Clinical Superiority of Active Fixation Quadripolar Leads in Cardiac Resynchronization Therapy
Fuente:
Wiley Open Access
Saved in:
| Main Authors: | , , , , , , , , , |
|---|---|
| Format: | Artículo Open Access |
| Published: |
Wiley
2026
|
| Subjects: | |
| Online Access: | |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| _version_ | 1867019622079791104 |
|---|---|
| author | Kazuyuki Yamanaka Yosuke Murase Yasuya Inden Tomoyo Ikeda Keita Mamiya Naoaki Kano Hajime Imai Yasuhiro Ogawa Katsuhiro Kawaguchi Toyoaki Murohara |
| author_facet | Kazuyuki Yamanaka Yosuke Murase Yasuya Inden Tomoyo Ikeda Keita Mamiya Naoaki Kano Hajime Imai Yasuhiro Ogawa Katsuhiro Kawaguchi Toyoaki Murohara Kazuyuki Yamanaka Yosuke Murase Yasuya Inden Tomoyo Ikeda Keita Mamiya Naoaki Kano Hajime Imai Yasuhiro Ogawa Katsuhiro Kawaguchi Toyoaki Murohara |
| collection | Wiley Open Access |
| contents | Clinical Superiority of Active Fixation Quadripolar Leads in Cardiac Resynchronization Therapy Kazuyuki Yamanaka Yosuke Murase Yasuya Inden Tomoyo Ikeda Keita Mamiya Naoaki Kano Hajime Imai Yasuhiro Ogawa Katsuhiro Kawaguchi Toyoaki Murohara Pacing and Clinical Electrophysiology 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. 10.1111/pace.70303 http://onlinelibrary.wiley.com/termsAndConditions#vor |
| doi_str_mv | 10.1111/pace.70303 |
| format | Artículo Open Access |
| id | wiley_oa_10_1111_pace_70303 |
| institution | Wiley Open Access |
| license_str_mv | http://onlinelibrary.wiley.com/termsAndConditions#vor |
| publishDate | 2026 |
| publisher | Wiley |
| record_format | wiley_oa |
| spellingShingle | Clinical Superiority of Active Fixation Quadripolar Leads in Cardiac Resynchronization Therapy Kazuyuki Yamanaka Yosuke Murase Yasuya Inden Tomoyo Ikeda Keita Mamiya Naoaki Kano Hajime Imai Yasuhiro Ogawa Katsuhiro Kawaguchi Toyoaki Murohara Pacing and Clinical Electrophysiology Clinical Superiority of Active Fixation Quadripolar Leads in Cardiac Resynchronization Therapy Kazuyuki Yamanaka Yosuke Murase Yasuya Inden Tomoyo Ikeda Keita Mamiya Naoaki Kano Hajime Imai Yasuhiro Ogawa Katsuhiro Kawaguchi Toyoaki Murohara Pacing and Clinical Electrophysiology 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. 10.1111/pace.70303 http://onlinelibrary.wiley.com/termsAndConditions#vor |
| title | Clinical Superiority of Active Fixation Quadripolar Leads in Cardiac Resynchronization Therapy |
| topic | Pacing and Clinical Electrophysiology |
| url | https://onlinelibrary.wiley.com/doi/10.1111/pace.70303 |