Attain Performa(TM) Quadripolar Lead Study

Inclusion criteria

• Patient is indicated for implant of a CRT-D device and left-heart lead per local indications (In US only this is based on Class I and II indications for CRT-D implant per HRS/ACC/AHA guidelines)
• Patient (or legally authorized representative) has signed and dated the study-specific Consent Form
• Patient is 18 years of age or older, or is of legal age to give informed consent per local and national law
• Patient is expected to remain available for follow-up visits
• Patient understands the study and agrees to comply with study protocol

Exclusion criteria

• Patient has a previous LV lead implanted or previous implant attempt within 30 days of enrollment or has ongoing AEs from a previous unsuccessful implant attempt
• Patient has contraindications for standard transvenous cardiac pacing (e.g., mechanical right heart valve)
• Patient has had a heart transplant (Note: Patients waiting for heart transplants are allowed in the study)
• Patient is contraindicated for < 1 mg dexamethasone acetate
• Patient is currently enrolled or planning to participate in a potentially confounding drug or device study during the course of this study. (Note: Co-enrollment in concurrent studies may be allowed provided that documented pre-approval is obtained from Medtronic's study manager)
• Patient has a life expectancy less than 180 days
• Patient with exclusion criteria required by local law (e.g. age, pregnancy, breast feeding, etc.)

• In US, women of childbearing potential must have a negative pregnancy test 7 days prior to implant to be included
• Patient is unable to tolerate an urgent thoracotomy