Innovative cardiac resynchronization therapy (CRT) defibrillators include quadripolar leads to help physicians optimize treatment delivery.

The Attain PerformaModel 4298 uses leads with four electrodes to help physicians contend with the clinical challenges that can compromise lead position, offering them more options to maintain lead position and reduce the incidence of phrenic nerve stimulation (PNS), a potential side effect that results in muscle twitching, hiccups, or shortness of breath; a left-heart lead helps treat different patient anatomies. The Model 4298 provides 16 pacing configurations, shorter spacing between the two center electrodes, a canted lead shape, as well as steroid on all four electrodes for lower pacing thresholds.

The Viva Quad XT and the Viva Quad S CRT defibrillators (CRT-Ds) devices are equipped with proprietary AdaptivCRT, a feature which preserves normal heart rhythms and automatically adjusts to patients' needs to customize therapy. Benefits of the algorithm include a 21% reduction in heart failure hospitalizations, as compared to historical CRT trials; a 46% reduced risk of atrial fibrillation (AF) and a 61% lower risk of AF-related problems; and a 47% reduction in 30-day heart failure (HF) readmissions rates.

The Viva Quad systems also include VectorExpress technology, which reduces lead programming time to two minutes by providing physicians with optimal pacing configurations for each patient. The Attain PerformaModel 4298 quadripolar lead and the Viva Quad XT and Viva Quad S CRT-Ds are products of Medtronic (Minneapolis, MN, USA), and have been approved by the US Food and Drug Administration (FDA).

“With the new Attain Performa canted lead and Viva Quad devices, Medtronic is delivering a top-notch system for patients with heart failure,” said David Steinhaus, MD, medical director for the cardiac rhythm and heart failure management business at Medtronic. “Medtronic continues to advance the care of heart failure patients, as it has since it first commercialized cardiac resynchronization therapy in the United States with the previously available AdaptivCRT algorithm.”

“Compared to conventional leads, the additional pacing configurations offered by this system provide implanting physicians more options to optimize CRT delivery, which results in better patient care. Likewise, the narrow-spaced bipole helps avoid phrenic nerve capture,” added associate professor George Crossley, MD, of the Vanderbilt Heart and Vascular Institute (Nashville, TN, USA).

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