Clinical and procedural outcome of patients implanted with a quadripolar left ventricular lead: Early results of a prospective multicenter study

Giovanni B. Forleo, Massimo Mantica, Luigi Di Biase, Germana Panattoni, Domenico G. Della Rocca, Lida P. Papavasileiou, Matteo Santamaria, Pasquale Santangeli, Andrea Avella, Domenico Sergi, Luca Santini, Claudio Tondo, Andrea Natale, Francesco Romeo

Research output: Contribution to journalArticlepeer-review

59 Scopus citations


Background: Recent studies suggest that cardiac resynchronization therapy (CRT) with a quadripolar left ventricular (LV) lead results in low rates of dislocation and phrenic nerve stimulation (PNS) acutely and at short-term follow-up. Confirmation of these results by long-term observational studies is needed. Objective: To evaluate the long-term procedural and clinical outcomes of CRT patients implanted with a quadripolar LV lead. Methods: A total of 154 consecutive heart failure patients (79% men, age 68 ± 10 years) having CRT implantation attempts with a quadripolar LV lead were included in this observational registry. Demographic and clinical data were preoperatively collected, and patients were followed up for at least 6 months. Results: The overall implant success rate after coronary sinus cannulation was 97.4%. Mean overall duration and fluoroscopy time of successful procedures was 112 ± 22 and 16 ± 8 minutes, respectively, while 17 ± 13 minutes were necessary for the LV lead placement. After implant, the conventional bipolar configuration was used as the final pacing configuration in 33.3% of the patients. Four lead dislodgments (requiring reoperation) and 9 clinical PNS were reported during follow-up; reprogramming of the device was sufficient to prevent PNS in all patients. Once placed, the LV lead remained stable with excellent pacing thresholds during follow-up (15 ± 5 months). Overall, there were 71.3% CRT responders as assessed by 6-month echocardiography, and 66% improved at least 1 New York Heart Association class. Conclusion: Over the longer term, CRT with the quadripolar LV lead is associated with excellent pacing thresholds, low rates of dislocations, and PNS.

Original languageEnglish (US)
Pages (from-to)1822-1828.e3
JournalHeart Rhythm
Issue number11
StatePublished - Nov 2012
Externally publishedYes


  • Cardiac resynchronization therapy
  • Multiple pacing configurations
  • Phrenic nerve stimulation
  • Quadripolar left ventricular lead
  • Survey

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Physiology (medical)


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