{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,26]],"date-time":"2026-05-26T17:03:30Z","timestamp":1779815010441,"version":"3.53.1"},"reference-count":20,"publisher":"Wiley","license":[{"start":{"date-parts":[[2026,5,26]],"date-time":"2026-05-26T00:00:00Z","timestamp":1779753600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,5,26]],"date-time":"2026-05-26T00:00:00Z","timestamp":1779753600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Pacing Clinical Electrophis"],"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>The effectiveness of cardiac resynchronization therapy (CRT) depends on stable and optimal left ventricular (LV) lead placement. The Attain Stability Quadripolar (ASQ) lead uses active fixation to improve performance. We aimed to assess the clinical superiority of ASQ leads over conventional quadripolar leads.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This single\u2010center retrospective cohort study included 65 CRT recipients (31 ASQ, 34 non\u2010ASQ). Primary endpoints were lead stability and CRT response at 6 months (relative LVESV reduction and absolute LVEF increase); secondary endpoints included pacing thresholds, QRS changes, and LV functional parameters.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      No intraoperative dislodgement occurred with ASQ leads, versus six cases (17.6%) in the non\u2010ASQ group (\n                      <jats:italic>p<\/jats:italic>\n                      = 0.014). At 6 months, pacing thresholds were lower with ASQ (1.35 \u00b1 0.81\u00a0V vs. 1.80 \u00b1 0.77\u00a0V,\n                      <jats:italic>p<\/jats:italic>\n                      = 0.047). In patients with left bundle branch block, reverse remodeling as assessed by LVESV reduction was more frequent with ASQ (\u226515%: 82%\u00a0vs. 29%,\n                      <jats:italic>p<\/jats:italic>\n                      = 0.008; \u226530%: 64%\u00a0vs. 21%,\n                      <jats:italic>p<\/jats:italic>\n                      = 0.032), and this was accompanied by greater improvement in LVEF (\u226510 percentage points: 73%\u00a0vs. 21%,\n                      <jats:italic>p<\/jats:italic>\n                      = 0.01; \u226520 points: 64%\u00a0vs. 21%,\n                      <jats:italic>p<\/jats:italic>\n                      = 0.032). ASQ leads provided stable fixation across vessel diameters from 1.9\u20135.4\u00a0mm, including large veins &gt;4.0\u00a0mm.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>ASQ leads offer superior stability, lower pacing thresholds, and higher CRT response, supporting wider use of active fixation technology in CRT.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/pace.70303","type":"journal-article","created":{"date-parts":[[2026,5,26]],"date-time":"2026-05-26T16:13:37Z","timestamp":1779812017000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Clinical Superiority of Active Fixation Quadripolar Leads in Cardiac Resynchronization Therapy"],"prefix":"10.1111","author":[{"given":"Kazuyuki","family":"Yamanaka","sequence":"first","affiliation":[{"name":"Department of Cardiology Komaki City Hospital  Komaki Aichi Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9812-9595","authenticated-orcid":false,"given":"Yosuke","family":"Murase","sequence":"additional","affiliation":[{"name":"Department of Cardiology Komaki City Hospital  Komaki Aichi Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yasuya","family":"Inden","sequence":"additional","affiliation":[{"name":"Department of Cardiology Nagoya University Graduate School of Medicine  Nagoya Aichi Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tomoyo","family":"Ikeda","sequence":"additional","affiliation":[{"name":"Department of Cardiology Komaki City Hospital  Komaki Aichi Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Keita","family":"Mamiya","sequence":"additional","affiliation":[{"name":"Department