[1] CRT is indicated in patients with a low ejection fraction (typically <35%) indicating heart failure, where electrical activity has been compromised, with prolonged QRS duration to >120 ms.[2] The insertion of electrodes into the ventricles is done under local anesthetic, with access to the ventricles most commonly via the subclavian vein, although access may be conferred from the axillary or cephalic veins.

CRT defibrillators (CRT-D) also incorporate the additional function of an implantable cardioverter-defibrillator (ICD), to quickly terminate an abnormally fast, life-threatening heart rhythm.

[1] Left ventricular lead placement is the most complicated and potentially hazardous element of the operation, due to the significant variability of coronary venous structure.

[1] Several studies have also shown that CRT can decrease mortality, reverse left ventricular remodeling, and improve quality of life, walking distance, and peak oxygen uptake (VO2 max).

[10] Key complications include:[2] Several research papers[12][13] have proposed software platforms for planning and guiding the implantation of CRT devices.

This research proposes using pre-operative images to characterize tissue and left ventricle activation to identify potential target regions for deploying the CRT leads.