ArticleJournal of cardiovascular electrophysiology2026
Implantation Success, Electrical Performance, and Safety of an Active Fixation Stylet-Driven Lead for LBBAP in Clinical Practice: A Multicenter Experience.
Article in Journal of cardiovascular electrophysiology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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24 authors.
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Abstract
backgroundLeft bundle branch area pacing (LBBAP) has emerged as a promising physiological pacing strategy. However, its feasibility and safety using conventional stylet-driven leads (SDL) such as INGEVITY+ remain under investigation.
objectiveTo evaluate the clinical performance, safety, and follow-up outcomes of LBBAP using the INGEVITY+ lead in a real-world electrophysiology setting.
methodsFrom 2021 to 2024, 207 consecutive patients underwent LBBAP implant attempts using the INGEVITY+ lead across 19 centers. Of these, 146 had bradycardia indications, and 61 had heart failure indications. A control group of 200 patients received standard right ventricular (RV) pacing with the same lead. Procedural outcomes, electrical parameters, complications, and mid-term lead performance were assessed.
resultsLBBAP was successfully achieved in 201 (97%) cases. Procedural and fluoroscopy times were slightly longer for LBBAP than for RV pacing. Acute complications included one helix fracture, one atrioventricular block, and one septal perforation. During a median follow-up of 9 months, no lead fractures were reported; lead dislodgment occurred in three cases. Kaplan-Meier analysis showed no significant difference in time to first lead-related complication between the LBBAP and RV pacing groups (hazard ratio: 4.69, 95%CI: 0.63-34.90, p = 0.139). Electrical performance remained stable, with 98% of retained leads maintaining capture thresholds ≤ 2 V and 92% with sensed amplitudes ≥ 5 mV.
conclusionsLBBAP using the INGEVITY + SDL is feasible and safe in clinical practice, with excellent implant success and stable mid-term electrical performance. These findings support its use as a viable conduction system pacing strategy.
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