Cardiac Resynchronization Therapy With Wireless Left Ventricular Endocardial Pacing: The SELECT-LV Study.

Area of Science:

• Cardiology
• Medical Devices
• Heart Failure Management

Background:

• 30-40% of heart failure patients eligible for cardiac resynchronization therapy (CRT) do not respond or cannot undergo coronary sinus (CS) lead implantation.
• The WiSE-CRT system provides biventricular pacing via a wireless left ventricular (LV) endocardial electrode for this challenging patient group.

Purpose of the Study:

• To assess the safety and performance of the WiSE-CRT system in patients indicated for CRT.
• The SELECT-LV study is a prospective, multicenter, non-randomized trial evaluating this novel pacing approach.

Main Methods:

• 35 patients with "failed" conventional CRT underwent implantation of a wireless LV endocardial electrode and a subcutaneous pulse generator.
• System performance, clinical efficacy, and safety were evaluated up to 6 months post-implantation.

Main Results:

• Procedure success rate was 97.1% (34/35 patients).
• Primary endpoint of biventricular pacing achieved in 33/34 patients at 1 month.
• 84.8% showed clinical composite score improvement, and 66% had positive echocardiographic CRT response at 6 months.

Conclusions:

• The WiSE-CRT system is clinically feasible and offers benefits to a majority of patients with previously "failed" CRT.
• This wireless endocardial pacing approach addresses limitations of conventional CRT lead implantation.