
Understanding Painful Left Bundle Branch Block Syndrome: Where Does the Evidence Lead Us?
Author Sub-editor: Dr Hnin Zaw Dr Hnin Zaw is a cardiology registrar from the East of England Deanery with a specialist interest in electrophysiology and
Conduction system pacing (CSP) is a novel method of cardiac pacing that uses the heart’s own conduction system to enable efficient, physiological ventricular activation (1,2).
Right ventricular pacing (RVP) and biventricular pacing (BVP) are the known conventional pacing methods. In RVP, by the nature of lead placement, inter-ventricular dysynchrony is introduced. In patients with left bundle branch block (LBBB) and severe left ventricular dysfunction, dysynchrony is particularly deleterious, and so a left ventricular lead is added in an endeavour to overcome this dysynchrony (3–5).
Conduction system pacing, through careful placement of the lead in the His-bundle or the left bundle area (LBA), provides an alternative to overcome inter-ventricular dysynchrony through physiological activation (5,6).

Author Sub-editor: Dr Hnin Zaw Dr Hnin Zaw is a cardiology registrar from the East of England Deanery with a specialist interest in electrophysiology and

Author Sub-editor: Dr Tha Htet Nyi Dr Tha Htet Nyi is a cardiology registrar in South London Deanery with subspecialty interests in multimodal cardiac imaging and

Author Sub-editor: Dr Chi Ho Fung Dr Chi Ho Fung graduated with Distinction from Imperial College School of Medicine in 2019 with an Intercalated Bachelor

Authors Heartbeat Sub-Editor: Alexandar Drampalou I am Dr.Alexandar Drampalou ,a cardiologist currently specializing in cardiac magnetic resonance (CMR) at Guy’s and St Thomas’ Hospital and

Authors Heartbeat Sub-Editor: Marina Zafeiri Dr Marina Zafeiri is an IMT3 in the Wessex deanery, with a strong interest in Cardiology. She graduated from Athens

Author Sub-editor: Dr Joshua Rowland Dr Joshua Rowland is a cardiology registrar working in the North West Deanery. He graduated from the University of Manchester