Cardiac magnetic resonance imaging-guided evaluation of right ventricular dyssynchrony and cardiac resynchronization therapy for severe right ventricular heart failure

Research Project

Project/Area Number	26670392
Research Category	Grant-in-Aid for Challenging Exploratory Research
Allocation Type	Multi-year Fund
Research Field	Cardiovascular medicine
Research Institution	独立行政法人国立病院機構高崎総合医療センター(臨床研究部) (2016) Gunma University (2014-2015)
Principal Investigator	Ota Masaki 独立行政法人国立病院機構高崎総合医療センター(臨床研究部), 臨床研究部, 循環器内科医師 (10719876)
Co-Investigator(Kenkyū-buntansha)	中島忠群馬大学, 医学部附属病院, 講師 (40510574) 金古善明群馬大学, 大学院医学系研究科, 准教授 (60302478)
Project Period (FY)	2014-04-01 – 2017-03-31
Project Status	Completed (Fiscal Year 2016)
Budget Amount *help	¥3,770,000 (Direct Cost: ¥2,900,000、Indirect Cost: ¥870,000) Fiscal Year 2016: ¥650,000 (Direct Cost: ¥500,000、Indirect Cost: ¥150,000) Fiscal Year 2015: ¥910,000 (Direct Cost: ¥700,000、Indirect Cost: ¥210,000) Fiscal Year 2014: ¥2,210,000 (Direct Cost: ¥1,700,000、Indirect Cost: ¥510,000)
Keywords	右心不全 / 心臓再同期療法 / 心臓MRI画像 / 心房粗動 / 十二誘導心電図 / リエントリー回路 / カテーテルアブレーション / 右室非同期 / 右室多点ペーシング
Outline of Final Research Achievements	Right ventricular (RV) mechanical dyssynchrony is proposed as a desirable therapeutic target in patients with right bundle branch block (RBBB) or RV apical pacing complicated with RV heart failure and can be visualized by transthoracic echocardiography or electroanatomical mapping that reveals a marked conduction delay of the RV free wall compared to the septal wall. Right-sided cardiac resynchronization therapy (R-CRT) by application of additional pacing at the RV free wall is effective for treatment of RV heart failure refractory to medical therapy in patients with RV dyssynchrony. To perform R-CRT by using standard CRT equipped with three ports only, one can connect the RV apical lead to the RV port to keep ventricular sensing stable, and connected the other two leads at the RV free wall and LV to LV port via the Y-connector.