Pacing of conduction system EHRA position paper 2023

Abstract

Over the last 65 years of the history of cardiac pacing, clinical goals have changed dramatically. The definition of physiological pacing has also evolved. In recent years, there has been a lot of interest in the possibility of direct pacing the conduction system. Particular hopes are associated with direct pacing of the left bundle branch area as it is easier to obtain in comparison to His bundle pacing, does not require advanced electrophysiological systems, and the electrical parameters of the lead are similar to those obtained during classic right ventricular pacing. This year, the EHRA consensus has been published, which introduces definitions of the pacing of specific levels of the conduction system, discusses in detail the technique of the procedure, and requirements for the team and the centre and also provides criteria for obtaining effective pacing. Presents a proposal for the configuration of the pacemaker sockets and lists the most common complications of the procedure. The current paper presents selected definitions and criteria of obtaining effective pacing of the left bundle branch area.