Worldwide survey on implantation of and outcomes for conduction system pacing with His bundle and left bundle branch area pacing leads

Alexander C. Perino, Paul J. Wang, Michael Lloyd, Francesco Zanon, Katsuhito Fujiu, Faizel Osman, Sem Briongos-Figuero, Toshiaki Sato, Tolga Aksu, Marek Jastrzebski, Skevos Sideris, Praveen Rao, Krzysztof Boczar, Xu Yuan-ning, Michael Wu, Narayanan Namboodiri, Rodrigue Garcia, Vikas Kataria, Jan De Pooter, Oliver PrzibilleAnil K. Gehi, Oscar Cano, Grigorios Katsouras, Binni Cai, Klaus Astheimer, Tanyanan Tanawuttiwat, Tomas Datino, Jacques Rizkallah, Mohammad Alasti, Gregory Feld, Maria Teresa Barrio-Lopez, Mark Gilmore, Sergio Conti, Satoshi Yanagisawa, Julia H. Indik, Jiangang Zou, Sandeep A. Saha, Daniel Rodriguez-Munoz, Kuan Cheng Chang, Dmitry S. Lebedev, Miguel A. Leal, Andreas Haeberlin, Alexander R.J.Dal Forno, Michael Orlov, Manuel Frutos, Pilar Cabanas-Grandio, Jonathan Lyne, Francisco Leyva, Jose Maria Tolosana, Pierre Ollitrault, Pasquale Vergara, Cristina Balla, Subodh R. Devabhaktuni, Giovanni Forleo, Konstantinos P. Letsas, Atul Verma, Jeffrey P. Moak, Abhijeet B. Shelke, Karol Curila, Edmond M. Cronin, Piotr Futyma, Elaine Y. Wan, Pietro Enea Lazzerini, Felipe Bisbal, Michela Casella, Gioia Turitto, Lawrence Rosenthal, T. Jared Bunch, Artur Baszko, Nicolas Clementy, Yong Mei Cha, Huang Chung Chen, Vincent Galand, Robert Schaller, Julian W.E. Jarman, Masahide Harada, Yong Wei, Kengo Kusano, Constanze Schmidt, Marco Antonio Arguello Hurtado, Niyada Naksuk, Tadashi Hoshiyama, Krishna Kancharla, Yoji Iida, Mashiro Mizobuchi, Daniel P. Morin, Serkan Cay, Gabriele Paglino, Tillman Dahme, Sharad Agarwal, Pugazhendhi Vijayaraman, Parikshit S. Sharma

Research output: Contribution to journalArticlepeer-review

9 Scopus citations

Abstract

Background: Adoption and outcomes for conduction system pacing (CSP), which includes His bundle pacing (HBP) or left bundle branch area pacing (LBBAP), in real-world settings are incompletely understood. We sought to describe real-world adoption of CSP lead implantation and subsequent outcomes. Methods: We performed an online cross-sectional survey on the implantation and outcomes associated with CSP, between November 15, 2020, and February 15, 2021. We described survey responses and reported HBP and LBBAP outcomes for bradycardia pacing and cardiac resynchronization CRT indications, separately. Results: The analysis cohort included 140 institutions, located on 5 continents, who contributed data to the worldwide survey on CSP. Of these, 127 institutions (90.7%) reported experience implanting CSP leads. CSP and overall device implantation volumes were reported by 84 institutions. In 2019, the median proportion of device implants with CSP, HBP, and/or LBBAP leads attempted were 4.4% (interquartile range [IQR], 1.9–12.5%; range, 0.4–100%), 3.3% (IQR, 1.3–7.1%; range, 0.2–87.0%), and 2.5% (IQR, 0.5–24.0%; range, 0.1–55.6%), respectively. For bradycardia pacing indications, HBP leads, as compared to LBBAP leads, had higher reported implant threshold (median [IQR]: 1.5 V [1.3–2.0 V] vs 0.8 V [0.6–1.0 V], p = 0.0008) and lower ventricular sensing (median [IQR]: 4.0 mV [3.0–5.0 mV] vs. 10.0 mV [7.0–12.0 mV], p < 0.0001). Conclusion: In conclusion, CSP lead implantation has been broadly adopted but has yet to become the default approach at most surveyed institutions. As the indications and data for CSP continue to evolve, strategies to educate and promote CSP lead implantation at institutions without CSP lead implantation experience would be necessary.

Original languageEnglish (US)
Pages (from-to)1589-1600
Number of pages12
JournalJournal of Interventional Cardiac Electrophysiology
Volume66
Issue number7
DOIs
StatePublished - Oct 2023

Keywords

  • Conduction system pacing
  • His bundle pacing
  • Left bundle branch area pacing

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Physiology (medical)

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