Arrhythmias & electrophysiology
Procedural Success, Predictors of Failure, and Clinical Outcomes of Conduction System Pacing in Korea: The Korean Conduction System Pacing (K-CSP) Registry
Authors' conclusion
In this large-scale Asian CSP registry, LBBAP was feasible and safe, performed predominantly with stylet-driven leads. Direct conduction system capture (LBBP+LFP) was associated with a lower adjusted risk of heart-failure hospitalization than LVSP, although this was based on few events; these findings are hypothesis-generating and warrant confirmation in randomized trials.
Study context
- Population
- Patients undergoing attempted conduction system pacing (CSP) in Korea, January 2021 to June 2025consecutive patients undergoing attempted CSP
- Participants
- 2,215 patients
- Exposure
- Left ventricular septal pacing (LVSP) vs left bundle branch pacing (LBBP)+left fascicular pacing (LFP) among left bundle branch area pacing (LBBAP) patients
- Outcome
- CSP success
Methodological detailsnationwide, multicenter, 35 Korean centers, consecutive patients
- Nationwide
- Multicenter
- 35 Korean centers
- Consecutive patients
Main finding
As reported in the abstract
CSP succeeded
87.4%
1,932/2,211
Observational data: associations, not effects.
Further findings
| Outcome | Adjusted HR (95% CI) | P value | |
|---|---|---|---|
| Heart-failure hospitalization among LBBAP patients | 3.04 (1.05–8.73) | P = 0.039 | |
| 0.10.31310Adjusted hazard ratio (log scale) |
- Heart-failure hospitalization among LBBAP patients: few events, wide confidence intervals; not significant on unadjusted analysis
Capture type among LBBAP patients
- LBBP achieved, among 1,922 LBBAP patients
- 35.1%
- LFP achieved, among 1,922 LBBAP patients
- 31.3%
- LVSP achieved, among 1,922 LBBAP patients
- 17.2%
Independent predictors of CSP failure
- Prior open-heart surgery involving septal manipulation, right-sided approach, and male sex
Composite outcomes, CSP failure
- Worse composite outcomes on unadjusted analysis; attenuated and no longer significant after adjustment
Lead type
- Stylet-driven leads used
- 87.0%
Pacing parameters · 17.0±10.8 months
- Pacing parameters stable
Original publication
Procedural Success, Predictors of Failure, and Clinical Outcomes of Conduction System Pacing in Korea: The Korean Conduction System Pacing (K-CSP) Registry. Heart Rhythm. Published 23 October 2026. doi:10.
Summarised from the published abstract; every number is checked against it