Background: WiSE-CRT (EBR system, Sunnyvale, California) is a leadless CRT endocardial pacing system, which utilize ultrarasound to transfer energy to a receiver electrode on the Left Ventricle (LV) endocardial wall in conjunction with a co-implanted right ventricular (RV) pacing system.
SELECT-LV was a prospective multicenter non-randomized study assessing the safety and the performance of biventricular pacing obtained with a wireless LV endocardial system.
Objective: In SELECT-LV patient population we observed the time dependent electrical remodelling based on measurement of the intrinsic QRS duration.
Methods: SELECT-LV trial represents 35 patients who had “failed” conventional CRT (Ø age ±SD 65,4±7,7); Male 30 (85,7%). Ischemic cardiomyopathy was diagnosed in 15 (42,9%) and non-ischemic in 16 (45,7%), LV EF 26.0± 6.2% with NYHA Class mean±SD 2,7±0,5. Mean baseline intrinsic QRS (msec) was 169,6 ±SD 28,9. After 24 months we compared NYHA responder rate and change in intrinsic QRS (msec).
Results: Of the patients enrolled in the SELECT-LV clinical trial (N=39), 35 patients (89.7%) underwent the WiSE procedure. Out of these 35 patients there were significant reductions in the intrinsic QRS duration after 6 months (N=27), 12 months (N=22) and 24 months (N=18) patients, which indicate continuous positive change of myocardial activation (Table 1). This positive electrical remodelling was accompanied with NYHA responder rate which indicated the time continuity as well.
Conclusion: This is the first report of wireless LV endocardial based CRT approach showed positive effect on electrical remodelling which is expressed in significant clinical improvement of the patients included in SELECT-LV trial.