Outcome of Patients Treated by Cardiac Resynchronization Therapy Using a Quadripolar Left Ventricular Lead

Gemma Pelargonio, Gaetano Antonio Lanza, Filippo Crea, Gianluigi Bencardino, Antonio Di Monaco, Eleonora Russo, Francesco Perna, Maria Lucia Narducci, Francesca Augusta Gabrielli, Antonio Giuseppe Rebuzzi

Research output: Contribution to journalArticle

13 Citations (Scopus)

Abstract

Background: Not all heart failure (HF) patients benefit from cardiac resynchronization therapy (CRT). We assessed whether choosing the site of left ventricular (LV) pacing by a quadripolar lead may improve response to CRT. Methods and Results: We prospectively randomized 23 patients with HF (67+/-11 years; 21 males) to CRT with a quadripolar LV lead (group 1, with the LV pacing site chosen on the basis of QRS shortening using simultaneous biventricular pacing), and 20 patients (71+/-6 years; 16 males) to a bipolar LV lead (group 2, with devices programmed with a conventional tip-to-ring configuration). New York Heart Association (NYHA) class and LV ejection fraction (EF) by 2D echocardiography were assessed at baseline and after 3 months. The baseline EF was not different between the 2 groups (25+/-6% group 1 vs. 27+/-3% group 2; P=0.22), but after 3 months EF was higher in group 1 (35+/-13% group 1 vs. 31+/-4% group 2; P<0.001). A reduction in at least 1 NYHA class at 3 months was observed in 22 (96%) and 12 (60%) of group 1 and group 2 patients, respectively (P<0.05). Conclusions: CRT with a quadripolar LV lead was associated with an improvement of EF greater than that observed in patients receiving a bipolar LV lead. In devices with a quadripolar lead, CRT programming based on the best QRS shortening is reliable and effective.
Original languageEnglish
Pages (from-to)613-618
Number of pages6
JournalCirculation Journal
Volume80
DOIs
Publication statusPublished - 2016

Keywords

  • Cardiac resynchronization therapy
  • Heart failure
  • Mortality
  • Multipolar pacing
  • Quadripolar lead

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