title: Left ventricular three-dimensional quadripolar lead acute clinical study: the LILAC study.
abstract: OBJECTIVE
  This multicenter acute clinical study was designed to verify novel three-dimensional (3D) quadripolar lead designs that can achieve ≤2.5 V average pacing capture threshold (PCT) not only at the apex, but also at the base of the left ventricle with phrenic nerve stimulation (PNS) avoidance for cardiac resynchronization.
  
  
  METHODS
  During the implant procedure, up to two different left ventricular investigational leads were introduced and tested in the same target coronary vein based on the coronary sinus venogram in a wedged and unwedged position. Adverse events were collected in 30 days following the procedure.
  
  
  RESULTS
  Eighty-seven leads were tested in 50 patients. When the best performing spiral electrode was chosen from each lead testing, the average of the best PCT on spiral in a wedged position was similar to the unwedged position (1.7 ± 1.5 V vs 1.9 ± 1.5 V, P = ns) and was similar to the wedged tip electrode average PCT (1.7 ± 1.5 V vs 1.6 ± 1.6 V, P = ns). In the majority of patients (89-96%), pacing was achievable in a mid-basal ventricular location without PNS.
  
  
  CONCLUSIONS
  This acute study demonstrated that a 3D quadripolar spiral lead design can achieve acceptable PCTs and avoid PNS without repositioning the lead at implant in the vast majority of patients. It also demonstrated that this lead design can achieve mid-basal ventricular stimulation with low PCT and good acute stability.
authors: Electrophysiology Division, Institut universitaire de cardiologie et de pneumologie de Québec, Québec, Canada.
authors: François
authors: F
authors: Philippon
authors: Lili
authors: L
authors: Liu
authors: Jeffrey Wing-Hong
authors: JW
authors: Fung
authors: Jean-Claude
authors: JC
authors: Deharo
authors: Frederic
authors: F
authors: Anselme
authors: Peter Paul
authors: PP
authors: Delnoy
authors: Harry
authors: H
authors: Crijns
authors: Carlos A
authors: CA
authors: Morillo
authors: Andrew D
authors: AD
authors: Krahn
authors: Klaus
authors: K
authors: Gutleben
authors: Julien
authors: J
authors: Delumeau
authors: Franck
authors: F
authors: Molin
mesh_terms: D000368:Aged; D058409:Cardiac Resynchronization Therapy Devices; D004567:Electrodes, Implanted; D004867:Equipment Design; D019544:Equipment Failure Analysis; D005260:Female; D006333:Heart Failure / Q000150:complications* / Q000175:diagnosis / Q000517:prevention & control*; D006801:Humans; D038622:Internationality; D008297:Male; D016896:Treatment Outcome; D018487:Ventricular Dysfunction, Left / Q000175:diagnosis / Q000209:etiology* / Q000517:prevention & control*
keywords: cardiac resynchronization; lead design; quadripolar leads