First prospective, multi-centre clinical experience with a novel left ventricular quadripolar lead
| Autor: | K. Seidl, Burkert Pieske, Christopher A. Rinaldi, Derek T. Connelly, Giuseppe Boriani, Klaus Gutleben, Wolfgang Kranig, Johannes Sperzel, Peter Thomas Mortensen, Werner Jung, Richard J. Schilling, Wilfried Dänschel, Marcus Simon, Hans Joachim Trappe, Jochem Stockinger, Benoit Hallier, Linda Saberi, Gabor Z. Duray |
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| Přispěvatelé: | Sperzel J, Dänschel W, Gutleben KJ, Kranig W, Mortensen P, Connelly D, Trappe HJ, Seidl K, Duray G, Pieske B, Stockinger J, Boriani G, Jung W, Schilling R, Saberi L, Hallier B, Simon M, Rinaldi CA. |
| Jazyk: | angličtina |
| Rok vydání: | 2012 |
| Předmět: |
Male
medicine.medical_specialty Phrenic nerve stimulation medicine.medical_treatment Treatment outcome Myocardial Ischemia Cardiac resynchronization therapy Quadripolar lead CARDIAC RESYNCHRONIZATION THERAPY left ventricular pacing Ventricular Dysfunction Left Physiology (medical) Internal medicine Humans Medicine Cardiac Resynchronization Therapy Devices Multi centre Lead (electronics) Coronary sinus Aged Heart Failure business.industry Middle Aged Electrodes Implanted Phrenic Nerve Treatment Outcome Cardiac resynchronization Cardiology Female Cardiology and Cardiovascular Medicine business |
| Popis: | AIMS: Cardiac resynchronization therapy (CRT) is sometimes complicated by elevated pacing thresholds and phrenic nerve stimulation (PNS), both of which may require that the coronary sinus lead be repositioned. The purpose of this study was to evaluate the performance of a novel quadripolar electrode lead and cardiac resynchronization therapy-defibrillator (CRT-D) device that enables electrical repositioning, potentially obviating a lead reposition procedure. METHODS AND RESULTS: Patients indicated for CRT were enrolled and received a quadripolar electrode lead and CRT-D device (Quartetmodel 1458Q and Promote Q; St Jude Medical, Sylmar, CA, USA). Electrical data, and the presence of PNS during pacing from each left ventricular (LV) configuration, were documented at pre-hospital discharge and at 1 month. Seventy-five patients were enrolled and 71 were successfully implanted with a Quartetlead. Electrical measurements were stable over the follow-up period. Ninety-seven per cent (64 of 66) of patients had one or more programmable configurations with a threshold < 2.5 V and no PNS vs. 86% (57 of 66) if only conventional bipolar configurations were considered. Physicians were able to use the increased programming options to manage threshold changes and PNS. CONCLUSION: The new quadripolar electrode LV lead provides more programming options to address common problems faced when managing CRT patients. Electrical measurements from new vectors are comparable with conventional configurations. Furthermore, 11% of patients in the study suffered PNS on all conventional bipolar vectors |
| Databáze: | OpenAIRE |
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