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Reccomendation for CRT surgery
Hi Dr.Rich,

  I posted a question about my mom's HF a few months back. As per your advice, we have decided to go for the CRT-D, as her EF is still slightly below 35%. I had a question about the implantation of the CRT-D. Do any imaging studies need to be done, in order to find the most suitable position for the placement of the CRT-D? One of the doctors we visited recommended a MUGA before the procedure, while another doctor has told us that they would not recommend the MUGA, instead preferred to use the Echo. I would really appreciate your advice in clarifying what imaging studies are recommended before the implantation of the CRT-D.

Thank You,
Vik
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1884349 tn?1353818598
Hi Vik and welcome back to the forum:

In the vast majority of cases, specific imaging studies for CRT lead placement is actually not routinely done at all.  If the patient meets criteria for CRT, the procedure is simply done.  However, research studies are being done to try to see if specific imaging studies or other tests might prove useful to help guide the exact location where the lead should be placed.  The reason why you are probably getting different opinions is because there is no consensus and no specific guidelines currently.  

Thus, I would defer to the electrophysiologist who is going to do the procedure and allow him/her to approach it according to how he/she typically does.  The most important thing is that this relatively safe procedure is being done by someone who you feel comfortable with and who has experience with it.  If that is the case, your mom should do just fine.

All the best,

Dr. Rich
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Avatar universal
Thank you very much for your response! That really gives us clarity. My mom will choose the physician she is most comfortable with and get the procedure done. Thanks again for your advice.
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A related discussion, MUGA vs. Echo was started.
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