Healthcare Professionals

Viva Quad XT CRT-D

Cardiac Resynchronization Therapy Defibrillators (CRT-D)

Viva Quad XT Cardiac Resynchronization Therapy Defibrillators (CRT-D)

Viva™ Quad XT CRT-D device, paired with the Attain® Performa™ Quadripolar LV Lead, features 16 Programmable Vectors, the VectorExpress™ LV Automated Test, and the AdaptivCRT® algorithm, which improves CRT response rate* with minute-to-minute optimization of CRT pacing.

*Compared to echo-optimized CRT.

Optimize CRT Response

While CRT is a highly effective therapy, there remains a need to improve the percentage of patients who receive full benefits. Studies have shown that up to one-third of patients do not experience all of the benefits of CRT.1-6

Many factors contribute to CRT non-response, including suboptimal AV timing, suboptimal LV lead placement, presence of arrhythmias, and reduced BiV pacing.7

As part of its comprehensive approach to treating heart failure patients with CRT, Medtronic offers a variety of solutions across every stage of care, including ways to optimize CRT response.

Percentage of Patients with Adequate CRT Response1-6

Adequate CRT Response

Detail - Adequate CRT Response

Potential Factors Contributing to Suboptimal CRT Response7

Suboptimal CRT Response

Detail - Suboptimal CRT Response

Important Safety Information

For CRT-D devices, certain programming and device operations may not provide cardiac resynchronization therapy. Changes in a patient's disease and/or indications may alter the efficacy of a device's programmed parameters or related features and may impact longevity.

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Attain Performa Quad LV Lead and VectorExpress

Attain Performa Quad LV Lead and VectorExpress

Advanced Quadripolar Leads with More Shape Options
Models 4298/4398/4598
5.3 Fr, Quadripolar
Designed to address common clinical challenges.

Short Bipolar Spacing – Reduce phrenic nerve stimulation occurrence1-3
Steroid on All Electrodes – Improve thresholds and longevity4
Compatible With all Attain® Delivery Systems – Use preferred delivery tools including sub-selection catheters

Attain Performa with Short Bipolar Spacing vs Other Quadripolar LV Lead with Equal Electrode Spacing

LV Automated Test

Provides clinically actionable data on 16 vectors in 2 minutes5

  • Eliminates the need for manual, time consuming testing of multiple vectors
  • In 2 minutes, you have clinically actionable data to:
    • Maximize longevity
    • Select pacing location
    • Optimize CRT response

LV Automated Test Results

Important Safety Information

Surgical complications, such as cardiac perforation, may occur and care must be taken when placing and positioning a cardiac lead.



Biffi M, et al. Utilizing Short Spacing between Quadripolar LV lead Electrodes to Avoid PNS. Cardiostim 2014, Poster presentation, Session 56P.


Biffi M, Foerster L, Eastman W, et al. Effect of bipolar electrode spacing on phrenic nerve stimulation and left ventricular pacing thresholds: an acute canine study. Circ Arrhythm Electrophysiol. August 1, 2012;5(4):815-820.


Biffi M, Zanon F, Bertaglia E, et al. Short-spaced dipole for managing phrenic nerve stimulation in patients with CRT: the “phrenic nerve mapping and stimulation EP” catheter study. Heart Rhythm. January 2013;10(1):39-45.


Lunati MG, Gasparini M, Landolina M, et al. Long-Term Effect of Steroid Elution on the Electrical Performance of Coronary Sinus Leads for Cardiac Resynchronization Therapy. Presented at HRS 2012 (AB10-05).


Demmer W. VectorExpress Performance Results. Medtronic Data on File, January 2013.

AdaptivCRT Algorithm

PhysioCurve Design

SmartShock 2.0

OptiVol 2.0




Abraham WT, Fisher WG, Smith AL, et al. Cardiac resynchronization in chronic heart failure. N Engl J Med. June 13, 2002;346(24):1845-1853.


Young JB, Abraham WT, Smith AL, et al. Combined cardiac resynchronization and implantable cardioversion defibrillation in advanced chronic heart failure: the MIRACLE ICD Trial. JAMA. May 28, 2003;289(20):2685-2694.


Abraham WT, Young JB, León AR, et al. Effects of cardiac resynchronization on disease progression in patients with left ventricular systolic dysfunction, an indication for an implantable cardioverter-defibrillator, and mildly symptomatic chronic heart failure. Circulation. November 2, 2004;110(18):2864-2868.


Abraham WT, Leon AR, Hannon C, et al. Results of the InSync III Marquis clinical trial. Heart Rhythm. May 2005;2(5):S65.


Chung ES, Leon AR, Tavazzi L, et al. Results of the predictors of response to CRT (PROSPECT) trial. Circulation. May 20, 2008;117(20):2608-2616.


Abraham WT, et al. Results from the FREEDOM Trial – Assess the Safety and Efficacy of Frequent Optimization of Cardiac Resynchronization Therapy. Late-Breaking Clinical Trials. SP08. Presented at the Heart Rhythm Society 31st Annual Scientific Sessions, May 2010, Denver, Colorado.


Mullens W, Grimm RA, Verga T, et al. Insights from a cardiac resynchronization optimization clinic as part of a heart failure disease management program. JACC. 2009; 53(9):765-773.