Stylet-Driven Versus Non-Stylet-Driven Leads for Conduction System Pacing: Insights from the NCDR EP Device Registry.
Aashish, K., Archana, T., Yang, S., Daniel, K., Jiaqi, M., K, P.N.V., Birgesdotter, G.U., Rajesh, K., Rakesh, G., Dhanunjaya, L., & Douglas, D. (2026). Stylet-Driven Versus Non-Stylet-Driven Leads for Conduction System Pacing: Insights from the NCDR EP Device Registry.. Heart Rhythm. https://doi.org/10.1016/j.hrthm.2026.04.004
Aashish K, Archana T, Yang S, Daniel K, Jiaqi M, K PNV, et al. Stylet-Driven Versus Non-Stylet-Driven Leads for Conduction System Pacing: Insights from the NCDR EP Device Registry.. Heart Rhythm. 2026; doi: 10.1016/j.hrthm.2026.04.004
Aashish K, Archana T, Yang S, et al. Stylet-Driven Versus Non-Stylet-Driven Leads for Conduction System Pacing: Insights from the NCDR EP Device Registry.[J]. Heart Rhythm. 2026. DOI: 10.1016/j.hrthm.2026.04.004.
@article{aashish2026,
author = {Katapadi Aashish and Tale Archana and Song Yang and Kramer Daniel and Mi Jiaqi and Pothineni Naga Venkata K and Green Ulrika Birgesdotter and Kabra Rajesh and Gopinathannair Rakesh and Lakkireddy Dhanunjaya and Darden Douglas},
title = {Stylet-Driven Versus Non-Stylet-Driven Leads for Conduction System Pacing: Insights from the NCDR EP Device Registry.},
journal = {Heart Rhythm},
year = {2026},
doi = {10.1016/j.hrthm.2026.04.004},
note = {PMID: 41997385},
}
TY - JOUR AU - Katapadi Aashish AU - Tale Archana AU - Song Yang AU - Kramer Daniel AU - Mi Jiaqi AU - Pothineni Naga Venkata K AU - Green Ulrika Birgesdotter AU - Kabra Rajesh AU - Gopinathannair Rakesh AU - Lakkireddy Dhanunjaya AU - Darden Douglas TI - Stylet-Driven Versus Non-Stylet-Driven Leads for Conduction System Pacing: Insights from the NCDR EP Device Registry. T2 - Heart Rhythm PY - 2026 DO - 10.1016/j.hrthm.2026.04.004 AN - PMID:41997385 ER -
Conduction system pacing (CSP), including His bundle pacing (HBP) and left bundle branch area pacing (LBBAP), is a growing alternative to traditional right ventricular or biventricular pacing. The choice between stylet-driven leads (SDLs) and non-stylet-driven leads (NSDLs) remains operator-dependent, with limited comparative data. To compare characteristics and outcomes of SDLs and NSDLs for CSP using data from the National Cardiovascular Data Registry (NCDR). We analyzed 11,412 CSP implantations from April 2021 to December 2023 in the NCDR Electrophysiology Device Implant Registry. A descriptive analysis of baseline and procedural characteristics, as well as crude in-hospital outcomes, was conducted between the study groups. Additionally, in-hospital outcomes were assessed using multivariable logistic regression, accounting for the patient and hospital-level covariates. NSDLs (87.7%, n=10005) were the predominant lead type, though SDL (12.3%, n=1407) use increased significantly over time. Compared with NSDL recipients, patients receiving SDLs had higher rates of heart failure (61.6% vs. 48.6%; p<0.001) and lower LVEF (42.3% vs. 47.4%; p<0.001). Implant success was slightly higher with SDLs (98.4% vs. 96.2%; p<0.001). Overall complication rates were low and similar (2.8% vs. 2.1%; p=0.089), with no statistical differences in perforation, lead dislodgement, or mortality. Lead type was not associated with increased odds of complications or prolonged hospitalization. In this large national cohort, both SDL and NSDL leads 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.