Efficacy and safety of leadless cardiac resynchronization therapy: An updated meta-analysis

The WiSE cardiac resynchronization therapy (CRT) system (EBR Systems Inc., Sunnyvale, CA, USA) is an innovative technique consisting of an electrode implanted in the endocardium of the left ventricle as an alternative to the conventional CRT for symptomatic patients with heart failure and reduced ejection fraction (EF) despite optimal medical treatment. The objective of this study was to evaluate the efficacy of the Wise CRT.

We searched two electronic databases from inception until November 2024.The primary outcomes were defined as the mean difference (MD) of left ventricular (LV) EF (%) and QRS (milliseconds) from baseline to 6 months post-procedure.

Our analysis included six studies (n = 281 patients). A meta-analysis was performed with the primary endpoints being the MD between baseline LVEF and 6-month follow-up and b) the MD between baseline QRS and 6-month follow-up. There was a mean increase in LVEF of 5.78 % (MD 5.78 %; CI 4.37-7.19; p < 0.01) and a mean reduction in QRS duration of 37.08 ms (MD -37.08 ms; CI -45.72 to -28.44; p < 0.01).

The WiSE CRT showed impressive electrocardiographic and echocardiographic responses in high-risk patients for whom conventional CRT implantation was impossible or resulted in suboptimal treatment.