HRS Congress 2026 — Dr Robert Schaller (Penn Medicine, US) presents results from the ASCEND CSP IDE Study, evaluating the safety and effectiveness of a novel stylet-driven ICD lead designed specifically for left bundle branch area pacing — a step toward establishing CSP as a viable platform for patients requiring both defibrillation therapy and physiological pacing.

This prospective, multicentre, global, single-arm pivotal study enrolled up to 414 subjects across 70 centres in the United States, Canada, Europe, and Asia Pacific. Patients indicated for de novo ICD or CRT-D implantation underwent LBBAP using the dedicated CSP ICD lead, with primary endpoints assessing freedom from lead-related serious adverse device effects at three months, composite pacing and sensing performance at the left bundle branch area, and defibrillation testing success at implant.

Interview Questions:

1. What was the rationale behind this study?
2. Can you walk us through the study design — the patient population, the implant procedure, and what the primary endpoints were measuring?
3. What were the key findings?
4. Were there any implant challenges or learning curve considerations that emerged across the participating centres?
5. What are the implications for CRT-D candidates specifically — does LBBAP with this lead offer a meaningful advance over biventricular pacing in this context?
6. What are the next steps for this technology, and what longer-term data are still needed before this becomes standard of care?

For more expert interviews, late-breaking trial coverage and device insights from HRS 2026, head to our Heart Rhythm 2026 collection page.

Recorded on-site at HRS Congress 2026, Chicago.

Editor: Jordan Rance
Videographer: David-Ben Harosh

Support: This is an independent interview produced by Radcliffe Cardiology.