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Related Concept Videos

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Related Experiment Video

Updated: Apr 18, 2026

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Left ventricular three-dimensional quadripolar lead acute clinical study: the LILAC study.

François Philippon1, Lili Liu, Jeffrey Wing-Hong Fung

  • 1Electrophysiology Division, Institut universitaire de cardiologie et de pneumologie de Québec, Québec, Canada.

Pacing and Clinical Electrophysiology : PACE
|January 29, 2015
PubMed
Summary

Novel 3D quadripolar leads effectively pace the left ventricle base and apex, avoiding phrenic nerve stimulation (PNS) for cardiac resynchronization therapy. This design offers low pacing capture thresholds (PCT) and acute stability.

Keywords:
cardiac resynchronizationlead designquadripolar leads

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Area of Science:

  • Cardiology
  • Biomedical Engineering
  • Medical Devices

Background:

  • Cardiac resynchronization therapy (CRT) requires effective left ventricular (LV) pacing.
  • Achieving stable LV pacing at the base while avoiding phrenic nerve stimulation (PNS) is challenging.
  • Novel lead designs are needed to improve CRT outcomes.

Purpose of the Study:

  • To evaluate novel three-dimensional (3D) quadripolar lead designs for LV pacing.
  • To assess pacing capture thresholds (PCT) at the LV apex and base.
  • To determine the incidence of phrenic nerve stimulation (PNS) with these leads.

Main Methods:

  • A multicenter acute clinical study involving 50 patients.
  • Testing of up to two investigational 3D quadripolar LV leads per patient.
  • Coronary sinus venography guided lead placement in wedged and unwedged positions.

Main Results:

  • Eighty-seven leads were tested, with spiral electrodes showing optimal performance.
  • Average PCTs were low and similar in wedged and unwedged positions (1.7 ± 1.5 V vs 1.9 ± 1.5 V).
  • Pacing was achieved in the mid-basal LV without PNS in 89-96% of patients.

Conclusions:

  • 3D quadripolar spiral leads achieve acceptable PCTs and avoid PNS without repositioning.
  • These leads enable mid-basal LV stimulation with low PCT and good acute stability.
  • The novel lead design shows promise for improving CRT lead implantation and efficacy.