Author + information
- Received January 11, 2019
- Revision received April 2, 2019
- Accepted May 2, 2019
- Published online July 31, 2019.
- Michael Chapman, MBChB (Hons)a,∗ (, )
- Matthew G.D. Bates, BSc (Hons), MBChB (Hons), PGCClinEdPa,
- Nathan M. Behar, MBBS (Hons), BSc (Hons), CCDS, PhDb,
- Ian Williams, MBBChirc,
- Matthew Dewhurst, MD, CClinEda,
- Christopher Monkhouse, BSc, CCDSb,
- Carl Hayward, MBBChir, PhDb,
- Amal Muthumala, MDb,
- Anthony Chow, MDb,
- Nicholas J. Linker, BSc, MBChB, MDa,
- Andrew R. Thornley, MBBSa and
- Andrew J. Turley, MBChB, BMedSci (Hons), CClinEda
- aJames Cook University Hospital, Middlesbrough, United Kingdom
- bSt. Bartholomew's Hospital, United Kingdom
- cNorfolk and Norwich University Hospital, United Kingdom
- ↵∗Address for correspondence:
Dr. Michael Chapman, The James Cook University Hospital, Marton Road, Middlesbrough TS43BW, United Kingdom.
Objectives This study sought to assess immediate and short-term performance of the Medtronic Attain Stability Quadripolar 4798 lead (Medtronic, Dublin, Ireland).
Background Cardiac resynchronization therapy (CRT) is an established treatment for appropriately selected patients with left ventricular (LV) systolic dysfunction. The most common reason for failure to implant a lead is the lack of a suitable epicardial vein, due either to an absent vessel in the target site, an unacceptably high threshold, lead instability, phrenic nerve stimulation, or a combination of reasons. In August 2017, a novel quadripolar active fixation LV lead (Medtronic) was released. This paper reports the initial clinical experience with lead implantation and specifically immediate and short-term pacing parameters across 3 United Kingdom centers.
Methods Consecutive patients eligible for CRT were deemed suitable for this lead. Immediate and short-term lead performance data regarding LV threshold, impedance, and displacement rates were collected at standard pacing checks (1 day, 5 weeks, 3 months, and 9 months post-implantation).
Results CRT using this lead was attempted in 82 cases and was successful in 81 cases (98.8%). LV thresholds and impedance levels were 1.22 ± 0.75 V and 737 ± 319 Ω at implantation; 1.16 ± 0.71 V and 597 ± 218 Ω at day 1; 1.02 ± 0.48 V and 579 ± 148 Ω at week 6; 0.98 ± 0.49 V and 569 ± 133 Ω at 3 months; and 1.06 ± 0.48 V and 570 ± 140 Ω at 9 months. As of the publication of this paper, no LV lead has been displaced.
Conclusions CRT using the Medtronic lead was successful in more than 98% of the patients. Short-to-medium-term data regarding lead performance and stability were excellent, with zero displacements as of the publication of this paper.
No outside funding was received for this work. Dr. Behar and Dr. Monkhouse have received speakers’ honoraria from Abbott Laboratories. Dr. Linker has received support from Medtronic and a research fellowship from his department. All other authors have reported that they have no relationships relevant to the contents of this paper to disclose.
The authors attest they are in compliance with human studies committees and animal welfare regulations of the authors’ institutions and Food and Drug Administration guidelines, including patient consent where appropriate. For more information, visit the JACC: Clinical Electrophysiology author instructions page.
- Received January 11, 2019.
- Revision received April 2, 2019.
- Accepted May 2, 2019.
- 2019 American College of Cardiology Foundation
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