The purpose of this study is to use real-world evidence to validate that conduction system pacing (CSP), delivered via a Medtronic 3830 catheter-delivered lead and a Medtronic dual-chamber transvenous pacemaker, is a safe and effective alternative to biventricular pacing (BVP) in patients indicated for cardiac resynchronization therapy (CRT) to deliver cardiac physiologic pacing (CPP), as documented in the clinical literature.

Inclusion Criteria:

Dual-chamber CSP cohort:

• Medicare beneficiaries implanted with a Medtronic dual-chamber transvenous pacemaker on or after the study start date.
• Lead type and placement data indicating CSP.
• An indication for CRT.

BVP comparator cohort:

• Medicare beneficiaries implanted with a Medtronic biventricular pacemaker (CRT-P) on or after the study start date.

Exclusion Criteria:

Dual-chamber CSP cohort:

• Evidence of a prior CIED device.
• Less than 12 months continuous enrollment in Medicare Part A and Part B prior to implant date.
• Non-Medtronic pacemaker (unable to link to Medtronic device registration data).
• Missing lead type or placement data.
• Lead type and placement data indicating non-CSP placement.

BVP comparator cohort:

• Evidence of a prior CIED device.
• Less than 12 months continuous enrollment in Medicare Part A and Part B prior to implant date.
• Non-Medtronic pacemaker (unable to link to Medtronic device registration data).
• Missing lead type or placement data.

The study cohort will include all U.S. Medicare beneficiaries enrolled in fee-for-service Medicare implanted with a Medtronic pacemaker between January 1, 2017 and December 1, 2023.

Sharing individual participant data is not permitted under the data use agreement with the Centers for Medicare and Medicaid Services (CMS) which allows us to access the Medicare data for research purposes.