Corbisiero Raffaele, Muller David
Deborah Heart and Lung Center, 200 Trenton Rd, Browns Mills, NJ, USA.
Expert Rev Med Devices. 2015 Jan;12(1):41-8. doi: 10.1586/17434440.2015.984686. Epub 2014 Nov 22.
Congestive heart failure is a major public health epidemic and economic burden in the USA and worldwide. Cardiac resynchronization therapy is an effective therapy for treating congestive heart failure in conjunction with pharmacologic therapy. The average congestive heart failure admission costs approximately US$ 8 billion annually. Current cardiac resynchronization therapy pacemaker systems from various manufacturers deliver therapy-utilizing bipolar leads including the left ventricle, with electrode spacing ranging from 8 to 22 mm. The Quartet LV™ lead model 1458Q (St. Jude Medical Sylmar, CA) is a quadripolar lead with a 4.0 Fr. tip electrode and three 4.7 Fr. ring electrodes located 20, 30 and 47 mm from the tip. The Quartet lead and Allure Quadra TM allows 14 pacing configurations, providing benefits, including reductions in phrenic nerve stimulation, reduced pacing thresholds, improved battery longevity and potential reductions, in non-responders to cardiac resynchronization therapy. In addition, there is cost benefit data from utilizing quadripolar technology compared with traditional bipolar cardiac resynchronization therapy.
在美国乃至全球范围内,充血性心力衰竭都是一个重大的公共卫生问题和经济负担。心脏再同步治疗是一种结合药物治疗来治疗充血性心力衰竭的有效方法。每年充血性心力衰竭的住院费用平均约为80亿美元。目前,各制造商生产的心脏再同步治疗起搏器系统采用双极导联进行治疗,包括左心室导联,电极间距在8至22毫米之间。Quartet LV™ 1458Q型导联(圣犹达医疗公司,加利福尼亚州西尔玛)是一种四极导联,其尖端电极直径为4.0 Fr.,有三个直径为4.7 Fr.的环状电极,分别位于距尖端20、30和47毫米处。Quartet导联和Allure Quadra TM允许14种起搏配置,具有诸多益处,包括减少膈神经刺激、降低起搏阈值、延长电池寿命以及可能减少对心脏再同步治疗无反应者。此外,与传统双极心脏再同步治疗相比,使用四极技术还有成本效益数据。