parts":[[2018,10,30]],"date-time":"2018-10-30T09:00:56Z","timestamp":1540890056000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":7,"title":["Localization of Left Ventricular Lead Electrodes in Relation to Myocardial Scar in Patients Undergoing Cardiac Resynchronization Therapy"],"prefix":"10.1161","volume":"7","author":[{"given":"Arnaud","family":"Bisson","sequence":"first","affiliation":[{"name":"Cardiology Department Centre Hospitalier Universitaire Trousseau et Facult\u00e9 de M\u00e9decine Universit\u00e9 de Tours France"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Julien","family":"Pucheux","sequence":"additional","affiliation":[{"name":"Radiology Department Centre Hospitalier Universitaire Trousseau et Facult\u00e9 de M\u00e9decine Universit\u00e9 de Tours France"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Cl\u00e9mentine","family":"Andre","sequence":"additional","affiliation":[{"name":"Cardiology Department Centre Hospitalier Universitaire Trousseau et Facult\u00e9 de M\u00e9decine Universit\u00e9 de Tours France"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Anne","family":"Bernard","sequence":"additional","affiliation":[{"name":"Cardiology Department Centre Hospitalier Universitaire Trousseau et Facult\u00e9 de M\u00e9decine Universit\u00e9 de Tours France"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Bertrand","family":"Pierre","sequence":"additional","affiliation":[{"name":"Cardiology Department Centre Hospitalier Universitaire Trousseau et Facult\u00e9 de M\u00e9decine Universit\u00e9 de Tours France"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Dominique","family":"Babuty","sequence":"additional","affiliation":[{"name":"Cardiology Department Centre Hospitalier Universitaire Trousseau et Facult\u00e9 de M\u00e9decine Universit\u00e9 de Tours France"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Laurent","family":"Fauchier","sequence":"additional","affiliation":[{"name":"Cardiology Department Centre Hospitalier Universitaire Trousseau et Facult\u00e9 de M\u00e9decine Universit\u00e9 de Tours 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of the American Heart 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