eLym™ System: A New Frontier in Heart Failure Decongestion

The primary results of the DELTA-HF trial demonstrate that the eLym System heart failure therapy provides a safe and effective method for interstitial decongestion. Managing fluid overload is often difficult in patients with acute decompensated heart failure (ADHF). Consequently, persistent congestion remains a significant risk factor for rehospitalization. However, this innovative endovenous axial pump targets the lymphatic system directly to enhance fluid removal.

How the eLym System Heart Failure Technology Works

The system facilitates drainage by creating a localized reduced-pressure zone at the venous angle. Specifically, the device utilizes an endovenous pump to lower pressure where the thoracic duct connects to the venous system. Furthermore, this mechanism supports the natural drainage of interstitial fluid back into the circulation. This approach differs from standard diuretics, which primarily target intravascular volume.

Clinical Benefits of the eLym System Heart Failure Therapy

Notably, the trial achieved successful device deployment in all 40 participants. During the therapy period, patients lost an average of 3.6 kg. Furthermore, weight loss increased to 6.8 kg by the time of hospital discharge. Additionally, the median modified EVEREST Clinical Congestion Score improved significantly from 5.0 at baseline to 0.0 at discharge. Most importantly, kidney function remained stable throughout the treatment process.

Moreover, the study reported a low 90-day heart failure rehospitalization rate of only 9.5%. This finding is particularly encouraging compared to standard care. Consequently, the eLym system represents a promising adjunctive therapy for refractory congestion. Researchers look forward to further large-scale randomized controlled trials to confirm these benefits.

Frequently Asked Questions

What is the primary mechanism of the eLym System?

The system creates a low-pressure zone at the thoracic duct junction. This helps the lymphatic system move excess fluid from tissues into the bloodstream for excretion.

Does the eLym therapy affect renal function?

No, the DELTA-HF trial results showed that kidney function remained stable during and after the treatment. Creatinine levels and GFR did not change significantly.

What was the typical duration of the therapy?

In the trial, the mean therapy time was approximately 23.1 hours. Clinicians successfully deployed the device in every case with minimal complications.

Disclaimer: This content is for informational and educational purposes only. It does not constitute medical advice or establish a doctor-patient relationship. Professional judgment should be exercised. Refer to the latest local and national guidelines for clinical practice.

References

Nuche J et al. Safety and Feasibility of the eLymTM System for Interstitial Decongestion in Acute Decompensated Heart Failure: Primary results of the DELTA-HF trial. Eur J Heart Fail. 2026 May 10. doi: undefined. PMID: 42106950.

Biegus J, et al. Design and Rationale of the eLym™ System for Decongestion of Excess Lymphatic Fluid via the Thoracic Duct in Acute Heart Failure (DELTA-HF). ESC Heart Fail. 2024 Dec 24. doi: 10.1002/ehf2.15192.

WhiteSwell. WhiteSwell Announces New Data Supporting Acute Decompensated Heart Failure Treatment with eLym System. THT Meeting 2025.