{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,5]],"date-time":"2026-10-05T15:39:14Z","timestamp":1791214754356,"version":"4.1.0"},"reference-count":59,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2023,3,24]],"date-time":"2023-03-24T00:00:00Z","timestamp":1679616000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Physiol."],"abstract":"<jats:p>Conduction system pacing (CSP) has evolved rapidly to become the pacing method of choice for many adults with structurally normal hearts. Studies in this population have repeatedly demonstrated superior hemodynamics and outcomes compared to conventional pacing with the recruitment of the native conduction system. Children and patients with congenital heart disease (CHD) are also likely to benefit from CSP but were excluded from original trials. However, very recent studies have begun to demonstrate the feasibility and efficacy of CSP in these patients, with growing evidence that some outcomes may be superior in comparison to conventional pacing techniques. Concerns regarding the technical challenges and long-term lead parameters of His Bundle Pacing (HBP) have been overcome to many extents with the development of Left Bundle Branch Area Pacing (LBBAP), and both techniques are likely to play an important role in pediatric and CHD pacing in the future. This review aims to assimilate the latest developments in CSP and its application in children and CHD patients.<\/jats:p>","DOI":"10.3389\/fphys.2023.1154629","type":"journal-article","created":{"date-parts":[[2023,3,24]],"date-time":"2023-03-24T01:07:55Z","timestamp":1679620075000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":25,"title":["Conduction system pacing in pediatric and congenital heart disease"],"prefix":"10.3389","volume":"14","author":[{"given":"Henry","family":"Chubb","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Douglas","family":"Mah","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anne M.","family":"Dubin","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jeremy","family":"Moore","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2023,3,24]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"408","DOI":"10.1136\/thx.38.6.408","article-title":"The surgical anatomy of the conduction tissues","volume":"38","author":"Anderson","year":"1983","journal-title":"Thorax"},{"key":"B2","doi-asserted-by":"publisher","first-page":"98","DOI":"10.1016\/j.jelectrocard.2021.05.014","article-title":"Three-dimensional mapping for His-bundle pacing in pediatric patients, a case series","volume":"67","author":"Bury","year":"2021","journal-title":"J. Electrocardiol."},{"key":"B3","doi-asserted-by":"publisher","first-page":"2692","DOI":"10.1111\/jce.15213","article-title":"Safety and feasibility of conduction system pacing in patients with congenital heart disease","volume":"32","author":"Cano","year":"2021","journal-title":"J. Cardiovasc Electrophysiol."},{"key":"B4","doi-asserted-by":"publisher","first-page":"645947","DOI":"10.3389\/fcvm.2021.645947","article-title":"Procedure-related complications of left bundle branch pacing: A single-center experience","volume":"8","author":"Chen","year":"2021","journal-title":"Front. Cardiovasc Med."},{"key":"B5","doi-asserted-by":"publisher","first-page":"902","DOI":"10.1016\/j.jacc.2022.05.053","article-title":"Impact and modifiers of ventricular pacing in patients with single ventricle circulation","volume":"80","author":"Chubb","year":"2022","journal-title":"J. Am. Coll. Cardiol."},{"key":"B6","doi-asserted-by":"publisher","first-page":"e007925","DOI":"10.1161\/CIRCEP.119.007925","article-title":"Impact of cardiac resynchronization therapy on heart transplant-free survival in pediatric and congenital heart disease patients","volume":"13","author":"Chubb","year":"2020","journal-title":"Circ. Arrhythm. Electrophysiol."},{"key":"B7","doi-asserted-by":"publisher","first-page":"751","DOI":"10.1586\/14779072.2014.914434","article-title":"Tachyarrhythmias and catheter ablation in adult congenital heart disease","volume":"12","author":"Chubb","year":"2014","journal-title":"Expert Rev. Cardiovasc. Ther."