摘要目的 探索真实世界中左心室4极导线提供可用的起搏位点的数目.方法 本研究入选了2013年9月至2015年9月在中国医学科学院阜外医院接受心脏再同步治疗(CRT)的患者24例,所有患者均使用了QuartetTM(美国圣犹达公司)左心室4极导线.分别于出院前和术后3个月评价QuartetTM导线提供可用的左心室起搏位点的数目.可用起搏位点的标准设为:该位点至少1个起搏向量阈值≤2.5 V/0.5 ms且2倍起搏阈值不引起膈肌刺激.对照组采用4极导线模拟双极导线配置,即仅使用4极导线的远端两极模拟双极导线.结果 平均随访时间为(93±3)d.出院前,QuartetTM 4极导线比模拟双极导线提供了更多的可用起搏位点[中位数3(四分位间距2～4)对中位数2(四分位间距1～2),P＜0.001].4极导线和模拟双极导线能够提供至少1、2、3个和4个可用左心室起搏位点的比例分别为:100％ (24/24),91.7％ (22/24),58.3％ (14/24)和33.3％ (8/24)以及91.7％ (22/24),70.8％ (17/24),0(0/24)和0(0/24).3个月随访时,QuartetS4极导线提供的可用的左心室起搏位点较出院前保持不变[中位数3(四分位间距2～4),P=0.45].结论 与传统双极导线比较,QuartetTM 4极导线可以提供更多的可用的左心室起搏位点.QuartetTM 4极导线提供的左心室起搏位点数目在3个月随访时保持不变.

abstractsObjective This study aimed to evaluate the acute and 3-month availability of viable left ventricular pacing site(LVPS) provided by a quadripolar left ventricular(LV) pacing lead.Methods A singlecenter cohort study evaluated consecutive patients who underwent a cardiac resynchronization therapy (CRT) implant with the QuartetTM LV lead under local guidelines.The availability of viable LVPS was assessed at the pre-discharge and 3-month follow-up visit.Bipolar lead configurations,served as the control group,were modeled by eliminating the two proximal electrodes on the QuartetTM LV lead.Results A total of 24 patients were enrolled and finished 3-month follow-up.The mean follow-up period was (93 ± 3) days.At pre-discharge,the QuartetTM LV lead provided more viable LVPSs compared with the bipolar equivalents[median 3 (IQR 2-4)vs.median 2 (IQR 1-2),P＜ 0.001].The percentage of patients with at least 1,2,3,and 4 viable LVPSs were 100％ (24/24),91.7％ (22/24),58.3％ (14/24) and 33.3％ (8/24) for QuartetTM leads and 91.7％ (22/ 24),70.8 ％ (17/24),0 (0/24) and 0 (0/24) for bipolar lead configurations,respectively.The median and IQR values of viable LVPSs provided by the QuartetTM LV lead remained the same [3(IQR 2-4) between pre-discharge and 3-month follow-up (P =0.45)].Conclusions Compared with the bipolar equivalent,QuartetTM LV lead provides more viable LVPS.The number of LVPS provided by QuartetTM leads remained unchanged between pre-discharge and 3-month follow-up.