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. 2022 Mar 15:9:823797.
doi: 10.3389/fcvm.2022.823797. eCollection 2022.

WiSE CRT Is Beneficial for Heart Failure Patients as a Rescue Therapy: Evidence From a Meta-Analysis

Jiehui Cang  1 , Yaowu Liu  1 , Didi Zhu  1 , Shangshang Liu  1 , Junxian Shen  1 , Hongyu Miao  1 , Qianxing Zhou  1 , Long Chen  1
Affiliations

WiSE CRT Is Beneficial for Heart Failure Patients as a Rescue Therapy: Evidence From a Meta-Analysis

Jiehui Cang et al. Front Cardiovasc Med. .

Abstract

Background: Leadless endocardial left ventricular (LV) pacing resynchronization therapy is a novel solution for patients with heart failure (HF) in whom conventional cardiac resynchronization therapy (CRT) failed.

Methods: PubMed and the Cochrane Library were searched for relevant cohort studies. Clinical outcomes of interest such as ejection fraction (EF), QRS duration (QRSd), and left ventricular end-systolic volume (LVESV) were extracted and analyzed.

Results: Five studies involving 175 HF patients for WiSE CRT were included, and patients were followed-up for 6 months. The implanted success rate ranged from 76.5 to 100%. WiSE CRT resulted in significantly narrower QRSd [mean difference (MD): -38.21 ms, 95% confidence interval (CI): -44.36 to -32.07, p < 0.001], improved left ventricular ejection fraction (MD: 6.07%, 95% CI: 4.43 to 7.71, I2 = 0%, p < 0.001), reduced left ventricular end-systolic volume (MD: -23.47 ml, 95% CI: -37.18 to -9.13, p < 0.001), and reduced left ventricular end-diastolic volume (MD: -24.02 ml, 95% CI: -37.01 to -11.03, p = 0.02).

Conclusion: Evidence from current studies suggests that leadless endocardial LV pacing resynchronization is effective for HF patients who failed conventional CRT or needed a device upgrade, and it may be an interesting rescue therapy.

Keywords: CRT; WiSE system; endocardial pacing; heart failure; leadless cardiac pacing.

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Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

Figure 1
Figure 1
Flowchart of database search and study identification.
Figure 2
Figure 2
Forest plots for the meta-analysis. (A) QRSd, (B) LVEDV, (C) LVESV, and (D) LVEF.
Figure 3
Figure 3
Funnel plots for the meta-analysis. (A) QRSd, (B) LVEDV, (C) LVESV, and (D) LVEF.
See this image and copyright information in PMC

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