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Endocardial Breaching to Reduce Lead Entanglement in Conduction System Pacing

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Endocardial Breaching to Reduce Lead Entanglement in Conduction System Pacing

Professor Anand Ganesan, Flinders University

Vanguard Grant - 1 Year

Years funded: 2025 - 2025

Improving CSP pacemaker implantation: a safer, faster approach

Conduction system pacing (CSP) is a transformative new modality in pacemaker implantation that reduces heart failure, improves quality of life, and decreases mortality compared to conventional pacemaker implantation. A fundamental challenge in CSP implantation is that the pacemaker lead can be caught in the endocardium of the heart, a problem that can occur in ~40% of lead deployments. This problem, called entanglement, prolongs procedure time, increases procedural risks of complications such as lead damage, and makes the technique difficult to learn for new CSP implanting physicians. Here, we build on promising preliminary data conducted in our world-first ex-vivo model of CSP lead deployment. We have shown that a small breach (~2mm) delivered with a novel catheter, facilitates easy passage of CSP leads.

Implications for CSP lead implantation techniques globally

In this application, we aim to perform a critical large animal experiment to test the hypothesis that a small breach to the endocardial surface will facilitate easier and safer CSP lead implantation. Our project has the potential to directly improve the technique of CSP pacemaker lead implantation, to make the procedure faster, safer and more effective for patients in Australia and around the world. The project is supported by a multifaceted interdisciplinary team covering clincal and biomedical engineering expertise, in the world-class Flinders Heart Rhythm group.

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Last updated09 May 2025

Last reviewed08 May 2025