},{"key":"B8","doi-asserted-by":"publisher","first-page":"522","DOI":"10.1016\/j.jacep.2020.09.015","article-title":"Permanent His bundle pacing in patients with congenital complete heart block: A multicenter experience","volume":"7","author":"Dandamudi","year":"2021","journal-title":"JACC Clin. Electrophysiol."},{"key":"B9","doi-asserted-by":"publisher","first-page":"869","DOI":"10.1161\/01.cir.101.8.869","article-title":"Permanent, direct his-bundle pacing: A novel approach to cardiac pacing in patients with normal his-purkinje activation","volume":"101","author":"Deshmukh","year":"2000","journal-title":"Circulation"},{"key":"B10","doi-asserted-by":"publisher","first-page":"1974","DOI":"10.1016\/j.hrthm.2022.07.017","article-title":"Feasibility of leadless left ventricular septal pacing with the WiSE-CRT system to target the left bundle branch area: A porcine model and multicenter patient experience","volume":"19","author":"Elliott","year":"2022","journal-title":"Heart Rhythm."},{"key":"B11","doi-asserted-by":"crossref","first-page":"71","DOI":"10.1093\/europace\/euab232","article-title":"ESC Guidelines on cardiac pacing and cardiac resynchronization therapy","volume":"24","author":"Glikson","year":"2021","journal-title":"Europace"},{"key":"B12","doi-asserted-by":"publisher","DOI":"10.1007\/s00246-022-02942-9","article-title":"Conduction system pacing in pediatrics and congenital heart disease, a single center series of 24 patients","author":"Gordon","year":"2022","journal-title":"Pediatr. Cardiol."},{"key":"B13","doi-asserted-by":"publisher","first-page":"1719","DOI":"10.1093\/europace\/eux380","article-title":"Arrhythmias in congenital heart disease: A position paper of the European heart rhythm association (EHRA), association for European paediatric and congenital Cardiology (AEPC), and the European society of Cardiology (ESC) working group on grown-up congenital heart disease, endorsed by HRS, PACES, APHRS, and SOLAECE","volume":"20","author":"Hernandez-Madrid","year":"2018","journal-title":"Europace"},{"key":"B14","doi-asserted-by":"publisher","first-page":"1791","DOI":"10.1016\/j.hrthm.2019.06.016","article-title":"A beginner's guide to permanent left bundle branch pacing","volume":"16","author":"Huang","year":"2019","journal-title":"Heart Rhythm."},{"key":"B15","doi-asserted-by":"publisher","first-page":"1736 e1","DOI":"10.1016\/j.cjca.2017.09.013","article-title":"A novel pacing strategy with low and stable output: Pacing the left bundle branch immediately beyond the conduction block","volume":"33","author":"Huang","year":"2017","journal-title":"Can. J. Cardiol."},{"key":"B16","doi-asserted-by":"publisher","first-page":"613","DOI":"10.1161\/CIRCULATIONAHA.112.115428","article-title":"Permanent cardiac pacing in children: Choosing the optimal pacing site: A multicenter study","volume":"127","author":"Janou\u0161ek","year":"2013","journal-title":"Circulation"},{"key":"B17","doi-asserted-by":"publisher","first-page":"40","DOI":"10.1093\/europace\/euab164","article-title":"The V6-V1 interpeak interval: A novel criterion for the diagnosis of left bundle branch capture","volume":"24","author":"Jastrzebski","year":"","journal-title":"Europace"},{"key":"B18","doi-asserted-by":"publisher","first-page":"4161","DOI":"10.1093\/eurheartj\/ehac445","article-title":"Left bundle branch area pacing outcomes: The multicentre European MELOS study","volume":"43","author":"Jastrzebski","year":"","journal-title":"Eur. Heart J."},{"key":"B19","doi-asserted-by":"publisher","first-page":"485","DOI":"10.1111\/jce.14352","article-title":"Programmed deep septal stimulation: A novel maneuver for the diagnosis of left bundle branch capture during permanent pacing","volume":"31","author":"Jastrzebski","year":"2020","journal-title":"J. Cardiovasc Electrophysiol."},{"key":"B20","doi-asserted-by":"publisher","first-page":"2011","DOI":"10.1111\/j.1540-8159.1992.tb03012.x","article-title":"Septal his-purkinje ventricular pacing in canines: A new endocardial electrode approach","volume":"15","author":"Karpawich","year":"1992","journal-title":"Pacing Clin. Electrophysiol."