Abstract 12292: Magnetocardiography Can Predict Reverse Remodeling and Long-Term Prognosis After Cardiac Resynchronization Therapy
Background: Although cardiac resynchronization therapy (CRT), an established treatment for advanced heart failure (HF) with electromechanical dyssynchrony, is not effective in approximately one third of the patients, there is currently no available tool to accurately predict the CRT response. Magnetocardiography (MCG) is a unique tool for non-invasively recording the propagation of ventricular conduction with high spatio-temporal resolusion. We hypothesized that MCG can stratify patients who may or may not benefit from CRT and predict long-term prognosis.
Methods: We analyzed 64-ch MCGs (MC-6400, Hitachi, 1kHz sampling) in 25 patients with severe left ventricular (LV) dysfunction (LVEF<40%, 24 +/- 10%) and QRS prolongation (>120ms) on ECG (18 CLBBB, 7 IVCD). According to the 2-dimensional QRS current arrow mapping, they were divided into 2 groups (Group-A with Uni-directional QRS current pattern and Group-B with Multi-directional QRS current pattern, Figure). We compared clinical and echocardiographic characteristics at 6 months after CRT implantation. CRT responder was defined when >10% LVDd decrease or >10% LVEF increase was recognized.
Results: There were no significant differences between the groups with respect to the baseline data including LVDd, LVEF, BNP, and NYHA functional class. After 6 months, we found 12 responders (92%) out of 13 Group-A patients and 9 non-responders (75%) out of 12 Group-B patients (p=0.001). During the follow-up of 721 +/- 339 days, cardiac events occurred in only one patient (HF hospitalization) in Group-A (1/13, 8%), while the majority of Group-B patients (8/12, 75%) experienced adverse events (1 death, 2 LVAS implant, 5 HF hospitalization).
Conclusions: Magnetocardiographic analysis can identify patients who may or may not benefit from CRT and predict long-term prognosis after CRT.
- © 2011 by American Heart Association, Inc.