What is conduction system pacing and why is it better?

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Conventional method of permanent pacing in complete heart block involves pacing from the right ventricular apex. Though it is easy to achieve, there is a potential risk of pacing induced cardiomyopathy in the long run. That is because of left ventricular dyssynchrony. Normal sequence of activation of the left ventricle is lost. Septum is activated first and left ventricular lateral wall later. Some of those with right ventricular apical pacing may need an upgrade to cardiac resynchronization therapy. There is also an enhanced chance for heart failure hospitalization and mortality. Conduction system pacing is a pacing strategy to avoid these potential downsides of right ventricular pacing.
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Cardiology
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