BACKGROUND: The purpose of this study was to evaluate the feasibility of the use of a quadripolar left ventricular (LV) lead for cardiac resynchronization therapy and to compare its acute and mid-term outcomes with those obtained with bipolar leads. Cardiac resynchronization exhibits a high incidence of problems involving the LV lead when conventional leads are used, and these problems may be minimized by using multipolar leads. METHODS: We gathered clinical, implant, and follow-up data at 3 and 9 months from 21 consecutive patients in whom a quadripolar (Group Q) or bipolar (Group B) lead was used for a biventricular defibrillator implant. RESULTS: The leads were successfully implanted in all of the patients. In Group B, more than one lead was used in 20% (p = 0.048) of cases. There were no clinical differences or differences in the implant parameters between the two groups except for the radiation dose, which was greater in group B (p = 0.035). The incidence of problems related to the LV lead during follow-up was higher in group B, but the difference was not significant (42.9% vs. 23.8%, p = 0.326). The use of more than one LV lead was the only variable that was significantly associated with lead-related problems during follow-up (p = 0.03; OR = 10.8; 95% CI 1.07-108.61). CONCLUSIONS: The quadripolar lead was associated with excellent implantation success rates and mid-term performance. The multi-programmability capabilities of quadripolar leads facilitated the achievement of implant goals and helped to reduce problems during the implant and follow-up.
BACKGROUND: The purpose of this study was to evaluate the feasibility of the use of a quadripolar left ventricular (LV) lead for cardiac resynchronization therapy and to compare its acute and mid-term outcomes with those obtained with bipolar leads. Cardiac resynchronization exhibits a high incidence of problems involving the LV lead when conventional leads are used, and these problems may be minimized by using multipolar leads. METHODS: We gathered clinical, implant, and follow-up data at 3 and 9 months from 21 consecutive patients in whom a quadripolar (Group Q) or bipolar (Group B) lead was used for a biventricular defibrillator implant. RESULTS: The leads were successfully implanted in all of the patients. In Group B, more than one lead was used in 20% (p = 0.048) of cases. There were no clinical differences or differences in the implant parameters between the two groups except for the radiation dose, which was greater in group B (p = 0.035). The incidence of problems related to the LV lead during follow-up was higher in group B, but the difference was not significant (42.9% vs. 23.8%, p = 0.326). The use of more than one LV lead was the only variable that was significantly associated with lead-related problems during follow-up (p = 0.03; OR = 10.8; 95% CI 1.07-108.61). CONCLUSIONS: The quadripolar lead was associated with excellent implantation success rates and mid-term performance. The multi-programmability capabilities of quadripolar leads facilitated the achievement of implant goals and helped to reduce problems during the implant and follow-up.
Authors: Giovanni B Forleo; Luigi Di Biase; Germana Panattoni; Massimo Mantica; Quintino Parisi; Annamaria Martino; Augusto Pappalardo; Domenico Sergi; Manfredi Tesauro; Lida P Papavasileiou; Luca Santini; Leonardo Calò; Claudio Tondo; Andrea Natale; Francesco Romeo Journal: J Interv Card Electrophysiol Date: 2014-12-13 Impact factor: 1.900
Authors: Mohit K Turagam; Muhammad R Afzal; Sandia Iskander; Luigi Di Biase; Andrea Natale; Dhanunjaya Lakkireddy Journal: J Atr Fibrillation Date: 2016-08-31