Arrhythmias & electrophysiology
Safety and performance of a novel implantable cardioverter defibrillator (ICD) lead for left bundle branch area pacing: Results from the ASCEND conduction system pacing (CSP) trial
Authors' conclusion
In this pivotal IDE trial, a dedicated bipolar CSP ICD lead demonstrated high implant success, stable electrical performance, reliable defibrillation efficacy, and favorable short-term safety. Longer-term follow-up is warranted to confirm durability and sustained clinical benefit.
Study context
- Population
- Patients undergoing de novo ICD or cardiac resynchronization therapy defibrillator (CRT-D) implantationimplant attempts, 202 patients (98.5%) had successful lead implantation
- Participants
- 205 patients
- Exposure
- Compared with a pre-specified performance goal of 88% (safety) and a performance goal of 80% (effectiveness)
- Outcome
- Primary safety end point: freedom from lead-related serious adverse device effects (performance goal 88%); primary effectiveness end point: composite success rate of acceptable pacing capture threshold and R-wave sensing amplitude (performance goal 80%)
- Follow-up
- 3 months
Methodological detailsInvestigational Device Exemption (IDE)
- Investigational Device Exemption (IDE)
Main finding
As reported in the abstract
3-month major complication-free rate
97.5%
Primary effectiveness end point achieved
94.6%
Observational data: associations, not effects.
Further findings
Successful lead implantation
- Patients with successful lead implantation, of 205 implant attempts
- 202 patients (98.5%)
- Left bundle branch area pacing (LBBAP) criteria met
- 99.0%
- Among these, LBBP or likely LBBP capture criteria met
- 86.0%
Defibrillation testing success (pre-specified cohort)
- Defibrillation testing successful
- 100%
- Defibrillated with a single 20 J shock
- 92.5%
Lead electrical performance · 3 months
- Lead electrical performance remained stable through 3 months
Original publication
Safety and performance of a novel ICD lead for left bundle branch area pacing: Results from the ASCEND CSP trial. Heart Rhythm. Published 25 April 2026. doi:10.
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