title: Acute and mid-term outcomes of transvenous implant of a new left ventricular quadripolar lead versus bipolar leads for cardiac resynchronization therapy: results from a single-center prospective database.
abstract: BACKGROUND
  The purpose of this study was to evaluate the feasibility of the use of a quadripolar left ventricular (LV) lead for cardiac resynchronization therapy and to compare its acute and mid-term outcomes with those obtained with bipolar leads. Cardiac resynchronization exhibits a high incidence of problems involving the LV lead when conventional leads are used, and these problems may be minimized by using multipolar leads.
  
  
  METHODS
  We gathered clinical, implant, and follow-up data at 3 and 9 months from 21 consecutive patients in whom a quadripolar (Group Q) or bipolar (Group B) lead was used for a biventricular defibrillator implant.
  
  
  RESULTS
  The leads were successfully implanted in all of the patients. In Group B, more than one lead was used in 20% (p = 0.048) of cases. There were no clinical differences or differences in the implant parameters between the two groups except for the radiation dose, which was greater in group B (p = 0.035). The incidence of problems related to the LV lead during follow-up was higher in group B, but the difference was not significant (42.9% vs. 23.8%, p = 0.326). The use of more than one LV lead was the only variable that was significantly associated with lead-related problems during follow-up (p = 0.03; OR = 10.8; 95% CI 1.07-108.61).
  
  
  CONCLUSIONS
  The quadripolar lead was associated with excellent implantation success rates and mid-term performance. The multi-programmability capabilities of quadripolar leads facilitated the achievement of implant goals and helped to reduce problems during the implant and follow-up.
authors.affiliation: Cardiac Arrhythmia and Electrophysiology Unit, Department of Cardiology, Hospital Virgen de la Salud, Toledo, Spain. maapalomares@secardiologia.es
authors.forename: Miguel A
authors.initials: MA
authors.lastname: Arias
authors.forename: Marta
authors.initials: M
authors.lastname: Pachón
authors.forename: Alberto
authors.initials: A
authors.lastname: Puchol
authors.forename: Jesús
authors.initials: J
authors.lastname: Jiménez-López
authors.forename: Luis
authors.initials: L
authors.lastname: Rodríguez-Padial
mesh_terms: D000368:Aged; D058406:Cardiac Resynchronization Therapy / Q000009:adverse effects; D058409:Cardiac Resynchronization Therapy Devices; D016009:Chi-Square Distribution; D016208:Databases, Factual; D004567:Electrodes, Implanted; D004867:Equipment Design; D004868:Equipment Failure; D005240:Feasibility Studies; D005260:Female; D006333:Heart Failure / Q000503:physiopathology / Q000628:therapy*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D013030:Spain; D013318:Stroke Volume; D013997:Time Factors; D016896:Treatment Outcome; D016277:Ventricular Function, Left