Special Collections

Conduction System Pacing: A Fresh Look

Guest Editors: Pugazhendhi Vijayaraman and Weijian Huang 

Conduction system pacing (CSP) has evolved over the last two decades. While His bundle pacing (HBP) appeared promising and gained significant momentum, the emergence of left bundle branch area pacing (LBBAP) has accelerated the pace of CSP adoption worldwide. The development of new sets of tools and modification of existing leads and investments by device manufacturers has allowed more rapid use of this technique across the entire spectrum of implanters. Moreover, CSP has demonstrated the feasibility and benefits not only in bradycardia patients but also in patients requiring CRT.

In this special collection, we hope to explore the role of HBP in the era of LBBAP, review new clinical evidence and offer glimpses into its future. With mounting evidence for use in CRT, we hope to explore the value of CSP and define its role in this space. LBBB associated cardiomyopathy may need to be better classified to identify those likely to completely normalize as in LBBB induced cardiomyopathy is often a retrospective diagnosis. Additionally, the availability and increasing experience in stylet-driven leads has created new opportunities and challenges in performing CSP.  Describing best-practice approaches to perform CSP using these leads will help readers expand their application for more patients. Long-term adverse effects of right ventricular pacing can be pronounced in children and those with congenital heart disease. CSP in congenital heart disease can be challenging. Detailed description of innovative ways to achieve CSP in this population can be helpful for new implanters. Lastly, CSP is not without challenges. Understanding its limitations, anticipating, and managing unusual complications and troubleshooting is essential to establishing a successful conduction system pacing programme. 

We believe the collection of these review articles by experienced authors will help enrich the literature and offer more resources for both novice and experienced implanters of CSP.

LB-NICM: New Approach

Published:

25 September 2024

Citation:

Arrhythmia & Electrophysiology Review 2024;13:e15.

SDLs or LLLs for CSP

Published:

13 September 2024

Citation:

Arrhythmia & Electrophysiology Review 2024;13:e14.

Conduction System Pacing in Children and Congenital Heart Disease

Published:

07 November 2024

Citation:

Arrhythmia & Electrophysiology Review 2024;13:e19.