Mads Brix Kronborg

Bipolar versus quadripolar left ventricular leads for cardiac resynchronization therapy: evidence to date

Research output: Contribution to journal/Conference contribution in journal/Contribution to newspaperReviewResearchpeer-review

INTRODUCTION: In cardiac resynchronization therapy (CRT) devices, transvenous left ventricular (LV) leads are more prone to instability, high pacing thresholds, and phrenic nerve stimulation (PNS) that may necessitate lead revision, replacement in a suboptimal position, or deactivation of the lead. To overcome some of these challenges, quadripolar (QP) LV leads have been developed and accounted for over 90% of implanted LV leads 5 years after they were introduced.

AREAS COVERED: This review provides an overview of the current evidence of implanting QP leads in CRT as compared with traditional bipolar (BP) leads including details about feasibility, safety and lead performance, clinical outcomes and cost-effectiveness.

EXPERT OPINION: Based on the current literature, implantation with a QP lead decreases revision rates but does not affect any clinical outcomes including mortality, hospitalization, symptoms, or echocardiographic parameters. Feasibility and stability do not differ between QP and BP leads. A QP lead should be preferred as first choice over a BP lead due to lower rates of PNS and lower pacing thresholds leading to less frequent lead revisions and battery replacements. In addition, this strategy may be cost saving despite a higher price of QP leads.

Original languageEnglish
JournalExpert Review of Cardiovascular Therapy
Pages (from-to)1075-1084
Number of pages10
Publication statusPublished - Dec 2021

    Research areas

  • Cardiac Resynchronization Therapy, Cardiac Resynchronization Therapy Devices, Electrodes, Implanted, Equipment Design, Heart Failure/therapy, Humans, Treatment Outcome

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