Please login or register to print this page.

Clinical Articles, News & Views

Quadripolar leads receive CE Mark

A portfolio of quadripolar leads (Attain Performa®, Medtronic, Inc.) has received CE Mark and is to begin its European launch. The left-heart leads feature four electrodes with 16 pacing configurations. The leads are not approved for sale in the USA.

The leads are designed with shorter spacing between the two center electrodes to increase phrenic nerve thresholds and reduce phrenic nerve stimulation (PNS).1 With unipolar and bipolar leads, PNS may require surgery to reposition the lead or disable the cardiac resynchronisation therapy defibrillators (CRT-Ds), and occurs when a device’s electrical output inadvertently activates the diaphragm muscle, causing muscle twitching, hiccups or shortness of breath.

The leads include steroid elution on all four electrodes for lower chronic pacing thresholds, which contribute to greater device longevity and reduce the likelihood of PNS.2 They also utilise an automated in-office test (VectorExpress™, Medtronic Inc.) that provides information on physician-selected pacing configurations in less than three minutes to aid in selecting the optimal pacing configuration for stimulating the heart.

“This sophisticated new lead family provides physicians with the flexibility needed to effectively navigate diverse patient anatomies and help maintain optimal lead position, which has been proven to improve CRT response,” said World Society of Arrhythmias president Dr Massimo Santini (S. Filippo Neri Hospital, Rome).


1. Biffi et al. Effort of bipolar electrode spacing on phrenic nerve stimulation and left ventricular pacing thresholds: an acute canine study. Circulation: Arrhythmia and Electrophysiology 2012.

2. Lunati MG, Gasparini M, Landolina M, et al. Long-term effect of steroid elution on the electrical performance of coronary sinus leads for cardiac resynchronization therapy. Presented at HRS 2012 (AB10-05).

Published on: March 27, 2013

Members Area

Log in or Register now.



Subscribe to our RSS feed


Sign up for our regular email newsletters & be the first to know about fresh articles and site updates.


    None Found


  • ArrhythmiaAlliance
  • Stars
  • Anticoagulation Europe
  • Atrial Fibrillation Association

You are not logged in

You need to be a member to print this page.
Sign up for free membership, or log in.

You are not logged in

You need to be a member to download PDF's.
Sign up for free membership, or log in.