of Cardiology Komaki City Hospital  Komaki Aichi Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Naoaki","family":"Kano","sequence":"additional","affiliation":[{"name":"Department of Cardiology Komaki City Hospital  Komaki Aichi Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hajime","family":"Imai","sequence":"additional","affiliation":[{"name":"Department of Cardiology Komaki City Hospital  Komaki Aichi Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yasuhiro","family":"Ogawa","sequence":"additional","affiliation":[{"name":"Department of Cardiology Komaki City Hospital  Komaki Aichi Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Katsuhiro","family":"Kawaguchi","sequence":"additional","affiliation":[{"name":"Department of Cardiology Komaki City Hospital  Komaki Aichi Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Toyoaki","family":"Murohara","sequence":"additional","affiliation":[{"name":"Department of Cardiology Nagoya University Graduate School of Medicine  Nagoya Aichi Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,5,26]]},"reference":[{"issue":"352","key":"e_1_2_11_2_1","doi-asserted-by":"crossref","first-page":"1539","DOI":"10.1056\/NEJMoa050496","article-title":"The Effect of Cardiac Resynchronization on Morbidity and Mortality in Heart Failure","volume":"15","author":"Cleland J. G. F.","year":"2005","journal-title":"New England Journal of Medicine"},{"issue":"361","key":"e_1_2_11_3_1","doi-asserted-by":"crossref","first-page":"1329","DOI":"10.1056\/NEJMoa0906431","article-title":"Cardiac\u2010Resynchronization Therapy for the Prevention of Heart\u2010Failure Events","volume":"14","author":"Moss A. J.","year":"2009","journal-title":"New England Journal of Medicine"},{"issue":"53","key":"e_1_2_11_4_1","doi-asserted-by":"crossref","first-page":"483","DOI":"10.1016\/j.jacc.2008.10.032","article-title":"Long\u2010Term Prognosis After Cardiac Resynchronization Therapy Is Related to the Extent of Left Ventricular Reverse Remodeling at Midterm Follow\u2010Up","volume":"6","author":"Ypenburg C.","year":"2009","journal-title":"Journal of the American College of Cardiology"},{"issue":"38","key":"e_1_2_11_5_1","first-page":"1463","article-title":"Avoiding Non\u2010Responders to Cardiac Resynchronization Therapy: A Practical Guide","volume":"19","author":"Daubert C.","year":"2017","journal-title":"European Heart Journal"},{"issue":"17","key":"e_1_2_11_6_1","doi-asserted-by":"crossref","first-page":"84","DOI":"10.1093\/europace\/euu221","article-title":"Left Ventricular Lead Placement in the Latest Activated Region Guided by Coronary Venous Electroanatomic Mapping","volume":"1","author":"Rad M. M.","year":"2015","journal-title":"Europace"},{"issue":"12","key":"e_1_2_11_7_1","doi-asserted-by":"crossref","first-page":"1832","DOI":"10.1002\/ehf2.15190","article-title":"Real\u2010World Outcomes in Cardiac Resynchronization Therapy Patients: Primary Results of the SMART Registry","volume":"3","author":"Garc\u00eda\u2010Bolao I.","year":"2025","journal-title":"ESC Heart Failure"},{"issue":"9","key":"e_1_2_11_8_1","doi-asserted-by":"crossref","first-page":"516","DOI":"10.1093\/europace\/eum080","article-title":"Implantation of Cardiac Resynchronization Therapy Systems in the CARE\u2010HF Trial: Procedural Success Rate and Safety","volume":"7","author":"Gras D.","year":"2007","journal-title":"Europace"},{"issue":"31","key":"e_1_2_11_9_1","doi-asserted-by":"crossref","first-page":"1147","DOI":"10.1111\/jce.14439","article-title":"Performance of a Novel Active Fixation Quadripolar Left Ventricular Lead for Cardiac Resynchronization Therapy: Attain Stability Quad Clinical Study Results","volume":"5","author":"Jackson K. P.","year":"2020","journal-title":"Journal of Cardiovascular