Arrhythmias & electrophysiologyCohort study
Stylet-driven vs non–stylet-driven leads for conduction system pacing: Insights from the NCDR Electrophysiology Device Implant Registry
- registry analysis
- multivariable logistic regression
Authors' conclusion
In this large national cohort, both SDLs and NSDLs achieved high implant success with low complication rates. These findings support the safety and effectiveness of either lead type and suggest selection may be guided by operator preference.
Study context
- Population
- Conduction system pacing (CSP) lead implants (His bundle pacing and left bundle branch area pacing) in the National Cardiovascular Data Registry Electrophysiology Device Implant Registry, April 2021 to December 2023
- Participants
- 11,412 CSP lead implants
- Exposure
- Stylet-driven leads (SDLs) vs non-stylet-driven leads (NSDLs) for CSP
- SDLsn = 1,407
- NSDLsn = 10,005
Main finding
As reported in the abstract
Lead type use
Observational data: associations, not effects.
Further findings
Heart failure · higher with SDLs
P < 0.001
Left ventricular ejection fraction · lower with SDLs
P < 0.001
Implant success · slightly higher with SDLs
P < 0.001
Safety
Overall complications · in-hospital
P = 0.089
Overall complications · in-hospital
- No statistical differences in perforation, lead dislodgment, or mortality
- Lead type was not associated with increased odds of complications or prolonged hospitalization
Original publication
Stylet-driven vs non–stylet-driven leads for conduction system pacing: Insights from the NCDR Electrophysiology Device Implant Registry. Heart Rhythm. Published 15 April 2026. doi:10.1016/j.hrthm.2026.04.004
Summarised from the published abstract; every number is checked against it