VIDEO: VIDEO: Jagmeet Singh details the SOLVE-CRT study for a leadless CRT system

Jagmeet Singh, MD, professor of medicine with Harvard Medical School and founding director of the Resynchronization and Advanced Cardiac Therapeutics Program and Mass General Hospital, explained results from the SOLVE-CRT pivotal clinical trial he presented as a late-breaker at Heart Rhythm 2023. The trial was designed to see if leadless pacemaker technology can deliver cardiac resynchronization therapy (CRT) to patients who were not able to be treated with conventional CRT and epicardial leads.[1]

For many patients with heart failure, their two ventricles end up beating at different times in a dyssynchronous rhythm. The current standard of care to achieve synchrony is CRT, which uses pacing to synchronize the contraction of the right and left ventricles. However, lead-based pacemakers have known limitations and up to 30% of patients fail to benefit from this therapy. This trial was designed to address that population.

"The SOLVE-CRT trial looks at the roll of a leadless, ultrasound-based cardiac resynchronization therapy, primarily for patients who are unable to get CRT therapy, are at high risk, and also some patients who are non-responders," Singh explained. "I think this system allows more refined targeting of wherever you want to get the electrode. Also, this is endocardial pacing. Resynchronization therapy traditionally is done through the coronary sinus, which is epicardial to endocardial, so it is actually a reversal of the transmural gradient, which is non-physiological."