GRAND RAPIDS — Spectrum Health electrophysiologists are the first in West Michigan to begin implanting a new pacemaker and defibrillator that features four wires as opposed to three or two. It gives physicians more options and flexibility in treating patients with heart failure.
Bohuslav Finta, M.D., was the first electrophysiologist, or heart rhythm specialist, at Spectrum Health to implant the Unify Quadra cardiac resynchronization therapy defibrillator and Quartet Left Ventricular Quadripolar Pacing Lead.
The Quadra is an implanted device and the Quartet is the lead anchored in the heart. Leads are the wires that transmit electronic impulses from the pacemaker to the heart. This device has four leads placed in the heart to regulate rhythm.
This technology is the industry’s first quadripolar pacing system. The new pacemaker technology offers additional pacing options which can reduce the need for reoperation to reposition a lead. It also offers physicians the ability to more efficiently and effectively manage the individualized needs of patients with heart failure. The device is manufactured by St. Jude Medical.
“This device is important for patients because it increases the chance at a successful implant,” said Finta. “Historically, about five to 10 percent of CRT implants fail and the largest chunks of failures are due to poor cardiac anatomy, stimulation by an adjacent nerve or a high electrical stimulus required to produce proper heart pacing. The quadripolar technology decreases the possibility of the last two reasons for implant failure, thus increasing chance of successful implant.”
CRT devices such as this 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 instead of the current industry standard of two electrodes on a 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.
Finta said another advantage of this device is that it has more pacing settings to reduce the chance a second procedure to manually reposition the lead. 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 CRT device. The Quartet lead’s four electrodes can help avoid these complications by providing physicians more options to pace in additional configurations.
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 or the heart’s 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 and repair the electrical stimulation the device provides.
Approximately 10 percent of patients experience pacing-related lead complications and approximately five percent require surgical revision. The quadripolar pacing system available in the Unify Quadra CRT-D may become an industry standard as a result of its ability to reduce the impact of these complications. 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, which can be delivered by an implantable cardioverter defibrillator or a pacemaker, resynchronizes the beating of the heart’s lower chambers. 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, and 2 million new cases of CHF are diagnosed each year worldwide.
Spectrum Health is a not-for-profit health system in West Michigan offering a full continuum of care through the Spectrum Health Hospital Group, which is comprised of nine hospitals including Helen DeVos Children’s Hospital, a state of the art children’s hospital that opened in January 2011, and 183 service sites; the Spectrum Health Medical Group and West Michigan Heart, physician groups totaling more than 700 providers; and Priority Health, a health plan with 600,000 members. Spectrum Health is West Michigan’s largest employer with 19,000 employees.