Improvement in Hemodynamic Response Using a Quadripolar LV Lead

Bueno, Fernando Cabrera; Rodríguez, Javier Alzueta; Ros, José Olagüe de; Fernández‐Lozano, Ignacio; Guerrero, Juan José García; Concha, Joaquín Fernández de la; Madrid, Antonio Hernández; Viu, José María Tolosana; Osca, Joaquín; Cordero, Alberto; Hernangómez, Elena Llorente

doi:10.1111/pace.12172

Cited by 11 publications

(5 citation statements)

References 17 publications

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“…Consequently the obesity did not diminish the clinical benefit of CRT-d to reduce risk for appropriate ICD therapy, as we observed in our study [36]. This effect, and the opportunity to program multiple LV pacing configurations, may be induced by multipolar pacing [37]. The multipolar stable, and continuous biventricular pacing, may induce a stabilization effect on cellular membranes, ionic currents, and cardiac cells [37].…”

Section: Discussionmentioning

confidence: 49%

“…This effect, and the opportunity to program multiple LV pacing configurations, may be induced by multipolar pacing [37]. The multipolar stable, and continuous biventricular pacing, may induce a stabilization effect on cellular membranes, ionic currents, and cardiac cells [37]. This effect, reducing AF episodes PNS, LV lead dislodgments, and re-interventions to re-position LV leads, may be associated to a lowering of hospitalizations for HF worsening in T2DM failing heart patients [n 15 (15.2%) vs 24 (25%), p value 0.046], comparing multipolar pacing vs bipolar pacing (Table 4; Fig.…”

Section: Discussionmentioning

confidence: 99%

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Multipolar pacing by cardiac resynchronization therapy with a defibrillators treatment in type 2 diabetes mellitus failing heart patients: impact on responders rate, and clinical outcomes

Sardu

Barbieri

Santamaria³

et al. 2017

Cardiovasc Diabetol

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BackgroundType 2 diabetes mellitus (T2DM) is a multi factorial disease, affecting clinical outcomes in failing heart patients treated by cardiac resynchronization therapy with a defibrillator (CRT-d).MethodsOne hundred and ninety-five T2DM patients received a CRT-d treatment. Randomly the study population received a CRT-d via multipolar left ventricle (LV) lead pacing (n 99, multipolar group), vs a CRT-d via bipolar LV pacing (n 96, bipolar group). These patients were followed by clinical, and instrumental assessment, and telemetric device control at follow up. In this study we evaluated, in a population of failing heart T2DM patients, cardiac deaths, all cause deaths, arrhythmic events, CRT-d responders rate, hospitalizations for HF worsening, phrenic nerve stimulation (PNS), and LV catheter dislodgment events (and re-intervention for LV catheter re-positioning), comparing multipolar CRT-d vs bipolar CRT-d group of patients at follow up.ResultsAt follow up there was a statistical significant difference about atrial arrhythmic events [7 (7%) vs 16 (16.7%), p value 0.019], hospitalizations for HF worsening [15 (15.2% vs 24 (25%), p value 0.046], LV catheter dislodgments [1 (1%) vs 9 (9.4%), p value 0018], PNS [5 (5%) vs 18 (18.7%), p value 0.007], and LV re-positioning [1 (1%) vs 9 (9.4%), p value 0.018], comparing multipolar CRT-d vs bipolar CRT-d group of patients. Multipolar pacing was an independent predictor of all these events.ConclusionsCRT-d pacing via multipolar LV lead vs bipolar LV lead may reduce arrhythmic burden, hospitalization rate, PNS, LV catheters dislodgments, and re-interventions in T2DM failing heart patients. Clinical trial number NCT03095196

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Section: Discussionmentioning

confidence: 49%

Section: Discussionmentioning

confidence: 99%

Multipolar pacing by cardiac resynchronization therapy with a defibrillators treatment in type 2 diabetes mellitus failing heart patients: impact on responders rate, and clinical outcomes

