Pacing del sistema di conduzione per la terapia di resincronizzazione cardiaca: una revisione sistematica.

Biventricular pacing (BVP) remains the standard method for delivering cardiac resynchronization therapy (CRT) in patients with heart failure and left bundle branch block (LBBB). Despite its established role, BVP is a non-physiological pacing approach and is limited by factors such as anatomical constraints of the coronary sinus and a substantial proportion of non-responders. Conduction system pacing (CSP), including His bundle pacing and left bundle branch area pacing, has emerged as a more physiological alternative aimed at optimizing CRT outcomes. Early studies suggest that CSP may achieve superior electro-mechanical ventricular synchrony compared with BVP. Nevertheless, evidence from larg