A simpler heart device works as well as the standard three-wire option for heart failure patients

People with heart failure often need special devices to keep their heart beating in rhythm. The standard option uses three wires, but a new two-wire version might do the same job with fewer complications. This trial tested that idea in 636 patients across 23 Italian sites. Everyone had standard heart failure treatment and a resting heart rate of at least 45 beats per minute. One group got the two-wire device that senses the heart but does not pace it. The other group got the standard three-wire device that both senses and paces the heart. The main goal was to see if the simpler device was safe and effective for one year. The results showed the two-wire device was noninferior to the standard version. This means it performed just as well in preventing death, heart attacks, or hospital stays. Both groups also had similar improvements in heart function and walking distance. The simpler device actually caused fewer problems with the wires inside the heart. Only one patient in the two-wire group needed a standard wire added later. The study confirms that a less invasive option can work for many patients without losing safety or effectiveness.