Electrophysiology"},{"issue":"33","key":"e_1_2_11_10_1","doi-asserted-by":"crossref","first-page":"458","DOI":"10.1111\/jce.15346","article-title":"An Active Fixation Quadripolar Left Ventricular Lead for Cardiac Resynchronization Therapy With Reduced Postoperative Complication Rates","volume":"3","author":"Robertson C.","year":"2022","journal-title":"Journal of Cardiovascular Electrophysiology"},{"issue":"88","key":"e_1_2_11_11_1","doi-asserted-by":"crossref","first-page":"1425","DOI":"10.1253\/circj.CJ-24-0084","article-title":"Clinical Usefulness of the Active Fixation Quadripolar Left Ventricular Lead Compared With the Passive Fixation Quadripolar Lead in Cardiac Resynchronization Therapy","volume":"9","author":"Wakamiya A.","year":"2024","journal-title":"Circulation Journal"},{"issue":"85","key":"e_1_2_11_12_1","doi-asserted-by":"crossref","first-page":"1104","DOI":"10.1253\/circj.CJ-20-0637","article-title":"JCS\/JHRS 2019 Guideline on Non\u2010Pharmacotherapy of Cardiac Arrhythmias","volume":"7","author":"Nogami A.","year":"2021","journal-title":"Circulation Journal"},{"issue":"9","key":"e_1_2_11_13_1","article-title":"Longer Left Ventricular Electric Delay Reduces Mitral Regurgitation After Cardiac Resynchronization Therapy: Mechanistic Insights From the SMART\u2010AV Study (SmartDelay Determined AV Optimization: A Comparison to Other AV Delay Methods Used in Cardiac Resynchronization Therapy)","volume":"11","author":"Neal A.","year":"2016","journal-title":"Circulation"},{"issue":"7","key":"e_1_2_11_14_1","first-page":"377","article-title":"Determination of the Longest Intrapatient Left Ventricular Electrical Delay May Predict Acute Hemodynamic Improvement in Patients After Cardiac Resynchronization Therapy","volume":"3","author":"Zanon F.","year":"2014","journal-title":"Circulation"},{"issue":"9","key":"e_1_2_11_15_1","first-page":"146","article-title":"Novel Active Fixation Lead Guided by Electrical Delay Can Improve Response to Cardiac Resynchronization Therapy in Heart Failure","volume":"1","author":"Matteo C.","year":"2022","journal-title":"ESC Heart Failure"},{"issue":"17","key":"e_1_2_11_16_1","first-page":"615","article-title":"Comparison of Measures of Ventricular Delay on Cardiac Resynchronization Therapy Response","volume":"4","author":"Michael E.","year":"2020","journal-title":"Heart Rhythm"},{"issue":"25","key":"e_1_2_11_17_1","first-page":"283","article-title":"Fusion\u2010Optimized Intervals (FOI): A New Method to Achieve the Narrowest QRS for Optimization of the AV and VV Intervals in Patients Undergoing Cardiac Resynchronization Therapy","volume":"3","author":"Elena A.","year":"2014","journal-title":"Journal of Cardiovascular Electrophysiology"},{"issue":"5","key":"e_1_2_11_18_1","first-page":"1028","article-title":"A Novel Quadripolar Active Fixation Left\u2010Ventricular Pacing Lead for Cardiac Resynchronization Therapy: Initial United Kingdom Experience","volume":"9","author":"Michael C.","year":"2019","journal-title":"JACC Clinical Electrophysiology"},{"issue":"79","key":"e_1_2_11_19_1","first-page":"442","article-title":"Effective Nonapical Left Ventricular Pacing With Quadripolar Leads for Cardiac Resynchronization Therapy","volume":"4","author":"Giovanni B.","year":"2021","journal-title":"Kardiologia polska"},{"issue":"39","key":"e_1_2_11_20_1","article-title":"Predictors of Echocardiographic Response to Cardiac Resynchronization Therapy: A Systematic Review With Meta\u2010Analysis","volume":"28","author":"Rodrigo M.","year":"2002","journal-title":"International Journal of Cardiology"},{"issue":"67","key":"e_1_2_11_21_1","first-page":"1104","article-title":"QRS Duration or QRS Morphology: What Really Matters in Cardiac Resynchronization Therapy?","volume":"9","author":"Jeanne E.","year":"2016","journal-title":"Journal of the American College of Cardiology"}],"container-title":["Pacing and Clinical 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