Novel ICD Lead for Conduction System Pacing Enters the Arena

A dedicated bipolar implantable cardioverter-defibrillator (ICD) lead for conduction system pacing (CSP) performed well in a first-in-human multicenter study. Placement of the novel UltiSynq CSP ICD lead, designed for left bundle branch area (LBBA) pacing, met expectations for safety and effectiveness in over 200 patients with indications for novo ICD or cardiac resynchronization therapy defibrillator (CRT-D) implantation, according to researchers led by Robert Schaller, DO, of the Hospital of the University of Pennsylvania in Philadelphia. In these patients, the 3-month major complication-free rate was 97.5% and the primary effectiveness endpoint (a composite of acceptable pacing capture threshold and R-wave sensing amplitude) reached 94.6%, both exceeding preset goals (88% and 80%, respectively). Additionally, lead electrical performance remained stable through 3 months, Schaller told the audience at the Heart Rhythm Society annual meeting held in Chicago. These and other findings from the single-arm, pivotal ASCEND CSP investigational device exemption study were simultaneously published in Heart Rhythm. "These findings support the early safety and performance of a purpose built CSP ICD lead and demonstrate that integration of physiologic pacing into ICD systems can be achieved without compromising defibrillation reliability. Continued follow-up is essential to confirm long-term durability, electrical stability, and extractability. If sustained,