Conduction system pacing (CSP) has emerged as a more physiological alternative to right ventricular pacing and is also being used in selected cases for cardiac resynchronization therapy. His bundle pacing was first introduced over two decades ago and its use has risen over the last years with the advent of tools which have facilitated implantation. Left bundle branch area pacing is more recent but its adoption is growing fast due to a wider target area and excellent electrical parameters. Nevertheless, as with any intervention, proper technique is a prerequisite for safe and effective delivery of therapy. This document aims to standardize the procedure and to provide a framework for physicians who wish to start CSP implantation, or who wish to improve their technique. A synopsis is provided in this print edition of EP-Europace. The full document may be consulted online, and a 'Key Messages' App can be downloaded from the EHRA website.

1st Department of Cardiology and Electrocardiology and Arterial Hypertension Jagiellonian University Krakow Poland

Arrhythmia and Electrophysiology Unit Santa Maria della Misericordia General Hospital Rovigo Italy

Bethel Clinic Bielefeld Germany

Brigham and Women's Hospital Boston Massachusetts United States of America

Cardiac Pacing Unit University Hospital of Geneva Geneva Switzerland

Cardiocenter 3rd Faculty of Medicine Charles University and University Hospital Kralovske Vinohrady Prague Czech Republic

Department of Cardiology Cardiovascular Research Institute Maastricht Maastricht University Medical Center Maastricht The Netherlands

Department of Medicine McGill University Health Center Montreal Canada

Geisinger Wyoming Valley Medical Center Wilkes Barre PA United States of America

Heart Centre University Hospital Ghent Ghent Belgium

Hospital Universitario y Politecnico La Fe ValenciamSpain and Centro de Investigaciones Biomédicas en RED en Enfermedades Cardiovasculares Madrid Spain

National Heart and Lung institute Imperial College London United Kingdom

The 1st Affiliated Hospital of Wenzhou Medical University Wenzhou China

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