Postoperative performance of the quartet® left ventricular heart lead

Gery Tomassoni, James Baker, Raffaele Corbisiero, Charles Love, David Martin, Imran Niazi, Robert Sheppard, Seth Worley, Scott Beau, G. Stephen Greer, Arash Aryana, Michael Cao, Nicole Harbert, Suhong Zhang

Research output: Contribution to journalArticle

Abstract

Introduction: The Quartet® left ventricular (LV) lead is the first with 4 pacing electrodes (tip and 3 rings) that enables pacing from 10 different pacing vectors. Postoperative performance of this lead was evaluated in a prospective, nonrandomized, multicenter IDE study. Methods: Patients with standard indications for CRT-D were enrolled. Electrical performance and presence of phrenic nerve stimulation (PNS) were assessed during pacing from each of 10 vectors at predischarge (within 7 days), 1 month, and 3 months postimplant. Results: The Quartet LV lead was implanted successfully in 170 patients (95.5% implant success rate, 68 ± 11 years, 68.5% male, LVEF: 25 ± 7%, NYHA class III: 98.3% and class IV: 1.7%). Mean follow-up was 4.7 ± 1.9 months. Capture threshold and impedance for each of the 10 LV lead pacing vectors remained stable during follow-up. LV lead dislodgement occurred in 6 (3.5%) patients and PNS was observed in 23 (13.5%) patients. PNS was resolved noninvasively in all 23 (100%) patients, either by reprogramming to pace from the additional LV lead pacing vectors alone (13 pts, 56.5%), reprogramming to pace from the additional LV lead pacing vectors and reprogramming pacing output (4 pts, 17.4%), or by reprogramming pacing output alone (6 pts, 26.1%). Conclusions: 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.

Original languageEnglish (US)
Pages (from-to)449-456
Number of pages8
JournalJournal of cardiovascular electrophysiology
Volume24
Issue number4
DOIs
StatePublished - Apr 1 2013
Externally publishedYes

Keywords

  • cardiac resynchronization therapy
  • heart failure
  • implantable cardioverter defibrillator
  • phrenic nerve stimulation
  • quadripolar LV pacing lead

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Physiology (medical)

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