Congenital heart diseaseCohort study
Long-term performance of conduction system pacing in patients with congenital heart disease
- retrospective, multicenter, international study
Authors' conclusion
CSP is feasible across a broad spectrum of CHD and is associated with preservation or improvement of systemic ventricular function. Late lead-related complications are not negligible, underscoring the need for long-term follow-up.
Study context
- Population
- Patients with congenital heart disease (CHD) undergoing conduction system pacing (CSP) (His bundle pacing or left bundle branch area pacing (LBBAP)) with ≥12-month follow-uppatients included · His bundle pacing 29 · LBBAP 115
- Participants
- 144 patients
- Exposure
- His bundle pacing vs LBBAP
- His bundle pacingn = 29
- LBBAPn = 115
- Outcome
- Survival free from CSP lead-related complications (loss of conduction system capture, pacing threshold ≥2.5 V or a ≥2.0 V increase, or lead reintervention)
- Follow-up
- Median 32.2 months (interquartile range 18.2-47.1)
Main finding
As reported in the abstract
Survival free from CSP lead-related complications
0.89
CSP lead-related events occurring beyond 12 months of follow-up
88%
Observational data: associations, not effects.
Secondary outcomes
Acute implant success
- Acute implant success
- 95.1%
Microdislodgement, threshold increase, loss of conduction system capture
- Microdislodgement
- 14.6%
- Threshold increase
- 6.9%
- Loss of conduction system capture
- 5.6%
- Less frequent with LBBAP
Systemic ventricular function
- Among patients with cardiac resynchronization therapy indications, systemic ventricular function improved from 34% ± 10% to 41% ± 13%
- P < 0.001
- Left ventricular ejection fraction improved in patients with systemic left ventricle
- Patients with a systemic right ventricle preserved fractional area change
Safety
Device-related complications and reinterventions
- Device-related complications
- 11.8%
- Reinterventions
- 5.1%
Original publication
Long-term performance of conduction system pacing in patients with congenital heart disease. Heart Rhythm. Published 14 May 2026. doi:10.1016/j.hrthm.2026.05.011
Summarised from the published abstract; every number is checked against it