Key result
Leadless LBBAP using the WiSE-CRT system proves technically feasible in two patients.
Why the study?
Left bundle branch area pacing can deliver cardiac resynchronization therapy, and the study evaluated the technical feasibility of delivering leadless left bundle branch area pacing using the WiSE-CRT system.
Is leadless left bundle branch area pacing (LBBAP) using the WiSE-CRT system technically feasible in patients requiring cardiac resynchronization therapy?
Case Report (n=2)
Is leadless left bundle branch area pacing (LBBAP) using the WiSE-CRT system technically feasible in patients requiring cardiac resynchronization therapy?
Leadless left bundle branch area pacing using the WiSE-CRT system is technically feasible, offering a potential entirely leadless CRT option for patients with venous access issues or recurrent lead complications.
Hypothesis-generating for leadless LBBAP with WiSE-CRT; prospective trials needed before clinical adoption.
BACKGROUND: Left bundle branch area pacing (LBBAP) is a novel form of conduction system pacing which can reverse left bundle branch block and deliver cardiac resynchronization therapy (CRT). The WiSE-CRT system delivers leadless endocardial pacing with symptomatic and left ventricular (LV) remodelling improvements following intervention. We report the technical feasibility of delivering leadless LBBAP using the WiSE-CRT system. CASE SUMMARY: In Case 1, a 57-year-old male with ischaemic cardiomyopathy and complete heart block underwent implantation of the WiSE-CRT system, using a retrograde transaortic approach, after failed conventional CRT. Temporary left bundle stimulation from the LV septum achieved superior electrical resynchronization and equivalent haemodynamic response compared to endocardial pacing at the lateral LV wall. In Case 2, an 82-year-old gentleman with tachyarrhythmia-induced cardiomyopathy underwent WiSE-CRT implantation via a trans-septal inter-atrial approach, with the endocardial electrode successfully deployed in the LV septum. DISCUSSION: Here we report the first case of deployment of the WiSE-CRT endocardial electrode in the LV septum and demonstrate the technical feasibility of leadless LBBAP. Entirely leadless CRT is an attractive option for patients with venous access issues or recurrent lead complications and has previously been successful using the WiSE-CRT system and a leadless pacemaker in the right ventricle. Further studies are required to assess long-term efficacy and safety of leadless LBBAP.
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Elliott et al. (2021) conducted a case report in Cardiomyopathy requiring cardiac resynchronization therapy (n=2). Leadless left bundle branch area pacing (LBBAP) using the WiSE-CRT system was evaluated on Technical feasibility of delivering leadless LBBAP. Leadless left bundle branch area pacing using the WiSE-CRT system was technically feasible, with successful deployment of the endocardial electrode in the left ventricular septum in two patients.
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