Key result
Active fixation bipolar left ventricular leads showed no significant difference in pacing capture thresholds or success in reaching the target location compared to passive fixation quadripolar leads.
Why the study?
Active fixation bipolar LV leads represent an alternative approach to more commonly used passive fixation quadripolar leads in CRT, but their comparative performance required evaluation.
Does an active fixation bipolar left ventricular lead improve pacing capture thresholds or target segment concordance compared to passive fixation quadripolar leads in patients undergoing CRT?
RCT (n=62)
Randomly allocated
Does an active fixation bipolar left ventricular lead improve pacing capture thresholds or target segment concordance compared to passive fixation quadripolar leads in patients undergoing CRT?
Active fixation bipolar LV leads perform similarly to passive fixation quadripolar leads regarding pacing capture thresholds and target segment concordance during CRT.
Answers are grounded in this paper and cite their sources.
Active fixation bipolar LV leads match passive fixation quadripolar performance in CRT; supports interchangeable use and operator choice in practice.
BACKGROUND: Usage of active fixation bipolar left ventricular (LV) leads represents an alternative approach to the more commonly used passive fixation quadripolar leads in cardiac resynchronization therapy (CRT). We compared a bipolar LV lead with a side screw for active fixation and passive fixation quadripolar LV leads. METHODS: Sixty-two patients were before CRT implantations randomly allocated to receive a bipolar (n = 31) or quadripolar (n = 31) LV leads. Speckle-tracking radial strain echocardiography was used to define the LV segment with latest mechanical activation as the target LV segment. The electrophysiological measurements and the capability to obtain a proximal position in a coronary vein placed over the target segment were assessed. RESULTS: Upon implantation, the quadripolar lead demonstrated a lower pacing capture threshold than the bipolar lead, but at follow-up, there was no difference. There were no differences in the LV lead implant times or radiation doses. The success rate in reaching the target location was not significantly different between the two LV leads. CONCLUSIONS: The pacing capture thresholds were low, with no significant difference between active fixation bipolar leads and quadripolar leads. Active fixation leads did not promote a more proximal location of the stimulating electrode or a higher grade of concordance to the target segment than passive fixation leads.
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Keilegavlen et al. (2020) conducted an RCT in Cardiac resynchronization therapy (n=62). Active fixation bipolar left ventricular lead vs. Passive fixation quadripolar left ventricular lead was evaluated on Pacing capture threshold and success rate in reaching the target location. Active fixation bipolar left ventricular leads showed no significant difference in pacing capture thresholds or success in reaching the target location compared to passive fixation quadripolar leads.
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