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Title: Additional electrodes on the Quartet™ LV lead provide more programmable pacing options than bipolar and tripolar equivalents
Austin Authors: O'Donnell, David ;Sperzel, Johannes;Thibault, Bernard;Rinaldi, Christopher A;Pappone, Carlo;Gutleben, Klaus-Jürgen;Leclercq, Christopher;Razavi, Hedi;Ryu, Kyungmoo;Mcspadden, Luke C;Fischer, Avi;Tomassoni, Gery
Affiliation: Cardiology
Kerckhoff Klinik GmbH, Bad Nauheim, Germany
Montreal Heart Institute, Montreal, Québec, Canada
Guy's and St Thomas' Hospitals, London, UK
Department of Arrhythmology, IRCCS Policlinico San Donato, San Donato Milanese, Milan, Italy
Herz- und Diabeteszentrum NRW, Bad Oeynhausen, Germany
CHU Pontchaillou, Rennes, France
St Jude Medical, Inc., Sylmar, CA, USA
Baptist Health, Lexington, KY, USA
Issue Date: 1-Apr-2017
Date: 2017-04-01
Publication information: Europace 2017; 19(4): 588-595
Abstract: AIMS: The aim of this study was to evaluate any benefits to the number of viable pacing vectors and maximal spatial coverage with quadripolar left ventricular (LV) leads when compared with tripolar and bipolar equivalents in patients receiving cardiac resynchronization therapy (CRT). METHODS AND RESULTS: A meta-analysis of five previously published clinical trials involving the Quartet™ LV lead (St Jude Medical, St Paul, MN, USA) was performed to evaluate the number of viable pacing vectors defined as capture thresholds ≤2.5 V and no phrenic nerve stimulation and maximal spatial coverage of viable vectors in CRT patients at pre-discharge (n = 370) and first follow-up (n = 355). Bipolar and tripolar lead configurations were modelled by systematic elimination of two and one electrode(s), respectively, from the Quartet lead. The Quartet lead with its four pacing electrodes exhibited the greatest number of pacing vectors per patient when compared with the best bipolar and the best tripolar modelled equivalents. Similarly, the Quartet lead provided the highest spatial coverage in terms of the distance between two furthest viable pacing cathodes when compared with the best bipolar and the best tripolar configurations (P < 0.05). Among the three modelled bipolar configurations, the lead configuration with the two most distal electrodes resulted in the highest number of viable pacing vectors. Among the four modelled tripolar configurations, elimination of the second proximal electrode (M3) resulted in the highest number of viable pacing options per patient. There were no significant differences observed between pre-discharge and first follow-up analyses. CONCLUSION: The Quartet lead with its four electrodes and the capability to pace from four anatomical locations provided the highest number of viable pacing vectors at pre-discharge and first follow-up visits, providing more flexibility in device programming and enabling continuation of CRT in more patients when compared with bipolar and tripolar equivalents.
DOI: 10.1093/europace/euw039
Journal: Europace
PubMed URL:
Type: Journal Article
Subjects: Cardiac resynchronization therapy (CRT)
Device programmin
Left ventricular leads
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