The Lead Episode 146: Heart Rhythm 2026 Late Breaker Coverage: A Discussion of LEAP2: A First-In-Human Study of a Chronically-Implanted Novel Leadless Pacemaker for Conduction System Pacing-The Lead Episode 146 Bonus Video

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Video Summary

LEAP-2 was an early feasibility, first-in-human study of AVER CSP, a novel leadless pacemaker designed for conduction system pacing. Presented at HeartRhythm 2026 and published in HeartRhythm, the single-center Prague trial enrolled 20 patients with standard pacemaker indications. Nineteen underwent implantation attempts; 18 were successfully implanted, but 3 devices later dislodged—2 before discharge and 1 at one month—and were retrieved without complications. Despite this safety concern, device performance was stable through one month, with low capture thresholds and stable impedance and sensing. The panel emphasized that this technology is promising but still early, with important questions about true left bundle branch capture, imaging needs such as intracardiac echo, cost, and long-term stability. Overall, LEAP-2 supports feasibility of leadless conduction system pacing, while underscoring the need for more rigorous capture assessment and improved device design.

Keywords

LEAP-2

AVER CSP

leadless pacemaker

conduction system pacing

device dislodgement

HeartRhythm 2026