St Jude Medical receives CE mark approval of multipoint pacing CRT-D


St Jude Medical has announced CE mark approval of its next-generation quadripolar device, the Quadra Assura MP cardiac resynchronisation therapy defibrillator (CRT-D).

Built upon the company’s first-to-market Quadripolar pacing system, the Quadra Assura MP CRT-D features multipoint pacing (MPP) technology that enables physicians, according to the company, to pace multiple locations on the left side of the heart. This gives the clinician more choices to best optimise cardiac resynchronisation therapy (CRT) pacing to meet individual patient needs.

According to a press release, the Quadra Assura is designed to work with the Quartet Lead, which has four electrodes to offer maximum flexibility for different pacing configurations. The new MPP capability allows physicians to programme simultaneous or sequential delivery of two left ventricular pulses per pacing cycle, rather than the standard single pacing pulse. The capability to deliver two left ventricular pulses per cycle allows physicians to tailor CRT pacing for each patient, potentially leading to more effective outcomes compared to single site pacing, which may be particularly beneficial in patients not responding to traditional bi-ventricular pacing therapy.

“Many patients with heart failure have scar tissue on their cardiac anatomy that makes it difficult to provide them with optimal and effective therapy. The new multipoint pacing technology helps individualise therapy for each of my patients and potentially allows those patients unable to benefit from traditional cardiac resynchronisation therapy to be effectively treated,” said Carlo Pappone, director of the Department of Arrhythmology at Maria Cecilia Hospital, GVM Care and Research in Cotignola, Italy.

“Quadripolar pacing has become the standard of care for many physicians. We are pleased to continue our innovation by offering the industry’s first multipoint pacing system, which provides a new set of non-invasive tools to address patients who are non-responders to traditional CRT pacing, potentially decreasing heart failure hospitalisations and lowering the economic burden,” said Eric Fain, president of the St Jude Medical Implantable Electronic Systems Division.

Preliminary results from a study presented at this year’s Heart Rhythm Society (HRS) Scientific Sessions showed that after three months 89% of patients treated with the St Jude Medical MPP were classified as responders, an increase of nearly 20%. On average, the response rate to traditional CRT is approximately 70%.

St Jude Medical reported that it is currently conducting a pivotal US clinical study, under an Investigational Device Exemption (IDE), on the multipoint CRT pacing feature. The study is evaluating outcome benefits such as improved haemodynamics and cardiac function in heart failure patients who receive CRT. Additionally, a single-centre, research study will compare six-month efficacy of CRT with MPP at various programmed parameters. The results from these studies will strengthen the clinical evidence for MPP. Additionally, starting later this year, a European post-market study is expected to further evaluate the efficacy of MPP therapy in patients not responding to traditional CRT.

Quadra Assura MP CRT-D is an investigational device in the USA and is not commercially approved in the USA.