Moon Township, PA, (December 8, 2011)
– A physician at Heritage Valley Health System’s Beaver campus was the first in Pennsylvania to implant the Unify Quadra™ cardiac resynchronization therapy defibrillator (CRT-D) and Quartet® Left Ventricular Quadripolar Pacing Lead. The new pacing technology developed by St. Jude Medical 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.
Leonard I. Ganz, M.D., director of electrophysiology at Heritage Valley Beaver in Beaver, Pa., implanted the Unify Quadra quadripolar pacing system to regulate and resynchronize the heartbeat of a heart failure patient. The recipient of the new pacing system had chronic and severe cardiomyopathy, congestive heart failure, and left bundle branch block, evidence of slow electrical conduction through the lower heart chambers. The Unify Quadra implant was performed the day after the FDA granted approval of the new system.
“This new state-of-the-art pacing technology represents a tremendous advancement in the treatment of congestive heart failure, one of the greatest challenges in cardiovascular medicine,” said Dr. Ganz. “This technology is the industry’s first quadripolar pacing system and Heritage Valley Health System is proud to be among the first health systems in the country to implant this device.”
CRT-Ds like the Unify Quadra CRT-D are designed to optimize the heart’s pumping function and help the heart perform in its most natural state by synchronizing 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 bipolar lead. The additional electrodes provide more ways for a physician to configure an optimal pacing strategy while still implanting the lead in the most stable position. Ultimately, having four electrodes provides more options to effectively regulate the patient’s heartbeat.
Due to differences in individual patient anatomy, or results that can’t be seen until the procedure is complete, complications can arise after placing the lead of a cardiac resynchronization therapy (CRT) device. One example of a pacing complication is a high pacing threshold. Patients who already have scar tissue formed in the heart, possibly as a result of a previous heart attack, may require additional energy from their CRT device, which can wear out the battery more quickly. Another complication that can result is the unintentional stimulation of the diaphragm via the phrenic nerve, which results in hiccup-like symptoms. In both cases, without the ability to select different pacing locations, additional surgery may be needed to reposition the lead wire to deliver the electrical stimulation from a slightly different site. Approximately 10 percent of patients experience pacing-related lead complications and approximately 5 percent require surgical revision. The Quartet lead’s four electrodes can help avoid these complications by providing physicians more options to pace in additional configurations.
The quadripolar pacing system available in the Unify Quadra CRT-D is expected to become an industry standard. The many benefits conferred from the Quartet lead’s unconventional pacing have been demonstrated by implanters around the world and reported in a number of published studies.
A lead is a long insulated wire that serves as a conduit between an implanted device and the heart. The lead sends electrical signals from the device to the heart to provide therapy needed to address abnormal heart rhythms. The lead also carries information from the heart back to the implanted device, where the data can be used by the device to deliver therapy or make automatic adjustments, and used by physicians to determine optimal device settings and therapies for each patient.
Cardiac resynchronization therapy (CRT), which can be delivered by an implantable cardioverter defibrillator (ICD) or a pacemaker, resynchronizes the beating of the heart's lower chambers (ventricles). Studies have shown that CRT can improve the quality of life for many patients with heart failure, a progressive condition in which the heart weakens and loses its ability to pump an adequate supply of blood. Approximately 23 million people worldwide are afflicted with congestive heart failure (CHF), and 2 million new cases of CHF are diagnosed each year worldwide.