Heart Failure -> Cardiac Resynchronization Therapy: -> Lead and delivery systems D-PO04 - Poster Session IV (ID 15) Poster

D-PO04-067 - Acute And Chronic Performance Evaluation Of A New Ultra-Thin Left Ventricular Quadripolar Pacing Lead In A Canine Model (ID 417)

Disclosure
  F. Anselme: Honoraria/Speaking/Consulting Fee - Boston Scientific; Medtronic; MicroPort CRM.

Abstract

Background: Left ventricular (LV) lead positioning is one of the main contributors to cardiac resynchronization therapy (CRT) response. Additional and multiple LV sites could be stimulated by passing a new ultra-thin LV quadripolar lead from one LV vein into another via venous collaterals.
Objective: Study the acute and chronic stability and electrical pacing performance of a novel 1 Fr LV microlead in a canine model.
Methods: Six adult dogs that had undergone CRT defibrillator implantation, including a right ventricular (RV) lead and a novel 1 Fr LV quadripolar microlead (Axone 4LV microlead, MicroPort CRM, France), were followed up to 90 days post-implant for evaluation of acute and chronic stability and electrical pacing performance.
Results: Successful uncomplicated implantation was achieved in all cases. The LV microlead was advanced in the coronary sinus network using a microcatheter guide and, despite the thin veins of the animal model, it was feasible to pass the pacing electrodes from one LV vein into another through available collaterals in 5 out of 6 cases (Figure). A stable position of the LV microlead was achieved in all cases. Mean pseudo-bipolar ventricular capture threshold at 0.5 ms pulse width over the 4 LV pacing electrodes was 2.20±1.29V with 1180±179Ω of pacing impedance at 1 day post-implant and 2.19±0.84V with 1334±279Ω of impedance at 90 days (P=0.965 and P=0.039 compared to day 1, respectively). No phrenic nerve stimulation was observed during LV microlead pacing.
Conclusion: In the canine model this novel 1 Fr LV microlead demonstrated adequate stability and good electrical performance, offering potential advantages for extended pacing options in CRT.
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