Key result
Conduction system pacing provides physiological cardiac activation as an alternative to conventional RVP and BiVP.
Why the study?
Conduction system pacing has seen a recent resurgence as a physiological alternative to conventional right ventricular and biventricular pacing, prompting a review of its anatomical, pathophysiological, and technical aspects.
Conduction system pacing offers a physiological alternative to conventional right ventricular and biventricular pacing by directly stimulating the His-Purkinje system.
The conduction system of the human heart is composed of specialized cardiomyocytes that initiate and propagate the electric impulse with consequent rhythmic and synchronized contraction of the atria and ventricles, resulting in the normal cardiac cycle. Although the His-Purkinje system (HPS) was already described more than a century ago, there has been a recent resurgence of conduction system pacing (CSP), where pacing leads are positioned in the His bundle region and left bundle branch area to provide physiological cardiac activation as alternatives to the unnatural myocardial stimulation obtained with conventional right ventricular and biventricular pacing. In this review, we describe the fundamental anatomical and pathophysiological aspects of the specialized HPS along with the CSP technique's nuts and bolts to highlight its potential benefits in everyday clinical practice.
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Bressi et al. (2023) conducted a review in Cardiac pacing. Conduction system pacing (CSP) vs. Conventional right ventricular and biventricular pacing was evaluated. Conduction system pacing provides physiological cardiac activation as an alternative to conventional right ventricular and biventricular pacing.
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