A meta-analysis of quadripolar versus bipolar left ventricular leads on post-procedural outcomes

Mohit K. Turagam, Muhammad R. Afzal, Sandia Iskander, Madhu Reddy, Luigi Di Biase, Andrea Natale, Dhanunjaya Lakkireddy

Research output: Contribution to journalArticlepeer-review

10 Scopus citations


Objective: We aimed to perform a meta-analysis from eligible studies to analyze the true impact of QL when compared with BL with regard to post-procedural outcomes including lead deactivation, revision or replacement. Background: Many observational and retrospective studies showed that quadripolar left ventricular leads (QL) are associated with better outcomes and fewer complications when compared with bipolar leads (BL). Methods: We performed a comprehensive literature search through June 30, 2015 using: quadripolar, bipolar, left ventricular lead and CRT in Pubmed, Ebsco and google scholar databases. Results: The analysis included 8 studies comparing QL and BL implantation. Post-procedural outcomes such as lead deactivation, revision or replacement were used as primary outcome and assessed with Mantel-Haenszel risk ratio (RR). Secondary outcomes included total fluoroscopy/procedure time, occurrence of phrenic nerve stimulation (PNS) and all-cause mortality on follow up. Follow-up duration for the studies ranged from 3 to 60 months. Compared with BL, the use of QL is associated with 52 % reduction (relative risk 0.48; 95% CI: 0.36-0.64, p=0.00001) in the risk of deactivation, revision or replacement of the LV lead. QL had significantly lower fluoroscopy/procedure time, PNS and all-cause mortality when compared with BL. Conclusion: Our meta-analysis shows that QL implantation was associated with decreased risk of LV lead deactivation, revision or replacement when compared with BL.

Original languageEnglish (US)
Pages (from-to)7-11
Number of pages5
JournalJournal of Atrial Fibrillation
Issue number2
StatePublished - Aug 1 2016


  • Bipolar lead
  • Cardiac resynchronization therapy
  • Congestive heart failure
  • Meta-analysis
  • Quadripolar lead

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine


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