St Jude Medical, a global medical device company, announced the Indian launch of the Unify Quadra cardiac resynchronisation therapy defibrillator (CRT-D). The Unify Quadra CRT-D works with the company’s Quartet left ventricular pacing lead to offer a smaller quadripolar pacing system that helps physicians effectively and efficiently manage the changing pacing needs of patients with heart failure.

Heart failure occurs when the heart is unable to pump enough blood to meet the body’s demands. It results in the build-up of fluids throughout the body, which can lead to shortness of breath, swelling, and heart rhythm abnormalities. The Unify Quadra CRT-D system was designed to help the heart perform in its most natural state by synchronising the left and right ventricles of the heart through timed electrical pulses.

St Jude Medical first introduced quadripolar technology to India in 2011 with the launch of the Promote Quadra CRT-D, and remains the only company offering quadripolar technology anywhere in the world. The Unify Quadra is the next generation of the technology, providing all the benefits of quadripolar pacing technology in a smaller device.

The quadripolar system integrates multiple pacing configurations and features that provide physicians with more options to better manage common pacing complications without exposing the patient to additional surgeries in order to reposition the lead. This is important because approximately one in 10 patients who receive a CRT system have complications that could require an additional surgery. To date, more than fifty publications have provided clinical evidence supporting the benefits of quadripolar technology to manage common pacing complications, enable better clinical efficiency and provide a greater opportunity for efficacy.

The Unify Quadra CRT-D works with the company’s Quartet left ventricular pacing lead. It features four electrodes, rather than the conventional two or less. The additional electrodes allow for multiple pacing configurations, which provide the physician with more pacing options. This includes the ability to pace closer to the base of the left ventricle, which research has consistently shown to provide better patient outcomes and can be difficult to achieve with the conventional two-electrode lead. The quadripolar pacing electrodes also allow physicians to avoid the most common kinds of pacing complications and to pace around scar tissue found in the heart.

Commenting on the technology, Dr Aftab Ashrafuddin Khan, senior interventional cardiologist and director of electrophysiology services at Apollo Gleneagles Hospitals in Kolkata said, “With the Unify Quadra technology, I have more pacing options available than conventional CRT therapy, and also with a smaller device. This provides multiple benefits; first it improves the probability that a patient will respond well to the therapy, and second it helps patients avoid common complications by allowing for any adjustments of the leads without surgical revision.”

Due to differences in individual patient anatomy, or results that can not be seen until the procedure is complete, complications can arise after placing the lead of a CRT device. 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 from pacing the phrenic nerve, which results in hiccup-like symptoms. The Quartet lead’s four electrodes can help avoid these complications by providing physicians more options to choose alternative pacing sites without having to relocate the lead either during or with a second surgery.

Because the physician can non-invasively adjust pacing locations or configurations, the technology has the potential to reduce patients’ risk of needing multiple surgeries. This is important because some complications, such as phrenic nerve or diaphragmatic stimulation, are body-position sensitive and may not be evident until after the patient leaves the hospital.