yo cuando lo nesesite hice esta función, que retorna el item seleciónado.
Public Function GetSelectedItem() As Long
Dim lFlags As Long
If m_hListView Then
If Me.MultiSelect Then
GetSelectedItem = SendMessage(m_hListView, LVM_GETSELECTIONMARK, 0&, 0&)
Else
lFlags = LVNI_SELECTED
If GetFocus() = m_hListView Then lFlags = lFlags Or LVNI_FOCUSED
GetSelectedItem = SendMessage(m_hListView, LVM_GETNEXTITEM, &HFFFF, ByVal lFlags)
End If
End If
End Function