{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,14]],"date-time":"2026-10-14T15:51:53Z","timestamp":1791993113255,"version":"4.4.0"},"reference-count":63,"publisher":"Wiley","license":[{"start":{"date-parts":[[2026,10,4]],"date-time":"2026-10-04T00:00:00Z","timestamp":1791072000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,10,4]],"date-time":"2026-10-04T00:00:00Z","timestamp":1791072000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Pacing Clinical Electrophis"],"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:p>The management of bradyarrhythmias requiring permanent pacing in pediatric patients and those with congenital heart disease (CHD) remains uniquely challenging due to continuous somatic growth, complex cardiac anatomy, limited vascular access, and long\u2010term risks associated with conventional cardiac implantable electronic devices. Traditional transvenous endocardial and surgical epicardial pacing systems are associated with high rates of lead failure, venous occlusion, infection, and ventricular dyssynchrony. Leadless pacemakers and conduction system pacing have emerged as promising alternatives that overcome many of these historical limitations. This review provides a comprehensive, updated overview of the technical principles, clinical applications, advantages, limitations, and appropriate patient selection strategies for these two innovative modalities in the pediatric and CHD population. Critical clarifications are provided regarding venous access requirements, age\u2010adjusted interpretation of QRS duration, ventricular dyssynchrony evaluation, and indications for device therapy according to pediatric\u2010specific guidelines rather than adult\u2010derived criteria. Clinical decision\u2010making is integrated into a structured framework based on age, body size, clinical symptoms, ventricular synchrony, and arrhythmic risk stratification.<\/jats:p>","DOI":"10.1111\/pace.70452","type":"journal-article","created":{"date-parts":[[2026,10,5]],"date-time":"2026-10-05T03:46:16Z","timestamp":1791171976000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Contemporary Advances of Leadless Pacing and Conduction System Pacing in Children With Congenital Heart Disease"],"prefix":"10.1111","author":[{"ORCID":"https:\/\/orcid.org\/0009-0003-3778-4021","authenticated-orcid":false,"given":"Yu\u2010Ting","family":"Xia","sequence":"first","affiliation":[{"name":"Department of Pediatrics Key Laboratory of Birth Defects and Related Diseases of Women and Children of MOE  Chengdu China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tong","family":"Liu","sequence":"additional","affiliation":[{"name":"Department of Cardiology Chengdu Integrated TCM and Western Medicine Hospital  Chengdu China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Song","family":"Yan","sequence":"additional","affiliation":[{"name":"Department of Pediatrics Key Laboratory of Birth Defects and Related Diseases of Women and Children of MOE  Chengdu China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yang","family":"Zhang","sequence":"additional","affiliation":[{"name":"Department of Pediatrics Key Laboratory of Birth Defects and Related Diseases of Women and Children of MOE  Chengdu China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jin","family":"Liu","sequence":"additional","affiliation":[{"name":"Department of Pediatrics Key Laboratory of Birth Defects and Related Diseases of Women and Children of MOE  Chengdu China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0005-3381-8495","authenticated-orcid":false,"given":"Li","family":"Wei","sequence":"additional","affiliation":[{"name":"Department of Pediatrics Key Laboratory of Birth Defects and Related Diseases of Women and Children of MOE  Chengdu China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,10,4]]},"reference":[{"key":"e_1_2_11_2_1","doi-asserted-by":"publisher","DOI":"10.1111\/jce.15664"},{"key":"e_1_2_11_3_1","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCEP.122.011447"},{"key":"e_1_2_11_4_1","doi-asserted-by":"publisher","DOI":"10.2217\/fca-2023-0112"},{"key":"e_1_2_11_5_1","doi-asserted-by":"publisher","DOI":"10.1111\/jce.16173"},{"key":"e_1_2_11_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jccase.2024.02.004"},{"key":"e_1_2_11_7_1","doi-asserted-by":"publisher","DOI":"10.1097\/MD.0000000000039718"},{"key":"e_1_2_11_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ipej.2024.09.001"},{"key":"e_1_2_11_9_1","doi-asserted-by":"publisher","DOI":"10.1111\/pace.70085"},{"key":"e_1_2_11_10_1","doi-asserted-by":"publisher","DOI":"10.1111\/jce.16261"},{"key":"e_1_2_11_11_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10840-022-01218-9"},{"issue":"2","key":"e_1_2_11_12_1","doi-asserted-by":"crossref","first-page":"ii14","DOI":"10.1093\/eurheartjsupp\/suae090","article-title":"Leadless Pacing in Young Patients","volume":"27","author":"Roberts P. 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