Conduction System Pacing

While the concept of Conduction System Pacing or CSP is not new, its successful use and adoption is. CSP involves the permanent implantation of wires or leads, like those used in a traditional pacemaker, in various areas of the heart’s electrical signal conduction pathways. Known as His Bundle Pacing (HBP) and Left Bundle Branch Pacing (LBBP), these pacing techniques address some of the biggest concerns of Cardiac Resynchronization Therapy or CRT with biventricular pacing (Pacemaker). Research shows that CSP offers clinically significant benefits over traditional pacing of the right ventricle for many heart failure patients and those with conduction disorders.

Understanding conduction system pacing is important, and learning more about how a heartbeat is generated is essential. The heart’s electrical signal starts in the SA node in the heart’s right atrium. This triggers the contraction of the atria. The signal must then travel to the lower chambers of the heart or the ventricles through what is known as the AV node. Issues with this conduction area are a common cause of ventricular arrhythmias and related dysfunction. Over time, these issues can cause heart failure and pacing issues.

Until recently, the gold standard and treatment for these conduction issues had been cardiac resynchronization therapy CRT and biventricular pacing with a traditional pacemaker or a leadless pacemaker. While CRT effectively reduces some of the symptoms associated with heart failure, there’s always room for improvement.

This is one of the most exciting topics in electrophysiology research and technology and technique that Dr. Moretta has embraced wholeheartedly. As a leader in this emerging subfield, Dr. Moretta proctors EPs from around the country who fly into Sarasota to better understand best practices in CSP.