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Left Ventricular Reverse Remodeling Elicited by a Quadripolar Lead: Results from the Multicenter Per4mer Study
- Source :
- Pacing and clinical electrophysiology : PACE. 39(3)
- Publication Year :
- 2015
-
Abstract
- To understand the impact of a quadripolar left ventricular (LV) lead on reverse remodeling and phrenic nerve stimulation (PNS) in congestive heart failure patients treated by cardiac resynchronization therapy at 8-month follow-up (FU).One hundred and fifty-eight patients received an LV Medtronic Performa lead (Medtronic Inc., Minneapolis, MN, USA) and were reevaluated at FU by echocardiography and measurement of electrical parameters.A targeted LV lead placement was achieved in 140 (89%) patients. Super responders and responders were 76 (50%) and 26 (18%), respectively, at FU; seven (4%) died and 13 (8%) were hospitalized for any cause. Nonischemic etiology was the only independent predictor of reverse remodeling. The configurations available only with the Performa leads reduced PNS occurrence at 8 V@0.4 ms from 43 (27%) to 14 (9%) of patients at implantation, and from 44 (28%) to 19 (12%) at last FU, compared to configurations available with bipolar leads. Patients with detectable PNS had10/16 pacing configurations with a PNS safety margin2 V both at implantation and at FU. During FU 16 (10%) patients had an adverse event possibly related to the lead or to modification of the underlying heart disease but 99% of these events were fixed by reprogramming of the pacing vector.Performa Lead enables an increased capability to achieve a targeted lead positioning in the broad clinical scenario of large- and small-volume implanting centers, with a relevant impact on the occurrence of reverse remodeling compared to literature data. The enhanced management of PNS resulted in a dislodgement rate of only 1%.
- Subjects :
- Heart Failure
Male
Ventricular Remodeling
short-spaced quadripolar lead
Left
cardiac resynchronization therapy
heart failure
reverse remodeling
Aged
Equipment Design
Equipment Failure Analysis
Female
Humans
Italy
Treatment Outcome
Ventricular Dysfunction, Left
Cardiac Resynchronization Therapy Devices
Electrodes, Implanted
Cardiology and Cardiovascular Medicine
NO
Ventricular Dysfunction
Implanted
Electrodes
Subjects
Details
- ISSN :
- 15408159
- Volume :
- 39
- Issue :
- 3
- Database :
- OpenAIRE
- Journal :
- Pacing and clinical electrophysiology : PACE
- Accession number :
- edsair.pmid.dedup....d40e8c08af0d1dc0ff79465ae7177a17