Conduction system pacing “how to”: tips and tricks

Conduction system pacing (CSP), encompassing His bundle pacing (HBP) and left bundle branch area pacing (LBBAP), has emerged as a physiological pacing technique designed to activate the heart’s intrinsic conduction system. CSP is a promising alternative to traditional right ventricular pacing (RVP) for bradycardia and to biventricular pacing (BVP) for cardiac resynchronization therapy (CRT). This paper outlines key considerations for achieving successful CSP implantation, including procedural techniques, available tools, and programming strategies.