Postoperative Performance of the Quartet^® Left Ventricular Heart Lead

Abstract

The Quartet LV lead electrical performance was stable and was associated with a high implant success and low dislodgement rate during 3-month follow-up. In all patients with PNS, the 10 pacing vectors combined with reduced output programming enabled the elimination of PNS noninvasively.

Cardiac resynchronization therapy: a comparison among left ventricular bipolar, quadripolar and active fixation leads

“…Despite this, the LVT threshold at the target location may not differ from one lead platform to the other, being dependent on local tissue properties, electrode technology, and stabilization strategy 2–6,13,15 . Whereas QL leads ensure an easier management of PN and fewer lead dislodgments compared to conventional BL leads in comparative studies 16 , the dislodgement rate of QL was 3.5% at 3 months in Tomassoni multicenter study 5 , and very similar at one year in this study (with some differences across manufacturers). Enhanced stability portends improved clinical outcome: Forleo et al .…”

Performance of a novel left ventricular lead with short bipolar spacing for cardiac resynchronization therapy: Primary results of the Attain Performa Quadripolar Left Ventricular Lead Study

“…32,33 Implantation times have not been widely reported for previous leads, but our results of 13.9 Ϯ 19 minutes compare favorably with the results reported by others. 27,31,34 Study limitations This is an observational study that reports the results of these leads alone. It is neither a randomized study comparing results with those of unipolar or bipolar LV leads nor did it evaluate physician's choice of different models of the lead family.…”

“…27 We speculate that the high usage of nonstandard vectors was due to the fact that most LV polarities achieved low PCTs, and the unique short bipolar configurations avoid PNS symptoms successfully. The PNS rates elicited by the pacing test at 8 V ( Figure 4) were lower, and the PNS À PCT differences (Table 2) were wider at 6 months in the short bipolar configurations compared to other pacing vectors.…”

“…The data presented here, as compared with the data on the other market-released quadripolar leads, strongly suggest that steroid elution may improve the performance of all electrodes. 27 With a low PCT, clinicians targeted more specific pacing sites in proximal or basal regions that are associated with enhanced patient outcomes as compared with apical pacing sites, without compromising battery longevity. In addition, the availability of VectorExpress allowed the opportunity to evaluate 16 pacing vectors and choose a particular vector that would be best for patients in a reasonable time during a clinical visit.…”

For LV pacing, four is greater than two

“…Single-arm observational studies of the first two quadripolar lead families showed high implant success rates, low dislodgment rates, good chronic pacing thresholds, and an ability to resolve most cases of PNS via device reprogramming [4], [5], [6]. It has, however, taken several years since the launch of quadripolar pacing leads for data to emerge proving their clinical value relative to conventional bipolar leads.…”