},{"key":"B21","doi-asserted-by":"publisher","first-page":"856","DOI":"10.1093\/eurheartj\/ehu304","article-title":"Effect of right ventricular pacing lead site on left ventricular function in patients with high-grade atrioventricular block: Results of the protect-pace study","volume":"36","author":"Kaye","year":"2015","journal-title":"Eur. Heart J."},{"key":"B22","doi-asserted-by":"publisher","first-page":"e102","DOI":"10.1016\/j.hrthm.2014.05.009","article-title":"PACES\/HRS expert consensus statement on the recognition and management of arrhythmias in adult congenital heart disease","volume":"11","author":"Khairy","year":"2014","journal-title":"Heart Rhythm."},{"key":"B23","doi-asserted-by":"publisher","first-page":"741","DOI":"10.1016\/j.ccep.2021.06.009","article-title":"Pacing-induced cardiomyopathy","volume":"13","author":"Khurshid","year":"2021","journal-title":"Card. Electrophysiol. Clin."},{"key":"B24","doi-asserted-by":"publisher","first-page":"2272","DOI":"10.1016\/j.hrthm.2016.09.027","article-title":"Incidence and predictors of right ventricular pacing-induced cardiomyopathy in patients with complete atrioventricular block and preserved left ventricular systolic function","volume":"13","author":"Kiehl","year":"2016","journal-title":"Heart Rhythm."},{"key":"B25","doi-asserted-by":"publisher","first-page":"682","DOI":"10.1093\/europace\/euac201","article-title":"Conduction system pacing in everyday clinical practice: EHRA physician survey","volume":"25","author":"Kircanski","year":"2022","journal-title":"Europace"},{"key":"B26","doi-asserted-by":"publisher","first-page":"1189","DOI":"10.1093\/europace\/euu011","article-title":"His or para-his pacing preserves left ventricular function in atrioventricular block: A double-blind, randomized, crossover study","volume":"16","author":"Kronborg","year":"2014","journal-title":"Europace"},{"key":"B27","doi-asserted-by":"publisher","first-page":"e382","DOI":"10.1161\/CIR.0000000000000628","article-title":"2018 ACC\/AHA\/HRS guideline on the evaluation and management of patients with bradycardia and cardiac conduction delay: Executive summary","volume":"140","author":"Kusumoto","year":"2019","journal-title":"Circulation"},{"key":"B28","doi-asserted-by":"publisher","first-page":"e26560","DOI":"10.1097\/MD.0000000000026560","article-title":"Safety and efficacy of left bundle branch pacing in comparison with conventional right ventricular pacing: A systematic review and meta-analysis","volume":"100","author":"Liu","year":"2021","journal-title":"Med. Baltim."},{"key":"B29","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacep.2022.10.012","article-title":"Conduction system pacing versus conventional cardiac resynchronization therapy in congenital heart disease","author":"Moore","year":"2022","journal-title":"J. Am. Coll. Cardiol. Ep."},{"key":"B30","doi-asserted-by":"publisher","first-page":"991","DOI":"10.1016\/j.hrthm.2020.01.033","article-title":"Permanent conduction system pacing for congenitally corrected transposition of the great arteries: A pediatric and congenital electrophysiology society (PACES)\/International society for adult congenital heart disease (ISACHD) collaborative study","volume":"17","author":"Moore","year":"2020","journal-title":"Heart Rhythm."},{"key":"B31","doi-asserted-by":"publisher","first-page":"5","DOI":"10.1111\/pace.14050","article-title":"Clinical outcomes of His-Purkinje conduction system pacing","volume":"44","author":"Muthumala","year":"2021","journal-title":"Pacing Clin. Electrophysiol."},{"key":"B32","doi-asserted-by":"publisher","first-page":"e006897","DOI":"10.1161\/CIRCEP.118.006897","article-title":"Anatomical considerations for His bundle pacing","volume":"12","author":"Nagarajan","year":"2019","journal-title":"Circ. Arrhythm. Electrophysiol."