Quadripolar leads are associated with better results according to bipolar leads in cardiac resynchronization therapy in one-year follow-up: Multicenter, retrospective study

Abstract

Aim: In this study, we compared patients who were performed cardiac resynchronization therapy with quadripolar left ventricle lead or bipolar left ventricle lead in one-year follow-up. We investigated the relationship between the improvements of New York Heart Association classification, electrocardiography and echocardiography parameters according to lead type at one-year follow-up after CRT treatment. Materials and Methods: In this study, 91 patients were enrolled respectively as bipolar left ventricle lead and quadripolar left ventricle lead. 40 patients are quadripolar left ventricle lead and 51 patients are bipolar left ventricle lead. Results: After cardiac resynchronization therapy treatment in one year follow-up, patients with ≥1 NYHA improvement was 80% vs 56.8%, p=0.006 and left ventricular ejection fraction ≥5% was 77.5% vs 54.9%, p=0.031 and QRS duration 140.4±11.7 vs 151.7±19.4 ms, p=0.018 in quadripolar and bipolar left ventricle lead respectively. The univariable regression analysis revealed that left ventricular ejection fraction (OR:1.082 95%CI [1.005–1.165], p=0.037), QRS duration (OR:0.980 95%CI [0.961–0.999], p=0.038), NYHA class (OR:1.107 95%CI [0.075–0.682], p=0.008) and left ventricular ejection fraction improvement (OR:2.959 95%CI [1.083–8.086], p=0.034) were better response cardiac resynchronization therapy with quadripolar left ventricle rather than bipolar left ventricle lead. Conclusion: Qdp LVL can be considered instead of BiP LVL to shorten QRS duration and better improve LVEF and NYHA in patients undergoing CRT in long-term follow-up