Division of Cardiology, Duke University Medical Center, Durham, North Carolina.
Department of Clinical Science, University of Bergen and Haukeland University Hospital, Bergen, Norway.
J Cardiovasc Electrophysiol. 2020 May;31(5):1147-1154. doi: 10.1111/jce.14439. Epub 2020 Mar 18.
The Medtronic Attain Stability Quad lead is a quadripolar left ventricular (LV) lead with an active fixation helix assembly designed to fixate the lead within the coronary sinus and pace nonapical regions of the LV. The primary objective of this study was to determine the safety and effectiveness of this novel active fixation quadripolar LV lead.
Patients with standard indications for cardiac resynchronization therapy (CRT) were enrolled. All patients were followed at 3 and 6 months post-implant and every 6 months thereafter until study closure. Pacing capture thresholds (PCTs) were measured at implant and each follow-up and adverse events (AEs) were recorded upon occurrence.
Of the 440 patients who underwent implant procedures, placement of the Attain Stability Quad lead was successful in 426 (96.8%). LV lead-related complications occurred in 10 patients (2.3%), including LV lead dislodgement in three patients (0.7%). The percentage of patients with at least one LV pacing vector with a PCT ≤2.5 V at a 6-month follow-up was 96.3%. The LV lead was successfully fixated to the prespecified pacing location in 97.4% of cases.
This large, multinational study of the Attain Stability Quad lead demonstrated a high rate of implant success with a low complication rate. The active fixation mechanism allowed precise placement of the pacing electrodes at the desired target region with good PCTs and a very low dislodgement rate.
美敦力 Attain Stability Quad 导联是一种四极左心室(LV)导联,带有主动固定螺旋组件,旨在将导联固定在冠状窦内和 LV 的非心尖区域起搏。本研究的主要目的是确定这种新型主动固定四极 LV 导联的安全性和有效性。
患有心脏再同步治疗(CRT)标准适应证的患者被纳入研究。所有患者在植入后 3 个月和 6 个月以及此后每 6 个月进行随访,直至研究结束。在植入时和每次随访时测量起搏捕获阈值(PCT),并在发生时记录不良事件(AE)。
在 440 例接受植入手术的患者中,有 426 例(96.8%)成功植入了 Attain Stability Quad 导联。LV 导联相关并发症发生在 10 例患者(2.3%)中,包括 3 例(0.7%)LV 导联脱位。在 6 个月随访时,至少有一个 LV 起搏向量的 PCT≤2.5 V 的患者比例为 96.3%。在 97.4%的情况下,LV 导联成功固定在预设起搏部位。
这项针对 Attain Stability Quad 导联的大型多国研究显示,植入成功率高,并发症发生率低。主动固定机制允许将起搏电极精确放置在所需的目标区域,具有良好的 PCT 和极低的脱位率。