Document Detail


First prospective, multi-centre clinical experience with a novel left ventricular quadripolar lead.
MedLine Citation:
PMID:  21993431     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
AimsCardiac resynchronization therapy (CRT) is sometimes complicated by elevated pacing thresholds and phrenic nerve stimulation (PNS), both of which may require that the coronary sinus lead be repositioned. The purpose of this study was to evaluate the performance of a novel quadripolar electrode lead and cardiac resynchronization therapy-defibrillator (CRT-D) device that enables electrical repositioning, potentially obviating a lead reposition procedure.Methods and resultsPatients indicated for CRT were enrolled and received a quadripolar electrode lead and CRT-D device (Quartet(®) model 1458Q and Promote Q(®); St Jude Medical, Sylmar, CA, USA). Electrical data, and the presence of PNS during pacing from each left ventricular (LV) configuration, were documented at pre-hospital discharge and at 1 month. Seventy-five patients were enrolled and 71 were successfully implanted with a Quartet(®) lead. Electrical measurements were stable over the follow-up period. Ninety-seven per cent (64 of 66) of patients had one or more programmable configurations with a threshold <2.5 V and no PNS vs. 86% (57 of 66) if only conventional bipolar configurations were considered. Physicians were able to use the increased programming options to manage threshold changes and PNS.ConclusionThe new quadripolar electrode LV lead provides more programming options to address common problems faced when managing CRT patients. Electrical measurements from new vectors are comparable with conventional configurations. Furthermore, 11% of patients in the study suffered PNS on all conventional bipolar vectors.
Authors:
Johannes Sperzel; Wilfried Dänschel; Klaus-Jürgen Gutleben; Wolfgang Kranig; Peter Mortensen; Derek Connelly; Hans-Joachim Trappe; Karlheinz Seidl; Gabor Duray; Burkert Pieske; Jochem Stockinger; Giuseppe Boriani; Werner Jung; Richard Schilling; Linda Saberi; Benoit Hallier; Marcus Simon; Christopher A Rinaldi
Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2011-10-11
Journal Detail:
Title:  Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology     Volume:  -     ISSN:  1532-2092     ISO Abbreviation:  -     Publication Date:  2011 Oct 
Date Detail:
Created Date:  2011-10-13     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  100883649     Medline TA:  Europace     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Affiliation:
1Cardiology Department, Kerckhoff-Klinik GmbH, Benekestr 2-8, 61231, Bad Nauheim, Germany.
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