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.