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Two Allina hospitals and clinics in the Twin Cities are among the first in the country to implant St. Jude Medical’s newly approved Quadra cardiac resynchronization therapy defibrillator (CRT-D) and Quartet Left Ventricular Quadripolar Pacing Lead.
The new technology offers additional pacing options which can reduce the need for reoperation to reposition a lead and offers physicians the ability to more efficiently and effectively manage the individualized needs of patients with heart failure. A lead is a long insulated wire that runs between in implanted device and the heart.
Minneapolis Heart Institute at Abbott Northwestern Hospital is the first center to use the device in Minneapolis and United Heart & Vascular Clinic at United Hospital is the first center in St. Paul to use the device.
Dr. William Katsiyiannis, a cardiac rhythm specialist at Minneapolis Heart Institute at Abbott Northwestern, implanted the Unify Quadra quadripolar pacing system to regulate and resynchronize the heartbeat of a heart failure patient. The patient, Terrie Pearson from Farmington, was diagnosed with cardiomyopathy with the need for cardiac resynchronization therapy.
Dr. Michael Peterson, a cardiac electrophysiologist at United Heart & Vascular Clinic at United Hospital, successfully implanted the Unify Quadra CRT-D in a heart failure patient and United Hospital will now offer the device to its patients.
Unify Quadra CRT-D received U.S. Food and Drug Administration (FDA) approval on November 29, 2011.
CRT-Ds are designed to optimize the heart’s pumping function and synchronize the left and right ventricles of the heart through timed electrical pulses. The Quartet lead features four electrodes on a single, left-ventricular lead (or wire) instead of the current industry standard of two electrodes on a lead. The additional electrodes give physicians more ways to configure the defibrillator while still implanting the lead in the most stable position.
Patients who have scar tissue formed in the heart may require additional energy from their CRT device and that can wear out the battery more quickly. Another challenge that can result is the unintentional stimulation of the diaphragm or the heart’s phrenic nerve, which results in hiccup-like symptoms. In both cases, without the ability to select different pacing configurations, additional surgery may be needed to reposition the lead wire and repair the electrical stimulation the device provides.
Approximately 10 percent of patients experience these pacing-related lead challenges and approximately 5 percent require surgical revision to attempt to reposition the previously placed pacing lead. The quadripolar pacing system available in the Unify Quadra CRT-D is an additional tool available for physicians to use to effectively deliver CRT therapy. The benefits conferred from the Quartet lead’s multiple electrode choices for pacing have been demonstrated by implanters around the world and reported in a number of published studies.