Abstract 14151: Comparing Effectiveness of Quadripolar and Bipolar Left Ventricular Leads in Cardiac Resynchronization Therapy
Introduction: Cardiac resynchronization therapy (CRT) is an established treatment for patients with heart failure. Quadripolar LV leads create multiple pacing vectors, with potential advantages of reduced pacing thresholds, improved CRT response, less phrenic nerve capture, and less need for LV lead revision.
Hypothesis: We assessed the hypothesis that quadripolar leads would be associated with fewer complications and more effective CRT than traditional bipolar LV leads.
Methods: In this single-center, retrospective cohort study, 259 consecutive patients receiving a LV pacing lead from 2012-2014 were reviewed. Complications were defined as intra-op (coronary sinus perforation, need to attempt multiple LV leads, inability to place lead) and post-op (need for LV lead or system revision). For complication rates, groups were defined by initial type of LV lead attempted. For effectiveness of CRT, groups were defined by type of LV lead implanted and post-procedure echocardiograms were compared.
Results: There were 111 patients initially planned for a bipolar lead and 148 planned for a quadripolar lead with an average follow-up time of 17.5 months. Comparison between the two groups and p-values are summarized in Table 1.
Conclusion: A significantly lower complication rate was observed with initial use of quadripolar LV leads compared to bipolar LV leads; this difference was driven by intra-op complications (specifically the need to attempt multiple LV leads). Post-op complications, threshold voltage, and effectiveness of CRT were not significantly different. In conclusion, quadripolar leads decreased the need to attempt multiple LV leads intra-op, but long-term outcomes were not significantly different than with bipolar leads. As the usage of quadripolar LV leads increases, the benefits need to be further characterized.
Author Disclosures: D. Lee: None. C. Liu: None. B. Lerman: None. S. Markowitz: Speakers Bureau; Modest; St. Jude Medical. Honoraria; Modest; Boston Scientific. J. Cheung: Honoraria; Modest; Medtronic. Other; Modest; Fellowship grant support: St. Jude Medical, Fellowship grant support: Medtronic, Fellowship grant support: Biotronick. J. Ip: None. G. Thomas: Research Grant; Modest; Biotronik. Speakers Bureau; Modest; Medtronic, St. Jude Medical, Biotronik. Honoraria; Modest; Medtronic.
- © 2016 by American Heart Association, Inc.