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


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
Pages (from-to)1589-1600
Number of pages12
JournalJournal of Interventional Cardiac Electrophysiology
Issue number7
Early online date6 Jan 2023
Publication statusPublished - Oct 2023

Bibliographical note

Funding Information:
The Stanford REDCap platform ( is developed and operated by Stanford Medicine Research IT team. The REDCap platform services at Stanford are subsidized by (a) Stanford School of Medicine Research Office and (b) the National Center for Research Resources and the National Center for Advancing Translational Sciences, National Institutes of Health, through grant UL1 TR001085. A complete list of institutions and survey respondents contributing data to the worldwide survey on conduction system pacing is available in the supplemental material.

Publisher Copyright:
© 2022, The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.


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


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