Feasibility, safety, and short-term outcome of leadless ultrasound-based endocardial left ventricular resynchronization in heart failure patients: results of the Wireless Stimulation Endocardially for CRT (WiSE-CRT) study

Auricchio, Angelo; Delnoy, Peter-Paul; Butter, Christian; Brachmann, Johannes; Erven, Lieselot van; Spitzer, Stefan G.; Moccetti, Tiziano; Seifert, Martin; Markou, Thanasie; Laszo, Karolyi; Regoli, François

doi:10.1093/europace/eut435

Cited by 173 publications

(127 citation statements)

References 21 publications

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“…This can deliver LV endocardial stimulation within 3 ms of sensing a RV pacing spike from a preexisting pacemaker, enabling LV endocardial stimulation but without the presence of a pacing lead in the arterial system of the left heart. Among the 54 patients implanted across two small studies, the mean clinical response to CRT was 74% (which is notable given this group are self selected non responders to conventional CRT) 11, 12. Longer term efficacy and safety data are awaited, but results are certainly promising and this too may represent a tangible approach for delivering CRT via LV endocardial stimulation, without the risk of disruption to the mitral valve.…”

Section: Discussionmentioning

confidence: 99%

Splinting and mechanical disruption of the mitral valve apparatus by an endocardial left ventricular lead while delivering cardiac resynchronization therapy

Behar

Ranjan

Sporton

et al. 2018

Clinical Case Reports

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Section: Discussionmentioning

confidence: 99%

Splinting and mechanical disruption of the mitral valve apparatus by an endocardial left ventricular lead while delivering cardiac resynchronization therapy

Behar

Ranjan

Sporton

et al. 2018

Clinical Case Reports

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“…16,17 Leadless endocardial left ventricular pacing is also a reality, as is wireless communication between implanted systems to achieve resynchronisation. 18 …”

Section: Future Developmentsmentioning

confidence: 99%

Lead or be led: an update on leadless cardiac devices for general physicians

Wiles

Roberts

2017

Clinical Medicine

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“…This system has undergone initial evaluation in the WISE-CRT trial, with a 50% response rate in patients who failed to respond to conventional epicardial CRT, albeit with a significant complication rate, likely due to the design characteristics of the early delivery system. 9 The pivotal trial will commence in 2018, using an updated delivery system. We will await the results with interest.…”

Section: Left Ventricular Endocardial Pacingmentioning

confidence: 99%

Electrical Therapy of Heart Failure

Niazi

2017

J Innov Cardiac Rhythm Manage

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' 2017 Innovations in Cardiac Rhythm ManagementThis year brought increasing interest in more physiologic forms of pacing for the prevention and treatment of heart failure (HF).Permanent His bundle pacing, with depolarization of the ventricles via the intrinsic His-Purkinje system (HPS), is arguably the most physiologic form of ventricular pacing. Its practical application in narrow QRS patients was demonstrated by Deshmukh et al. in 2000. 1 More recently, Lustgarten and colleagues showed that His-bundle pacing (HBP) was able to narrow the QRS complex in patients with left bundle branch block (BBB) to a variable extent in most patients.2 Barba-Pichardo et al. demonstrated similar narrowing in 81% of 16 patients. In another example, Ajijola et al. built upon this by reporting on a two-center pilot study of permanent HBP in a cardiac resynchronization therapy (CRT) population, published in Heart Rhythm this year. 4 Permanent HBP with narrowing of the baseline QRS was possible in 16 of the 21 patients involved, with the mean QRS shrinking from 181ms ± 23 ms to 129 ms ± 13 ms. Normalization of the QRS was only possible in one patient; yet, the mean LVEF demonstrated an improvement from 27% to 41%, and New York Heart Association functional class recovered from 111 to 11. At one year, thresholds remained acceptable and all leads were stable. Interestingly, four of these 16 patients had right BBB, while the rest had left BBB.One question to ask is, how does HBP resolve left BBB? Narula and others demonstrated this phenomenon in left BBB patients during distal but not proximal HBP. 5,6 Presumably, longitudinal stratification of the fibers in the His bundle, coupled with intra-His block, was resolved by distal HBP. This appears to hold true even for HF patients with severely diseased ventricles in whom it may appear counterintuitive. In 27 HF patients with left BBB undergoing CRT, we were able to demonstrate significant narrowing of the QRS complex along with a shortening in intra-left ventricular conduction in 24 patients during the use of temporary HBP. Of these, the QRS normalized in 12, with a corresponding further shortening of intra-left ventricular conduction.

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Feasibility, safety, and short-term outcome of leadless ultrasound-based endocardial left ventricular resynchronization in heart failure patients: results of the Wireless Stimulation Endocardially for CRT (WiSE-CRT) study

Abstract: NCT01294527.

Cited by 173 publications

References 21 publications

Splinting and mechanical disruption of the mitral valve apparatus by an endocardial left ventricular lead while delivering cardiac resynchronization therapy

Splinting and mechanical disruption of the mitral valve apparatus by an endocardial left ventricular lead while delivering cardiac resynchronization therapy

Lead or be led: an update on leadless cardiac devices for general physicians

Electrical Therapy of Heart Failure

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