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Italian multicenter experience with a new active fixation quadripolar left ventricular lead

Session Rapid Fire 5: improving the response to cardiac resynchronization therapy: emerging technologies

Speaker Matteo Ziacchi

Congress : EHRA 2019

  • Topic : arrhythmias and device therapy
  • Sub-topic : Cardiac Resynchronization Therapy
  • Session type : Rapid Fire Abstracts
  • FP Number : 922

Authors : M Ziacchi (Bologna,IT), T Infusino (Catanzaro,IT), M Mezzetti (Urbino,IT), F Urraro (Benevento,IT), S Savastano (Pavia,IT), F Solimene (Mercogliano,IT), M Landolina (Crema,IT), A Capucci (Ancona,IT), S Iacopino (Cotignola,IT), G Luzzi (Bari,IT), R Foti (Taormina,IT), T Agricola (Pescara,IT), D Pecora (Brescia,IT), W Rauhe (Bolzano,IT), M Biffi (Bologna,IT)


M Ziacchi1 , T Infusino2 , M Mezzetti3 , F Urraro4 , S Savastano5 , F Solimene6 , M Landolina7 , A Capucci8 , S Iacopino9 , G Luzzi10 , R Foti11 , T Agricola12 , D Pecora13 , W Rauhe14 , M Biffi1 , 1University Hospital Policlinic S. Orsola-Malpighi - Bologna - Italy , 2S.Anna Hospital - Catanzaro - Italy , 3Ospedale S. M. della Misericordia - Urbino - Italy , 4A. O. Rummo - Benevento - Italy , 5Policlinic Foundation San Matteo IRCCS - Pavia - Italy , 6Montevergine Cardiology Clinic - Mercogliano - Italy , 7Maggiore Hospital of Crema - Crema - Italy , 8AO Torrette-Umberto I-Lancisi - Ancona - Italy , 9Maria Cecilia Hospital - Cotignola - Italy , 10Polyclinic Hospital of Bari - Bari - Italy , 11S. Vincenzo Hospital - Taormina - Italy , 12S. Spirito Hospital - Pescara - Italy , 13Poliambulanza Foundation Hospital Institute of Brescia - Brescia - Italy , 14S. Maurizio Hospital - Bolzano - Italy ,


Aim: To evaluate implant success rate and acute performance of a new quadripolar active fixation left ventricular lead (QAF). The exclusive fixation system consists of an exposed side helix for fixation to the vein wall. A narrow space between central electrodes ("Short dipole") was designed to reduce phrenic nerve stimulation risk.

Methods: 191 patients (72% male, 73±9 years, 60% NYHA III-IV, QRS width 152±26 ms) in 29 Italian hospitals received QAF between September 2017 and April 2018.

Results: QAF was successfully implanted in 185 (96.8%) and in 172 (94%) it was placed in the target area, as declared after coronary venogram. Median time for lead positioning was 15 minutes (25th-75th percentile: 5-30). No complications occurred during procedure. Pacing was basal in 37% patients, middle in 61% and apical in 2%. Short dipole was programmed in 16.8% patients. Mean implant pacing threshold (@0.4ms) was 1.3±1.1V, sensing 10.8±6.4mV and impedance 700.0±265.5W, comparable to other Medtronic LV leads. During 3.3 (1.3-4.8) months of follow-up 1 QAF dislodgement occurred 20 days after implantation and it was replaced by another QAF.

In 185 procedures (96.8%) the physicians judged the lead performance good/excellent and in 189 (98.9%) they ranked the easiness of fixation good/excellent.

Conclusion: The Attain Stability Quad lead allows stable placement in different cardiac veins, with high success rate and good handling performance. This lead is a valuable tool for LV pacing in desired target areas, even in case of high dislodgement risk or need of myocardial/phrenic threshold management.

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