Data Sheet 1_Conduction system pacing as a rescue strategy for unsuccessful cardiac resynchronisation therapy implantation.pdf

Conduction system pacing (CSP), incorporating His bundle pacing and left bundle branch area pacing, has emerged as a physiological alternative; however, data focussing specifically on its role as a rescue strategy following unsuccessful CRT implantation, rather than biological non-response, remain limited.</p>Objective<p>To evaluate the feasibility, safety, and short- to mid-term clinical and echocardiographic outcomes of CSP in patients with unsuccessful conventional CRT implantation.</p>Methods<p>In this single-centre retrospective study, consecutive patients undergoing attempted CSP after unsuccessful CRT between January 2020 and May 2025 were analysed.

Unsuccessful CRT was defined as inability to deliver effective biventricular pacing due to anatomical or technical limitations, excluding patients with true non-response despite successful implantation. Procedural success, electrical resynchronisation, changes in left ventricular ejection fraction (LVEF), and clinical outcomes were assessed.</p>Results<p>Thirty-two patients (mean age 69 years, mean LVEF 27.8%) were included.