Why the study?
Cardiac physiologic pacing has emerged as a strategy that may mitigate or prevent heart failure, warranting guidance on indications, patient selection, procedures, and management.
Provides updated clinical practice guidelines on cardiac physiologic pacing (CRT and CSP) for avoiding and mitigating heart failure.
Supports physiologic pacing to reduce heart failure risk in high ventricular pacing patients; extends prior guidelines with CRT and CSP options.
Cardiac physiologic pacing (CPP), encompassing cardiac resynchronization therapy (CRT) and conduction system pacing (CSP), has emerged as a pacing therapy strategy that may mitigate or prevent the development of heart failure (HF) in patients with ventricular dyssynchrony or pacing-induced cardiomyopathy. This clinical practice guideline is intended to provide guidance on indications for CRT for HF therapy and CPP in patients with pacemaker indications or HF, patient selection, pre-procedure evaluation and preparation, implant procedure management, follow-up evaluation and optimization of CPP response, and use in pediatric populations. Gaps in knowledge, pointing to new directions for future research, are also identified.
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Chung et al. (2023) conducted a review in Heart failure, ventricular dyssynchrony, and pacing-induced cardiomyopathy. Cardiac physiologic pacing (CRT, HBP, LBBAP) vs. Right ventricular pacing was evaluated. Cardiac physiologic pacing, encompassing cardiac resynchronization therapy and conduction system pacing, is recommended to mitigate or prevent heart failure in patients requiring substantial ventricular pacing.
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