Achieving Cardiac Resynchronization Through Conduction System Pacing: The Sky is the Limit?-Achieving Cardiac Resynchronization Through Conduction System Pacing: The Sky is the Limit?

Achieving Cardiac Resynchronization Through Conduction System Pacing: The Sky is the Limit?

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Video Summary

In a session co-chaired by Dr. Mondeser and Dr. Zanon, experts debated the efficacy of conduction system pacing (CSP) versus cardiac resynchronization therapy (CRT) in heart failure patients. Dr. Neeraj from the Cleveland Clinic argued that CSP could potentially replace CRT, citing the evolution of pacing technologies and consistent positive outcomes in recent trials. He highlighted the physiological advantages and safety of CSP, suggesting it can lead to improved patient outcomes, fewer complications, and significant advances in technologies like leadless pacing.<br /><br />Conversely, Dr. Judith Mackel defended the use of CRT, stressing its robust evidence base from multiple large randomized controlled trials supporting its efficacy in reducing mortality and heart failure hospitalizations. She raised concerns about the technical challenges, complications, and long-term performance data for CSP, noting that CRT remains a reliable option, especially in complex cases. The session considered the need for further research and nuanced guidelines, concluding that while CSP shows promise, it should complement rather than replace CRT, particularly in established indications. The discussion also emphasized the importance of training in both approaches to allow for tailor-made patient care.

Keywords

conduction system pacing

cardiac resynchronization therapy

heart failure

CSP vs CRT

pacing technologies

leadless pacing

randomized controlled trials

patient outcomes

training