Abstract：
BACKGROUND: This study compared the stability of the Medtronic Attain Stability Quad (ASQ), a novel quadripolar active fixation left ventricular (LV) lead with a side helix, to that of conventional quadripolar leads with passive fixation (non-ASQ) and evaluated their LV lead performance.Methods and Results: In all, 183 consecutive patients (69 ASQ, 114 non-ASQ) who underwent cardiac resynchronization therapy (CRT) between January 2018 and June 2021 were enrolled. Complications, including elevated pacing capture threshold (PCT) levels, phrenic nerve stimulation (PNS), and LV lead dislodgement, were analyzed during the postimplantation period until the first outpatient visit after discharge. The frequency of LV lead-related complications was significantly lower in the ASQ than non-ASQ group (14% vs. 30%, respectively; P=0.019). Specifically, LV lead dislodgement occurred only in the non-ASQ group, and elevated PCT levels were significantly lower in the ASQ group (7% vs. 23%; P=0.007). Kaplan-Meier analysis confirmed a significantly lower incidence of LV lead-related complications in the ASQ group (log-rank P=0.005). Cox multivariable regression analysis showed a significant reduction in lead-related complications associated with ASQ (hazard ratio 0.44; 95% confidence interval 0.23-0.83; P=0.011).
CONCLUSIONS: The ASQ group exhibited fewer LV lead-related complications requiring reintervention and setting changes than the non-ASQ group. Thus, the ASQ may be a favorable choice for CRT device implantation.
CONCLUSIONS: The ASQ group exhibited fewer LV lead-related complications requiring reintervention and setting changes than the non-ASQ group. Thus, the ASQ may be a favorable choice for CRT device implantation.
摘要：
背景：这项研究比较了MedtronicAttainStabilityQuad（ASQ）的稳定性，带有侧螺旋的新型四极主动固定左心室（LV）导线，与具有被动固定（非ASQ）的常规四极导线相同，并评估了其LV导线性能。方法和结果：总之，183名连续患者(69名ASQ，在2018年1月至2021年6月期间接受心脏再同步治疗（CRT）的114名非ASQ）患者纳入研究。并发症,包括升高的起搏夺获阈值（PCT）水平，膈神经刺激(PNS),和LV导线移位，在植入后期间进行分析，直到出院后的第一次门诊就诊。ASQ组的LV导线相关并发症发生率明显低于非ASQ组(14%vs.30%,分别；P=0.019）。具体来说,仅在非ASQ组发生LV导线移位,和升高的PCT水平在ASQ组显著降低(7%vs.23%；P=0.007）。Kaplan-Meier分析证实ASQ组的LV导线相关并发症发生率显著降低(log-rankP=0.005)。Cox多变量回归分析显示与ASQ相关的导线相关并发症显著减少(风险比0.44;95%置信区间0.23-0.83;P=0.011)。
结论：与非ASQ组相比，ASQ组表现出更少的需要重新干预和设置改变的LV导线相关并发症。因此，ASQ可能是CRT设备植入的有利选择。
结论：与非ASQ组相比，ASQ组表现出更少的需要重新干预和设置改变的LV导线相关并发症。因此，ASQ可能是CRT设备植入的有利选择。
