Key result
Conduction system pacing provides a physiological alternative to BiV CRT by correcting bundle branch block.
Why the study?
Many factors contribute to the failure of conventional CRT with biventricular pacing, including coronary anatomy and an inability to stimulate diseased tissue.
Conduction system pacing is highlighted as an evolving physiological alternative to overcome the limitations of conventional biventricular CRT.
Answers are grounded in this paper and cite their sources.
Should not yet change CRT practice; leaves open need for RCTs versus biventricular pacing.
There are many factors contributing to the failure of conventional CRT with biventricular pacing, including coronary anatomy and an inability to stimulate diseased tissue. In this paper, we review evolving conduction system pacing (CSP), a physiological alternative to conventional CRT. CSP allows correction of bundle branch block and provides new opportunities to address multiple limitations of conventional CRT. Further studies are required to determine how the techniques are best applied in specific clinical situations.
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Herweg et al. (2025) conducted a review in Heart failure requiring cardiac resynchronization therapy. Conduction system pacing (His bundle pacing and left bundle branch area pacing) vs. Conventional biventricular pacing was evaluated. Conduction system pacing provides a physiological alternative to conventional biventricular pacing for cardiac resynchronization therapy by allowing correction of bundle branch block.
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