The European Society of Cardiology (ESC) has unveiled a landmark consensus statement on conduction system pacing (CSP), a transformative approach to treating heart rhythm disorders. Presented at the EHRA 2025 congress in Vienna and published in EP Europace, the document addresses the limitations of traditional pacing methods and offers updated guidance for healthcare professionals worldwide.
Right ventricular pacing has been the standard for managing slow heart rhythms for decades, but it can sometimes impair heart function. Though effective for certain heart failure patients, Biventricular pacing has its limitations. CSP—which targets the heart’s natural electrical pathways—has emerged as a promising alternative. The consensus highlights two key techniques: His bundle pacing (HBP), recognized in the 2021 ESC guidelines, and left bundle branch area pacing, praised for its ease of use and superior performance.
Developed by international experts and endorsed by major heart rhythm societies, the statement provides clear, evidence-based recommendations. It also incorporates patient perspectives to ensure a holistic approach. Professor Haran Burri, co-chair of the document, emphasized its significance while noting the need for further research to refine patient selection.
Professor Michael Glikson, co-chair of the consensus, stated, “CSP represents a major leap in pacing therapy. Since 2021, real-world adoption has surged, and this document will help standardize its use globally.”
The ESC consensus marks a pivotal shift in pacing therapy, offering hope for improved patient outcomes. As ongoing trials yield new data, CSP is poised to become a cornerstone of cardiac care, bridging gaps left by traditional methods.
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