The Attain family of left-heart leads and delivery systems is the most often used in the industry, and the two new systems are designed to enhance cannulation of the coronary sinus, which provides access to the left side of the heart, as well as assist with cardiac vein subselection.
The Attain Prevail system is the first left-heart lead delivery system in the industry to combine steerability, catheter telescoping and vein subselection in a single package. It allows the user to create multiple curve shapes without changing guide catheters, and also permits deep advancement of the guide catheter and guide wire. In addition, its soft, tapered tip design and small size (7 French), helps minimize the chance of venous trauma.
The Attain Deflectable guiding catheter provides physicians with an excellent opportunity for successful coronary sinus cannulation and left-heart lead placement. Implanters are able to vary the catheter curve to match a patient's anatomy and, once cannulation has been achieved, the Attain Deflectable provides a stable workstation for the passing of guidewires, leads and venogram balloon catheters for greater visualization of the cardiac venous anatomy.
"The success of a CRT implant is tied to the ease of the left-heart lead delivery, and these systems are designed to offer the best opportunity for success", stated Steve Mahle, president of Medtronic Cardiac Rhythm Management. "These new delivery tools will help both experienced physicians, who do a lot of CRT implants, as well as other physicians who are just beginning to manage their heart failure patients with CRT devices."
Both new delivery systems allow contrast injection through the lumen to help visualize the anatomy, especially the cardiac veins on the left ventricle. The Attain Prevail can be inserted into straight or other fixed shape catheters to accomplish telescoping techniques, and the Attain Deflectable allows for adjustable curve reach and telescoping with a guidewire and over-the-wire lead.
Attain leads and delivery systems are used with implantable cardiac resynchronization therapy devices such as the InSync III CRT pacing system and the InSync II Marquis system that also includes a defibrillator. Medtronic remains the only company to offer both CRT pacing systems and CRT plus defibrillator systems in the United States. More news on Medtronic is available in the VMW May 2003 article Medtronic's cardiac resynchronization therapy reverses progression of heart failure.