What is the clinical evidence from this study?

Study design: Cohort. Population: Single-chamber ventricular pacing with preserved left ventricular ejection fraction (n=103). Intervention: Leadless pacemaker (LPM) vs. Conduction system pacing (CSP). Primary outcome: Total procedure duration (minutes) (p=0.048).

March 31, 2026Heart Rhythm O20 citationsOpen Access

Real-world comparison of conduction system pacing and helix-based leadless pacemakers in single-chamber pacing: Procedural outcomes from the PACEMAN study

BSBehnam Subin CICorinne Isenegger FMFelix Mahfoud

Key Result

Leadless pacemaker implantation was associated with a shorter total procedure duration (39 vs 45 minutes) but longer fluoroscopy time compared to conduction system pacing.

Study Design

Type

Cohort (n=103)

Multicenter

Yes

Structured PICO

Does leadless pacemaker implantation compared to conduction system pacing improve procedural outcomes and electrical performance in patients requiring single-chamber ventricular pacing with preserved LVEF?

Population

103 patients requiring single-chamber ventricular pacing with preserved left ventricular ejection fraction (LVEF)

Intervention

Leadless pacemaker (LPM) implantation (n=68)

Comparator

Conduction system pacing (CSP) (n=35)

Outcome

Procedural characteristics (procedure duration, fluoroscopy time), electrical performance (paced QRS duration), and acute complications

In patients requiring single-chamber pacing, leadless pacemakers offer shorter procedure times with 100% acute success, while conduction system pacing provides more physiological ventricular activation but with lower acute success and longer procedure times.

Main Result

Absolute Event Rate: 39% vs 45%

p-value: p=0.048

Limitations

Observational design
Modest sample size
Lack of long-term follow-up
Baseline differences in pacing indication and functional status
Potential operator-related confounding
Procedural characteristics may differ across leadless platforms, limiting generalizability

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Cite This Study

Subin et al. (Sun,) conducted a cohort in Single-chamber ventricular pacing with preserved left ventricular ejection fraction (n=103). Leadless pacemaker (LPM) vs. Conduction system pacing (CSP) was evaluated on Total procedure duration (minutes) (p=0.048). Leadless pacemaker implantation was associated with a shorter total procedure duration (39 vs 45 minutes) but longer fluoroscopy time compared to conduction system pacing.

synapsesocial.com/papers/6a025cc7edf6f481385949a2 https://doi.org/https://doi.org/10.1016/j.hroo.2026.03.010