Two-year follow-up of the safety and clinical outcomes of stylet-driven leads for left bundle branch area pacing compared with right ventricular pacing in the Medicare population
Bibliographic record
Abstract
BACKGROUND: Stylet-driven leads have been increasingly used for left bundle branch area pacing (LBBAP). The long-term outcomes associated with LBBAP by stylet-driven leads have not been reported in a large cohort. OBJECTIVE: The purpose of this study was to compare the safety and clinical outcomes of stylet-driven leads placed at LBBAP vs right ventricular pacing (RVP) locations in dual-chamber (DC) pacemaker patients using large real-world data. METHODS: Medicare Fee-for-Service claims and Abbott device registration databases were linked to identify patients who had de novo DC pacemaker implants with the Tendril STS or UltiPace leads (Abbott, Abbott Park, IL) from January 1, 2020, to June 30, 2024, at LBBAP or RVP locations. The unadjusted and propensity score overlap weight-adjusted rates of complications, reinterventions, heart failure hospitalizations (HFHs), incident HFHs, and all-cause mortality at 2 years post-implantation were compared between the 2 groups. RESULTS: A total of 2341 patients with LBBAP and 68,241 patients with RVP were identified. There was no difference in the rates of 30-day acute complications (hazard ratio [HR] 1.01; P = .95), chronic complications (HR 0.92; P = .51), or reinterventions (HR 0.76; P = .06) at 2 years between patients with LBBAP and RVP. The LBBAP group experienced significantly lower rates of HFHs (HR 0.72; P = .015), incident HFHs (HR 0.54; P = .04), and all-cause mortality (HR 0.64; P < .0001) at 2 years than did the RVP group. CONCLUSION: DC pacemaker patients with LBBAP using Tendril STS or UltiPace stylet-driven leads experienced significantly lower rates of HFH and all-cause mortality, with similarly low complication rates compared with RVP over 2 years of follow-up in this large Medicare population.
Fetched live from OpenAlex and de-inverted. Abstracts are not stored in this database: the inverted indexes are 8.6 GB of the frame’s 9.3 GB of text, and the host has 13 GB free.
How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.004 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.001 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.000 | 0.001 |
| Research integrity | 0.000 | 0.001 |
| Insufficient payload (model declined to judge) | 0.001 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".