Attain Stability Quadripolar leads provided superior stability with 0% intraoperative dislodgement versus 17.6% for conventional leads (p=0.014), and improved CRT response at 6 months.
Cohort (n=65)
No
Does the Attain Stability Quadripolar (ASQ) lead improve lead stability and CRT response compared to conventional quadripolar leads in CRT recipients?
Active fixation quadripolar leads in CRT significantly reduce intraoperative dislodgement and improve echocardiographic response compared to conventional leads.
Absolute Event Rate: 0% vs 17.6%
p-value: p=0.014
ABSTRACT Background The effectiveness of cardiac resynchronization therapy (CRT) depends on stable and optimal left ventricular (LV) lead placement. The Attain Stability Quadripolar (ASQ) lead uses active fixation to improve performance. We aimed to assess the clinical superiority of ASQ leads over conventional quadripolar leads. Methods This single‐center retrospective cohort study included 65 CRT recipients (31 ASQ, 34 non‐ASQ). Primary endpoints were lead stability and CRT response at 6 months (relative LVESV reduction and absolute LVEF increase); secondary endpoints included pacing thresholds, QRS changes, and LV functional parameters. Results No intraoperative dislodgement occurred with ASQ leads, versus six cases (17.6%) in the non‐ASQ group ( p = 0.014). At 6 months, pacing thresholds were lower with ASQ (1.35 ± 0.81 V vs. 1.80 ± 0.77 V, p = 0.047). In patients with left bundle branch block, reverse remodeling as assessed by LVESV reduction was more frequent with ASQ (≥15%: 82% vs. 29%, p = 0.008; ≥30%: 64% vs. 21%, p = 0.032), and this was accompanied by greater improvement in LVEF (≥10 percentage points: 73% vs. 21%, p = 0.01; ≥20 points: 64% vs. 21%, p = 0.032). ASQ leads provided stable fixation across vessel diameters from 1.9–5.4 mm, including large veins >4.0 mm. Conclusions ASQ leads offer superior stability, lower pacing thresholds, and higher CRT response, supporting wider use of active fixation technology in CRT.
Yamanaka et al. (Tue,) conducted a cohort in Cardiac resynchronization therapy (n=65). Attain Stability Quadripolar (ASQ) lead vs. Conventional quadripolar leads (non-ASQ) was evaluated on Lead stability (intraoperative dislodgement) (p=0.014). Attain Stability Quadripolar leads provided superior stability with 0% intraoperative dislodgement versus 17.6% for conventional leads (p=0.014), and improved CRT response at 6 months.