},{"key":"B33","doi-asserted-by":"publisher","DOI":"10.1093\/europace\/euac239","article-title":"Three-dimensional electroanatomical mapping guided right bundle branch pacing in congenitally corrected transposition of great arteries","author":"Namboodiri","year":"2022","journal-title":"Europace"},{"key":"B34","doi-asserted-by":"publisher","first-page":"77","DOI":"10.1161\/01.cir.41.1.77","article-title":"Pervenous pacing of the specialized conducting system in man. His bundle and A-V nodal stimulation","volume":"41","author":"Narula","year":"1970","journal-title":"Circulation"},{"key":"B35","doi-asserted-by":"publisher","first-page":"176","DOI":"10.1016\/j.hrcr.2021.12.001","article-title":"Left bundle pacing in transposition of the great arteries with previous atrial redirection operation","volume":"8","author":"O'Connor","year":"","journal-title":"Hear. Case Rep."},{"key":"B36","doi-asserted-by":"publisher","first-page":"561","DOI":"10.1093\/europace\/euac175","article-title":"Left bundle branch area pacing in congenital heart disease","volume":"25","author":"O'Connor","year":"","journal-title":"Europace"},{"key":"B37","doi-asserted-by":"publisher","first-page":"59","DOI":"10.1016\/j.hroo.2020.03.002","article-title":"Left bundle branch pacing is the best approach to physiological pacing","volume":"1","author":"Padala","year":"2020","journal-title":"Heart Rhythm."},{"key":"B38","doi-asserted-by":"publisher","first-page":"1116","DOI":"10.1016\/j.hrthm.2022.03.1222","article-title":"Atrioventricular junction ablation in patients with conduction system pacing leads: A comparison of his-bundle vs left bundle branch area pacing leads","volume":"19","author":"Pillai","year":"2022","journal-title":"Heart Rhythm."},{"key":"B39","doi-asserted-by":"publisher","first-page":"78","DOI":"10.1016\/j.ipej.2019.12.012","article-title":"Selective left bundle branch pacing for pediatric complete heart block","volume":"20","author":"Ponnusamy","year":"2020","journal-title":"Indian Pacing Electrophysiol. J."},{"key":"B40","doi-asserted-by":"publisher","first-page":"e13","DOI":"10.15420\/cfr.2021.04","article-title":"How to implant His bundle and left bundle pacing leads: Tips and pearls","volume":"7","author":"Ponnusamy","year":"2021","journal-title":"Card. Fail Rev."},{"key":"B41","doi-asserted-by":"publisher","first-page":"26","DOI":"10.1111\/pace.14108","article-title":"His bundle pacing: Tips and tricks","volume":"44","author":"Ravi","year":"2021","journal-title":"Pacing Clin. Electrophysiol."},{"key":"B42","first-page":"1","article-title":"PACES expert consensus statement on the indications and management of cardiovascular implantable electronic devices in pediatric patients","volume":"2021","author":"Shah","year":"2021","journal-title":"Cardiol. Young"},{"key":"B43","doi-asserted-by":"publisher","first-page":"305","DOI":"10.1016\/j.hrthm.2014.10.021","article-title":"Permanent His-bundle pacing is feasible, safe, and superior to right ventricular pacing in routine clinical practice","volume":"12","author":"Sharma","year":"2015","journal-title":"Heart Rhythm."},{"key":"B44","doi-asserted-by":"publisher","first-page":"e006967","DOI":"10.1161\/CIRCEP.118.006967","article-title":"Low fluoroscopy permanent His bundle pacing using electroanatomic mapping: A feasibility study","volume":"12","author":"Sharma","year":"2019","journal-title":"Circ. Arrhythm. Electrophysiol."},{"key":"B45","doi-asserted-by":"publisher","first-page":"e006613","DOI":"10.1161\/CIRCEP.118.006613","article-title":"Permanent His bundle pacing for cardiac resynchronization therapy in patients with heart failure and right bundle branch block","volume":"11","author":"Sharma","year":"2018","journal-title":"Circ. Arrhythm. Electrophysiol."},{"key":"B46","doi-asserted-by":"publisher","first-page":"51","DOI":"10.15420\/aer.2020.45","article-title":"Conduction system pacing for cardiac resynchronisation","volume":"10","author":"Sharma","year":"2021","journal-title":"Arrhythm. Electrophysiol. Rev."},{"key":"B47","doi-asserted-by":"publisher","first-page":"1227","DOI":"10.1016\/j.hrthm.2015.03.004","article-title":"Extraction of SelectSecure leads compared to conventional pacing leads in patients with congenital heart disease and congenital atrioventricular block","volume":"12","author":"Shepherd","year":"2015","journal-title":"Heart Rhythm."