Author + information
- A. Rajappan,
- R. Varma,
- S. Shivdas,
- M. Shaik and
- K. Zuurmond
Dynamic Coronary Roadmap (DCR) is a navigation support package that allows the users to see a roadmap of the coronary anatomy displayed on live fluoroscopy. By comparing moving structures that are present in both the angiogram and the live fluoroscopy images, with image registration techniques, DCR provides a precise overlay of the coronary vessel tree on top of the live fluoroscopy moving exactly with the cardiac and breathing motion. This same technique can also be used for imaging the coronary venous anatomy for guiding left ventricular lead placement.
A 70 year old man with dilated cardiomyopathy, LBBB and severe left ventricular dysfunction was taken up for triple chamber pacing. The DCR was used to create a mask of the coronary venous anatomy during the initial coronary sinus venogram. Subsequently, the wiring of the lateral vein and positioning the left ventricular lead was done with the guidance of the DCR.
Thus, dynamic coronary roadmap can be usefully adapted for assisting left ventricular lead placement in triple chamber pacing. This will reduce the procedure time and radiation involved in cardiac resynchronization.