Conduction System Pacing: Emerging Concepts and Future Directions

Conduction system pacing (CSP) is transforming the paradigm of cardiac electrophysiology by directly engaging the native conduction pathways, offering a more physiological alternative to traditional right atrial appendage, right ventricular, and biventricular pacing. As evidence grows regarding the limitations of conventional pacing, including suboptimal electrical synchrony and subsequent adverse cardiac remodeling, innovative CSP techniques such as His bundle pacing (HBP), left bundle branch area pacing (LBBAP), and emerging modalities like atrial septal and Bachmann’s bundle pacing are gaining significant clinical traction. These novel approaches promise improved ventricular activation, superior electrical resynchronization, and enhanced clinical outcomes across diverse patient populations. This Research Topic seeks to advance the field by addressing critical gaps in knowledge and practice related to CSP. We invite contributions that enhance understanding of underlying electrophysiological mechanisms, refine implantation techniques, integrate advanced procedural imaging and mapping strategies, and provide robust clinical evidence for the long-term efficacy and safety of CSP. Additionally, this Topic aims to explore optimal patient selection, device programming, and complication management, as well as the application of CSP in special populations such as heart failure, atrial fibrillation, or congenital heart disease. We welcome a broad range of manuscript types, including original research, comprehensive reviews, clinical trial protocols, case series, expert perspectives, and technology reports. Potential themes include, but are not limited to:• Innovative CSP implantation and mapping techniques;• Evaluation of electrical synchrony and resynchronization;• Patient-tailored device optimization;• Outcome data in unique patient cohorts.By fostering collaboration and sharing new insights, this Topic aims to elucidate the future directions and clinical potential of conduction system pacing. Topic editors: Shengjie Wu, Xiaohan Fan, Lan Su, Xiao Chen Source: https://www.frontiersin.org/research-topics/72425/conduction-system-pacing-emerging-concepts-and-future-directions