Initial Single-Center Experience of a Quadripolar Pacing Lead for Cardiac Resynchronization Therapy

Methods: Twenty-eight patients for a CRT with cardiac defibrillator were implanted between October 2009 and May 2010 with a Quartet lead. Lead position, pacing parameters, stability, complications, and presence of phrenic nerve stimulation (PNS) data were collected at implant and predischarge. Follow-up data were collected at 15 +/- 8 weeks for all patients. Results: A Quartet lead was successfully implanted in 96% (27/28) of patients (age 61 +/- 15 years; 82% male; ischemic etiology 50%; mean left ventricular [LV] ejection fraction 25 +/- 7%; left bundle branch block 68%). PNS was seen at implant in 11 patients (41%) with at least one vector. In eight of these cases (72%), the need for lead repositioning was averted by programming LV pacing utilizing the additional vectors available with the Quartet lead. Conclusion: These initial data suggest that pacing with the Quartet lead is associated with a high implant success rate and stable pacing parameters acutely and at short-term follow-up. The 10 LV pacing vectors available with this lead may allow PNS and capture threshold problems to be easily overcome. (PACE 2011; 34:484-489).