Conduction System Pacing: The future of pacing?
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Conduction system pacing (CSP) is a novel method of cardiac pacing that uses the heart’s own conduction system to enable efficient, physiological ventricular activation (1,2).
Right ventricular pacing (RVP) and biventricular pacing (BVP) are the known conventional pacing methods. In RVP, by the nature of lead placement, inter-ventricular dysynchrony is introduced. In patients with left bundle branch block (LBBB) and severe left ventricular dysfunction, dysynchrony is particularly deleterious, and so a left ventricular lead is added in an endeavour to overcome this dysynchrony (3–5).
Conduction system pacing, through careful placement of the lead in the His-bundle or the left bundle area (LBA), provides an alternative to overcome inter-ventricular dysynchrony through physiological activation (5,6).