title: Postoperative performance of the Quartet® left ventricular heart lead.
abstract: BACKGROUND
  The Quartet(®) left ventricular (LV) lead is the first with 4 pacing electrodes (tip and 3 rings) that enables pacing from 10 different pacing vectors. Postoperative performance of this lead was evaluated in a prospective, nonrandomized, multicenter IDE study.
  
  
  METHODS
  Patients with standard indications for CRT-D were enrolled. Electrical performance and presence of phrenic nerve stimulation (PNS) were assessed during pacing from each of 10 vectors at predischarge (within 7 days), 1 month, and 3 months postimplant.
  
  
  RESULTS
  The Quartet LV lead was implanted successfully in 170 patients (95.5% implant success rate, 68 ± 11 years, 68.5% male, LVEF: 25 ± 7%, NYHA class III: 98.3% and class IV: 1.7%). Mean follow-up was 4.7 ± 1.9 months. Capture threshold and impedance for each of the 10 LV lead pacing vectors remained stable during follow-up. LV lead dislodgement occurred in 6 (3.5%) patients and PNS was observed in 23 (13.5%) patients. PNS was resolved noninvasively in all 23 (100%) patients, either by reprogramming to pace from the additional LV lead pacing vectors alone (13 pts, 56.5%), reprogramming to pace from the additional LV lead pacing vectors and reprogramming pacing output (4 pts, 17.4%), or by reprogramming pacing output alone (6 pts, 26.1%).
  
  
  CONCLUSIONS
  The Quartet LV lead electrical performance was stable and was associated with a high implant success and low dislodgement rate during 3-month follow-up. In all patients with PNS, the 10 pacing vectors combined with reduced output programming enabled the elimination of PNS noninvasively.
authors: Lexington Cardiology Consultants, Lexington, Kentucky 40503, USA. gtomassoni@lexingtoncardio.com
authors: Gery
authors: G
authors: Tomassoni
authors: James
authors: J
authors: Baker
authors: Raffaele
authors: R
authors: Corbisiero
authors: Charles
authors: C
authors: Love
authors: David
authors: D
authors: Martin
authors: Imran
authors: I
authors: Niazi
authors: Robert
authors: R
authors: Sheppard
authors: Seth
authors: S
authors: Worley
authors: Scott
authors: S
authors: Beau
authors: G Stephen
authors: GS
authors: Greer
authors: Arash
authors: A
authors: Aryana
authors: Michael
authors: M
authors: Cao
authors: Nicole
authors: N
authors: Harbert
authors: Suhong
authors: S
authors: Zhang
mesh_terms: D000368:Aged; D058406:Cardiac Resynchronization Therapy / Q000009:adverse effects / Q000401:mortality; D058409:Cardiac Resynchronization Therapy Devices; D022062:Electrophysiologic Techniques, Cardiac; D004867:Equipment Design; D004868:Equipment Failure; D004869:Equipment Safety; D005260:Female; D006333:Heart Failure / Q000175:diagnosis / Q000401:mortality / Q000503:physiopathology / Q000628:therapy*; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D010791:Phrenic Nerve / Q000503:physiopathology; D011237:Predictive Value of Tests; D011446:Prospective Studies; D013318:Stroke Volume; D013997:Time Factors; D016896:Treatment Outcome; D014481:United States; D018487:Ventricular Dysfunction, Left / Q000175:diagnosis / Q000401:mortality / Q000503:physiopathology / Q000628:therapy*; D016277:Ventricular Function, Left