{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,9]],"date-time":"2026-03-09T11:47:57Z","timestamp":1773056877584,"version":"3.50.1"},"reference-count":25,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"10","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["JAHA"],"published-print":{"date-parts":[[2017,10,11]]},"abstract":"\n Background<\/jats:title>\n \n In cardiac resynchronization therapy (\n CRT<\/jats:styled-content>\n ), quadripolar (\n QUAD<\/jats:styled-content>\n ) left ventricular (\n LV<\/jats:styled-content>\n ) leads are less prone to postoperative complications than non\u2010\n QUAD<\/jats:styled-content>\n leads. Some studies have suggested better clinical outcomes.\n <\/jats:p>\n <\/jats:sec>\n \n Methods and Results<\/jats:title>\n \n Clinical events were assessed in 847 patients after\n CRT<\/jats:styled-content>\n \u2010pacing or CRT\u2010defibrillation using either\n QUAD<\/jats:styled-content>\n (n=287) or non\u2010\n QUAD<\/jats:styled-content>\n (n=560), programmed to single\u2010site site\n LV<\/jats:styled-content>\n pacing. Over a follow\u2010up period of 3.2\u00a0years (median [interquartile range, 1.90\u20135.0]),\n QUAD<\/jats:styled-content>\n was associated with a lower total mortality (adjusted hazard ratio [\n aHR<\/jats:styled-content>\n ]: 0.32, 95% confidence interval [\n CI<\/jats:styled-content>\n ], 0.20\u20130.52), cardiac mortality (\n aHR<\/jats:styled-content>\n : 0.36, 95%\n CI<\/jats:styled-content>\n , 0.20\u20130.65), and heart failure (\n HF<\/jats:styled-content>\n ) hospitalization (\n aHR<\/jats:styled-content>\n : 0.62, 95%\n CI<\/jats:styled-content>\n , 0.39\u20130.99), after adjustment for age, sex, New York Heart Association class,\n HF<\/jats:styled-content>\n etiology, device type (\n CRT<\/jats:styled-content>\n \u2010pacing or\n CRT<\/jats:styled-content>\n \u2010defibrillation), comorbidities, atrial rhythm, medication, left ventricular ejection fraction, and creatinine. Death from pump failure was lower with\n QUAD<\/jats:styled-content>\n (\n aHR<\/jats:styled-content>\n : 0.33; 95%\n CI<\/jats:styled-content>\n , 0.18\u20130.62), but no group differences emerged with respect to sudden cardiac death. There were no differences in implant\u2010related complications. Re\u2010interventions for\n LV<\/jats:styled-content>\n displacement or phrenic nerve stimulation, which were lower with\n QUAD<\/jats:styled-content>\n , predicted total mortality (\n aHR<\/jats:styled-content>\n : 1.68, 95%\n CI<\/jats:styled-content>\n , 1.11\u20132.54), cardiac mortality (\n aHR<\/jats:styled-content>\n : 2.61, 95%\n CI<\/jats:styled-content>\n , 1.66\u20134.11) and\n HF<\/jats:styled-content>\n hospitalization (\n aHR<\/jats:styled-content>\n : 2.09, 95% CI, 1.22\u20133.58).\n <\/jats:p>\n <\/jats:sec>\n \n Conclusions<\/jats:title>\n \n CRT<\/jats:styled-content>\n using\n QUAD<\/jats:styled-content>\n , programmed to biventricular pacing with single\u2010site\n LV<\/jats:styled-content>\n pacing, is associated with a lower total mortality, cardiac mortality, and\n HF<\/jats:styled-content>\n hospitalization. These trends were observed for both\n CRT<\/jats:styled-content>\n \u2010defibrillation and\n CRT<\/jats:styled-content>\n \u2010pacing, after adjustment for\n HF<\/jats:styled-content>\n cause and other confounders. Re\u2010intervention for\n LV<\/jats:styled-content>\n lead displacement or phrenic nerve stimulation was associated with worse outcomes.\n <\/jats:p>\n <\/jats:sec>","DOI":"10.1161\/jaha.117.007026","type":"journal-article","created":{"date-parts":[[2017,10,18]],"date-time":"2017-10-18T00:10:20Z","timestamp":1508285420000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":49,"title":["Cardiac Resynchronization Therapy Using Quadripolar Versus Non\u2010Quadripolar Left Ventricular Leads Programmed to Biventricular Pacing With Single\u2010Site Left Ventricular Pacing: Impact on Survival and Heart Failure Hospitalization"],"prefix":"10.1161","volume":"6","author":[{"given":"Francisco","family":"Leyva","sequence":"first","affiliation":[{"name":"Aston Medical Research Institute, Aston Medical School, Aston University, Birmingham, United Kingdom"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Abbasin","family":"Zegard","sequence":"additional","affiliation":[{"name":"Aston Medical Research Institute, Aston Medical School, Aston University, Birmingham, United Kingdom"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tian","family":"Qiu","sequence":"additional","affiliation":[{"name":"Quality and Outcomes Research Unit, Queen Elizabeth Hospital, Birmingham, United Kingdom"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Edmund","family":"Acquaye","sequence":"additional","affiliation":[{"name":"Queen Elizabeth Hospital, Birmingham, United Kingdom"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gaetano","family":"Ferrante","sequence":"additional","affiliation":[{"name":"Queen Elizabeth Hospital, Birmingham, United Kingdom"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jamie","family":"Walton","sequence":"additional","affiliation":[{"name":"Queen Elizabeth Hospital, Birmingham, United Kingdom"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Howard","family":"Marshall","sequence":"additional","affiliation":[{"name":"Quality and Outcomes Research Unit, Queen Elizabeth Hospital, Birmingham, United Kingdom"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"276","reference":[{"key":"e_1_3_2_2_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2014.06.1178"},{"key":"e_1_3_2_3_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1540-8159.1998.tb01096.x"},{"key":"e_1_3_2_4_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0002-9149(98)01015-7"},{"key":"e_1_3_2_5_2","doi-asserted-by":"publisher","DOI":"10.1093\/europace\/eur322"},{"key":"e_1_3_2_6_2","doi-asserted-by":"publisher","DOI":"10.1136\/heart.86.4.405"},{"key":"e_1_3_2_7_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2005.08.031"},{"key":"e_1_3_2_8_2","doi-asserted-by":"publisher","DOI":"10.1093\/europace\/eum080"},{"key":"e_1_3_2_9_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2010.06.037"},{"key":"e_1_3_2_10_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2011.06.007"},{"key":"e_1_3_2_11_2","first-page":"212","article-title":"Cardiac resynchronization therapy with a quadripolar electrode lead decreases complications at 6\u00a0months","volume":"2","author":"Boriani G","year":"2016","unstructured":"Boriani G, Connors S, Kalarus Z, Lemke B, Mullens W, Osca Asensi J, Raatikainen P, Gazzola C, Farazi TG, Leclercq C. 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