Initial experience with stylet-driven versus lumenless lead delivery systems for left bundle branch area pacing.

Area of Science:

• Cardiology
• Electrophysiology
• Medical Devices

Background:

• Left bundle branch area pacing (LBBP) is an emerging technique for conduction system pacing.
• Limited comparative data exists for different lead delivery systems used in LBBP.

Purpose of the Study:

• To compare the success rates and outcomes of LBBP utilizing stylet-driven versus lumenless lead delivery systems.

Main Methods:

• A retrospective analysis of 83 patients undergoing LBBP was conducted.
• Patients were grouped based on the lead delivery system: stylet-driven (n=53) or lumenless (n=30).
• Procedural findings and intermediate-term lead parameters were compared between groups.

Main Results:

• Overall LBBP success rate was 77%, with no significant difference between stylet-driven (76%) and lumenless (80%) systems.
• The stylet-driven group demonstrated significantly shorter procedure times (90 min vs. 112 min) and fluoroscopy times (10 min vs. 15 min).
• Both systems showed similar acute success, QRS parameters, and low rates of complications and lead revisions.

Conclusions:

• Stylet-driven and lumenless delivery systems for LBBP exhibit comparable acute success rates.
• Further long-term follow-up is necessary to evaluate lead performance differences between these delivery systems.