Physiologic Pacing in Heart Failure
Apr 30, 2026DOI: 10.1056/nejmc2602393CorrespondenceNEJM
To the Editor: Chelu et al. (Jan. 22 issue) provide a clear framework for cardiac physiologic pacing in heart failure. The 2023 guideline from the Heart Rhythm Society, Asia Pacific Heart Rhythm Society, and Latin American Heart Rhythm Society elevates conduction system pacing as a strategy for the avoidance or mitigation of heart failure, which will increasingly influence insurance coverage policies and quality measures for device therapy. The authors note that left bundle-branch pacing may capture only the interventricular myocardium and that confirming true left bundle-branch capture requires 12-lead electrocardiography (ECG) and pacing maneuvers (Fig. 3 of the article). In . . .
