PMID- 31025153
OWN - NLM
STAT- MEDLINE
DCOM- 20200109
LR  - 20200225
IS  - 1572-8595 (Electronic)
IS  - 1383-875X (Linking)
VI  - 55
IP  - 1
DP  - 2019 Jun
TI  - Effects of implantation of quadripolar left ventricular leads on CRT response.
PG  - 73-81
LID - 10.1007/s10840-019-00545-8 [doi]
AB  - BACKGROUND: The use of quadripolar (QP) left ventricular leads for cardiac 
      resynchronization therapy (CRT) is intended to improve outcomes compared with 
      conventional bipolar leads (BP). Hence, the number of implanted quadripolar CRT 
      systems is increasing despite limited long-term data. PURPOSE: The aim of this 
      study is to evaluate clinical response and long-term outcomes of CRT recipients 
      who were implanted with quadripolar versus bipolar left ventricular leads. 
      METHODS: Data from consecutive patients receiving a CRT defibrillator in one 
      German and one Hungarian tertiary referral center were retrospectively collected. 
      Long-term survival and response to CRT were analyzed. RESULTS: A total of 536 
      patients with structural heart disease and a mean left ventricular ejection 
      fraction (LVEF) of 25% received a CRT defibrillator (CRT-D) system for primary 
      (79%) or secondary (21%) prevention of sudden death. Comorbidities did not differ 
      significantly between patients receiving a QP (n = 123) or a BP lead (n = 413). 
      Procedure (101 vs. 120 min) and fluoroscopy times (14 vs. 20 min) were shorter in 
      patients implanted with QP compared with BP (both p < 0.001). At 6 months 
      follow-up, QP patients were more likely to respond to CRT measured as improvement 
      in the New York Heart Association (NYHA) functional class (77% vs. 63%; 
      p < 0.001). Use of QP left ventricle/left ventricular (LV) leads was associated 
      with greater reduction in QRS duration compared with patients implanted with BP 
      LV leads (- 21 +/- 30 vs. - 8 +/- 35 ms, p = 0.004). Mortality was not significantly 
      different between patients with QP and patients with BP LV leads at a mean 
      follow-up of 39 +/- 31 months. CONCLUSION: Implantation of quadripolar left 
      ventricular leads was associated with better CRT response compared with bipolar 
      left ventricular leads.
FAU - Erath, Julia W
AU  - Erath JW
AUID- ORCID: 0000-0003-3145-6767
AD  - Department of Cardiology, Division of Clinical Electrophysiology, University 
      Hospital Frankfurt, Theodor-Stern-Kai 7, 60590, Frankfurt, Germany.
FAU - Vamos, Mate
AU  - Vamos M
AD  - Department of Cardiology, Division of Clinical Electrophysiology, University 
      Hospital Frankfurt, Theodor-Stern-Kai 7, 60590, Frankfurt, Germany.
FAU - Domokos, Dominika
AU  - Domokos D
AD  - Department of Cardiology, Medical Centre, Hungarian Defence Forces, Budapest, 
      Hungary.
FAU - Benz, Alexander P
AU  - Benz AP
AD  - Department of Cardiology, Division of Clinical Electrophysiology, University 
      Hospital Frankfurt, Theodor-Stern-Kai 7, 60590, Frankfurt, Germany.
FAU - Bari, Zsolt
AU  - Bari Z
AD  - Department of Cardiology, Medical Centre, Hungarian Defence Forces, Budapest, 
      Hungary.
FAU - Bogyi, Peter
AU  - Bogyi P
AD  - Department of Cardiology, Medical Centre, Hungarian Defence Forces, Budapest, 
      Hungary.
FAU - Duray, Gabor Z
AU  - Duray GZ
AD  - Department of Cardiology, Medical Centre, Hungarian Defence Forces, Budapest, 
      Hungary.
FAU - Hohnloser, Stefan H
AU  - Hohnloser SH
AD  - Department of Cardiology, Division of Clinical Electrophysiology, University 
      Hospital Frankfurt, Theodor-Stern-Kai 7, 60590, Frankfurt, Germany. 
      hohnloser@em.uni-frankfurt.de.
LA  - eng
PT  - Journal Article
PT  - Multicenter Study
DEP - 20190425
PL  - Netherlands
TA  - J Interv Card Electrophysiol
JT  - Journal of interventional cardiac electrophysiology : an international journal of 
      arrhythmias and pacing
JID - 9708966
SB  - IM
MH  - Aged
MH  - *Cardiac Resynchronization Therapy Devices
MH  - *Electrodes, Implanted
MH  - Equipment Design
MH  - Female
MH  - Germany
MH  - Humans
MH  - Hungary
MH  - Male
MH  - Retrospective Studies
MH  - Survival Rate
OTO - NOTNLM
OT  - Bipolar lead
OT  - CRT
OT  - CRT-D
OT  - Cardiac resynchronization therapy
OT  - Quadripolar lead
OT  - Response
EDAT- 2019/04/27 06:00
MHDA- 2020/01/10 06:00
CRDT- 2019/04/27 06:00
PHST- 2018/12/23 00:00 [received]
PHST- 2019/03/26 00:00 [accepted]
PHST- 2019/04/27 06:00 [pubmed]
PHST- 2020/01/10 06:00 [medline]
PHST- 2019/04/27 06:00 [entrez]
AID - 10.1007/s10840-019-00545-8 [pii]
AID - 10.1007/s10840-019-00545-8 [doi]
PST - ppublish
SO  - J Interv Card Electrophysiol. 2019 Jun;55(1):73-81. doi: 
      10.1007/s10840-019-00545-8. Epub 2019 Apr 25.