},{"key":"B48","doi-asserted-by":"publisher","first-page":"2932","DOI":"10.1161\/01.CIR.0000072769.17295.B1","article-title":"Adverse effect of ventricular pacing on heart failure and atrial fibrillation among patients with normal baseline QRS duration in a clinical trial of pacemaker therapy for sinus node dysfunction","volume":"107","author":"Sweeney","year":"2003","journal-title":"Circulation"},{"key":"B49","doi-asserted-by":"publisher","first-page":"i105","DOI":"10.1093\/europace\/euaa400","article-title":"Exploring the cause of conduction delays in patients with repaired Tetralogy of Fallot","volume":"23","author":"Verzaal","year":"2021","journal-title":"Europace"},{"key":"B50","doi-asserted-by":"publisher","first-page":"460","DOI":"10.1016\/j.hrthm.2017.10.039","article-title":"Permanent His bundle pacing: Recommendations from a multicenter His bundle pacing collaborative working group for standardization of definitions, implant measurements, and follow-up","volume":"15","author":"Vijayaraman","year":"","journal-title":"Heart Rhythm."},{"key":"B51","doi-asserted-by":"publisher","first-page":"903","DOI":"10.1016\/j.jacep.2020.04.005","article-title":"Extraction of left bundle branch pacing lead","volume":"6","author":"Vijayaraman","year":"2020","journal-title":"JACC Clin. Electrophysiol."},{"key":"B52","doi-asserted-by":"publisher","first-page":"696","DOI":"10.1016\/j.hrthm.2017.12.022","article-title":"Permanent His-bundle pacing: Long-term lead performance and clinical outcomes","volume":"15","author":"Vijayaraman","year":"","journal-title":"Heart Rhythm."},{"key":"B53","doi-asserted-by":"publisher","first-page":"1263","DOI":"10.1016\/j.hrthm.2022.04.023","article-title":"Clinical outcomes of conduction system pacing compared to biventricular pacing in patients requiring cardiac resynchronization therapy","volume":"19","author":"Vijayaraman","year":"2022","journal-title":"Heart Rhythm."},{"key":"B54","doi-asserted-by":"publisher","first-page":"1558","DOI":"10.1111\/jce.15520","article-title":"Preliminary study on left bundle branch area pacing in children: Clinical observation of 12 cases","volume":"33","author":"Wenlong","year":"2022","journal-title":"J. Cardiovasc Electrophysiol."},{"key":"B55","doi-asserted-by":"publisher","first-page":"993604","DOI":"10.3389\/fphys.2022.993604","article-title":"Transvenous lead extraction in conduction system pacing","volume":"13","author":"Wijesuriya","year":"2022","journal-title":"Front. Physiol."},{"key":"B56","doi-asserted-by":"publisher","first-page":"1166","DOI":"10.1016\/j.jacep.2021.02.018","article-title":"Evaluation of the criteria to distinguish left bundle branch pacing from left ventricular septal pacing","volume":"7","author":"Wu","year":"2021","journal-title":"JACC Clin. Electrophysiol."},{"key":"B57","doi-asserted-by":"publisher","first-page":"1819","DOI":"10.1093\/europace\/euy058","article-title":"Permanent his-bundle pacing: A systematic literature review and meta-analysis","volume":"20","author":"Zanon","year":"2018","journal-title":"Europace"},{"key":"B58","doi-asserted-by":"publisher","first-page":"845312","DOI":"10.3389\/fcvm.2022.845312","article-title":"Which is more likely to achieve cardiac synchronization: Left bundle branch pacing or left ventricular septal pacing?","volume":"9","author":"Zhu","year":"2022","journal-title":"Front. Cardiovasc Med."},{"key":"B59","doi-asserted-by":"publisher","first-page":"199","DOI":"10.1111\/pace.14112","article-title":"His bundle pacing in a young child guided by electroanatomical mapping","volume":"44","author":"Zizek","year":"2021","journal-title":"Pacing Clin. Electrophysiol."}],"container-title":["Frontiers in Physiology"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fphys.2023.1154629\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,3,24]],"date-time":"2023-03-24T01:08:01Z","timestamp":1679620081000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fphys.2023.1154629\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,3,24]]},"references-count":59,"alternative-id":["10.3389\/fphys.2023.1154629"],"URL":"https:\/\/doi.org\/10.3389\/fphys.2023.1154629","relation":{},"ISSN":["1664-042X"],"issn-type":[{"value":"1664-042X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,3,24]]},"article-number":"1154629"}}