BACKGROUND: Adoption and outcomes for conduction system pacing (CSP), which includes His bundle pacing (HBP) or left bundle branch area pacing (LBBAP), in real-world settings are incompletely understood. We sought to describe real-world adoption of CSP lead implantation and subsequent outcomes. METHODS: We performed an online cross-sectional survey on the implantation and outcomes associated with CSP, between November 15, 2020, and February 15, 2021. We described survey responses and reported HBP and LBBAP outcomes for bradycardia pacing and cardiac resynchronization CRT indications, separately. RESULTS: The analysis cohort included 140 institutions, located on 5 continents, who contributed data to the worldwide survey on CSP. Of these, 127 institutions (90.7%) reported experience implanting CSP leads. CSP and overall device implantation volumes were reported by 84 institutions. In 2019, the median proportion of device implants with CSP, HBP, and/or LBBAP leads attempted were 4.4% (interquartile range [IQR], 1.9-12.5%; range, 0.4-100%), 3.3% (IQR, 1.3-7.1%; range, 0.2-87.0%), and 2.5% (IQR, 0.5-24.0%; range, 0.1-55.6%), respectively. For bradycardia pacing indications, HBP leads, as compared to LBBAP leads, had higher reported implant threshold (median [IQR]: 1.5 V [1.3-2.0 V] vs 0.8 V [0.6-1.0 V], p = 0.0008) and lower ventricular sensing (median [IQR]: 4.0 mV [3.0-5.0 mV] vs. 10.0 mV [7.0-12.0 mV], p < 0.0001). CONCLUSION: In conclusion, CSP lead implantation has been broadly adopted but has yet to become the default approach at most surveyed institutions. As the indications and data for CSP continue to evolve, strategies to educate and promote CSP lead implantation at institutions without CSP lead implantation experience would be necessary.

1st Affiliated Hospital of Nanjing Medical University Jiangsu Provincial Hospital Nanjing China

Ankara City Hospital Ankara Turkey

ARNAS Civico Hospital Palermo Italy

Aston University Birmingham UK

Azienda Ospedaliera Universitaria Senese Siena Italy

Azienda Ospedaliero Universitaria Di Ferrara Cona Italy

Baylor University Medical Center Dallas USA

Beacon Hospital Dublin Ireland

Bern University Hospital Bern Switzerland

Caen University Hospital Caen France

Cardioangiologic Centre Bethanien Frankfurt Germany

Cardiocenter 3Rd Faculty of Medicine Charles University Prague Czechia

Center for Academic Medicine Department of Medicine Division of Cardiovascular Medicine Stanford University School of Medicine 453 Quarry Road Palo Alto CA 94304 USA

Centro de Investigaciones Biomédicas en RED en Enfermedades Cardiovasculares Madrid Spain

Children's National Hospital Washington D C USA

China Medical University Hospital Taichung Taiwan

Columbia University New York NY USA

Emory University School of Medicine Atlanta USA

Ente Ecclesiastico Ospedale Miulli Acquaviva Delle Fonti BA Italy

Fujita Health University Toyoake Japan

Geisinger Heart Institute Danville USA

Hippokration General Hospital Athens Greece

Holy Family Hospital New Delhi India

Hospital Alvaro Cunqueiro Vigo Spain

Hospital Clínic de Barcelona Universitat de Barcelona Barcelona Spain

Hospital General Universitario Gregorio Marañon Madrid Spain

Hospital HM Monteprincipe Madrid Spain

Hospital of the University of Pennsylvania Philadelphia USA

Hospital Salud Integral Managua Nicaragua

Hospital Universitari 1 Politècnic La Fe Valencia Spain

Hospital Universitario Infanta Leonor Madrid Spain

Hospital Universitario Virgen del Rocío Seville Spain

IRCCS San Raffaele Hospital Segrate Italy

Kaohsiung Chang Gung Memorial Hospital Kaohsiung Taiwan

Kobari General Hospital Noda Japan

Krannert Institute of Cardiology Indiana University Avon IN USA

Krishna Institute of Medical Sciences Karad India

Kumamoto University Hospital Kumamoto Japan

Kyorin University School of Medicine Mitaka Japan

Kyoto Katsura Hospital Kyoto Japan

Lewis Katz School of Medicine at Temple University Philadelphia USA

Lifespan Cardiovascular Institute Brown University Providence USA

Marche Polytechnic University Ancona Italy

Mayo Clinic Rochester USA

Medical College University of Rzeszów Rzeszów Poland

Monash Health Melbourne Australia

Nagoya University Graduate School of Medicine Nagoya Japan

National Cerebral and Cardiovascular Center Suita Japan

National Medical Research Center VA Almazov Saint Petersburg Russia

New York Presbyterian Brooklyn Methodist Hospital New York NY USA

Ochsner Medical Center New Orleans USA

Onassis Cardiac Surgery Center Kallithea Greece

Oregon Heart Center Salem USA

Ospedale Luigi Sacco Milan Italy

Poznań University of Medical Sciences Poznań Poland

Princess of Wales Hospital Bridgend UK

Queen Elizabeth Hospital Birmingham UK

Royal Brompton Hospital London UK

Royal Papworth Hospital NHS Trust Cambridge UK

Rush University Medical Center Chicago USA

San Raffaele Scientific Institute Segrate Italy

Santa Maria Della Misericordia General Hospital Perugia Italy

School of Mdeicine Jagiellonian University Krakow Poland

School of Medicine and Public Health University of Wisconsin Madison USA

School of Medicine China Medical University Taichung Taiwan

Shanghai General Hospital Shanghai China

SOS Cardio Cardiology Hospital Center Florianópolis Brazil

Southlake Regional Health Centre Newmarket Canada

Sree Chitra Institute for Medical Sciences and Technology Thiruvananthapuram India

St Joseph's Heart Rhythm Center Rzeszów Poland

Steward St Elizabeth's Medical Center Boston USA

The John Paul 2 Hospital Krakow Poland

The University of Tokyo Tokyo Japan

UMass Memorial Health Cancer Center Worcester USA

Universitätsklinikum Ulm Ulm Germany

University Hospital Coventry Conventry UK

University Hospital Freiburg Freiburg Germany

University Hospital Germans Trias 1 Pujol Barcelona Spain

University Hospital Ghent Ghent Belgium

University Hospital Heidelberg Heidelberg Germany

University Hospital October 12 Madrid Spain

University Hospital of Poitiers Poitiers France

University Hospital of Rennes Rennes France

University of Arizona College of Medicine Tucson USA

University of Arkansas Medical Sciences Little Rock USA

University of Calgary Calgary Canada

University of California San Diego Health System San Diego USA

University of Nebraska Medical Center Omaha USA

University of North Carolina School of Medicine Chapel Hill USA

University of Pittsburgh Pittsburgh USA

University of Siena Siena Italy

University of Tours Tours France

University of Utah School of Medicine Salt Lake City USA

West China Hospital Sichuan University Chengdu China

Xiamen Cardiovascular Hospital Xiamen China

Yeditepe University Hospital Istanbul Turkey

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J Interv Card Electrophysiol. 2023 Oct;66(7):1545-1546. doi: 10.1007/s10840-023-01490-3. PubMed

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