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