Sardu

Barbieri

Santamaria³

et al. 2017

Cardiovasc Diabetol

View full text Add to dashboard Cite

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“…Since then, quadripolar leads have been introduced. While serving to address high pacing thresholds and phrenic nerve stimulation issues, the multiple pacing configurations can also result in better hemodynamic response than standard, distal biventricular stimulation . Using bioimpedance, Osca et al .…”

Section: Discussionmentioning

confidence: 99%

Combination of the best pacing configuration and atrioventricular and interventricular delays optimization in cardiac resynchronization therapy

Socie

Squara

Semichon

et al. 2018

Pacing Clinical Electrophis

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“…Several studies that compared bipolar with quadripolar leads for CRT showed improved acute LV lead implantation success rate, shorter implantation time and lower fluoroscopy dose with quadripolar leads 5–6 . Furthermore, CRT with an IS‐4 lead tends to provide better clinical outcome and performance parameters 7–10 . However data on long‐term clinical outcome and adverse event rates are necessary.…”

Section: Introductionmentioning

confidence: 99%

“…[5][6] Furthermore, CRT with an IS-4 lead tends to provide better clinical outcome and performance parameters. [7][8][9][10] However data on long-term clinical outcome and adverse event rates are necessary.…”

Section: Introductionmentioning

confidence: 99%

Acute and long‐term outcomes of quadripolar IS‐4 versus bipolar IS‐1 left ventricular leads in cardiac resynchronization therapy: A retrospective registry study

Maurhofer

Asatryan

Haeberlin

et al. 2023

Pacing Clinical Electrophis

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Background:The implantation procedure of left ventricular (LV) leads and the management of cardiac resynchronization therapy (CRT) patients can be challenging. The IS-4 standard for CRT offers additional pacing vectors compared to bipolar leads (IS-1). IS-4 leads improve procedural outcome and may also result in lower adverse events during follow-up (FU) and improve clinical outcome in CRT patients. Further long-term FU data comparing the two lead designs are necessary. Methods:In this retrospective, single-center study we included adult patients implanted with a CRT-Defibrillator (CRT-D) or CRT-Pacemaker (CRT-P) with a quadripolar (IS-4 group) or bipolar (IS-1 group) LV lead and with available ≥3 years clinical FU. The combined primary endpoint was a combination of predefined, lead-related adverse events. Secondary endpoints were all single components of the primary endpoint.Results: Overall, 133 patients (IS-4 n = 66; IS-1 n = 67) with a mean FU of 4.03 ± 1.93 years were included. Lead-related adverse events were less frequent in patients with an IS-4 lead than with an IS-1 lead (n = 8, 12.1% vs. n = 23, 34.3%; p = .002).The secondary outcomes showed a lower rate of LV lead deactivation/explantation and LV lead dislodgement/dysfunction (4.5% vs. 22.4%; p = .003; 4.5% vs. 17.9%; p = .015, respectively) in the IS-4 patient group. Less patients suffered from unresolved phrenic nerve stimulation with an IS-4 lead (3.0% vs. 13.4%; p = .029). LV lead-related re-interventions were fewer in case of an IS-4 lead (6.1% vs. 17.9%; p = .036). Conclusion:In this retrospective analysis, the IS-4 LV lead is associated with lower lead-related complication rates than the IS-1 lead at long-term FU.

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Improvement in Hemodynamic Response Using a Quadripolar LV Lead

Abstract: A quadripolar lead offers multiple additional pacing options to increase CO acutely compared to conventional bipolar leads.

Cited by 11 publications

References 17 publications

Multipolar pacing by cardiac resynchronization therapy with a defibrillators treatment in type 2 diabetes mellitus failing heart patients: impact on responders rate, and clinical outcomes

Multipolar pacing by cardiac resynchronization therapy with a defibrillators treatment in type 2 diabetes mellitus failing heart patients: impact on responders rate, and clinical outcomes

Combination of the best pacing configuration and atrioventricular and interventricular delays optimization in cardiac resynchronization therapy

Acute and long‐term outcomes of quadripolar IS‐4 versus bipolar IS‐1 left ventricular leads in cardiac resynchronization therapy: A retrospective registry study

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