VIDEO: Wireless left ventricular pacing shows ‘promise’

BOSTON — In this video, Vivek Y. Reddy, MD, director of electrophysiology at Mount Sinai Medical Center in New York, discusses results of the SELECT-LV study, which examined a novel leadless technology for cardiac resynchronization therapy.

The nonrandomized SELECT-LV trial evaluated the WiCS-LV technology (EBR Systems), which paces directly from inside the left ventricle, as opposed to traditional CRT, in which a pacing lead is placed outside of the heart through the coronary sinus. The device consists of a battery, a subcutaneous transmitter implanted in the chest wall that emits ultrasonic pulses and a pacing pellet within the ventricle that receives the impulses.

In the study presented at the Heart Rhythm Society Scientific Sessions, 39 patients in Europe who either failed or were nonresponsive to treatment with CRT received the device. Reddy said the efficacy of the treatment was "quite remarkable," with an improvement of almost 40 ms to baseline QRS, which persisted through the end of approximately 6 months of follow-up. Patients also experienced improvements to functional class, symptom score and ejection fraction, he noted.

Some patients experienced safety issues, including one infection, one case of technical failure in which the pacing pellet dislodged before entering the heart and vascular complications in two patients.

Reddy concluded that the results from SELECT-LV show "real promise" for leadless left ventricular pacing. The next step is a large, prospective, multicenter study to fully evaluate this new treatment option.