Leadless ultrasound-based LV endocardial pacing for CRT: systematic review and meta-analysis.

BACKGROUND

The purpose of the study was to appraise and compare cardiac resynchronization therapy (CRT) employing leadless left ventricular endocardial pacing (LVEP) with an ultrasound transmitter.

METHODS

The meta-analysis employed continuous random or fixed effect models to get mean difference (MD) with 95% confidence intervals (CIs). 6 papers with a total of 272 subjects, available between 2014 and 2022, were included in this meta-analysis from a search in PubMed, Cochrane Library, Google Scholar, OVID, and Embase databases.

RESULTS

Follow-up New York Heart Association had a significantly lower mean reduction in New York Heart Association functional class (MD, -0.44; 95% CI, -0.68 - -0.19,  < 0.001) with high heterogeneity (I = 77%) compared to baseline New York Heart Association in subjects with dyssynchronous heart failure. Also, follow-up left ventricular ejection fraction had a significantly higher mean increase in left ventricular ejection fraction (MD, 5.65; 95% CI, 3.99–7.31,  < 0.001) with no heterogeneity (I = 3%) compared to baseline left ventricular ejection fraction in subjects with dyssynchronous heart failure.

CONCLUSIONS

Leadless LVEP works well for CRT, so it can be used as a second-line treatment for people who can’t get normal CRT or it hasn’t worked for them. As the safety profile gets better, more people will be able to get this medicine for these patients. However, given that most of the studies comprised a small sample size of all the selected studies and a pre-post design, attention should be given to their values.

SUPPLEMENTARY INFORMATION

The online version contains supplementary material available at 10.1186/s12872-025-04965-5.