Conduction system pacing (CSP) is being increasingly adopted as a more physiological alternative to right ventricular and biventricular pacing. Since the 2021 European Society of Cardiology pacing guidelines, there has been growing evidence that this therapy is safe and effective. Furthermore, left bundle branch area pacing was not covered in these guidelines due to limited evidence at that time. This Clinical Consensus Statement provides advice on indications for CSP, taking into account the significant evolution in this domain.

1st Department of Cardiology Interventional Electrocardiology and Hypertension Jagiellonian University Medical College Krakow Poland

Arrhythmias ad Pacing Service Cardiology Division Department of Medicine South Medical Center Puebla Mexico

Aston Medical School Aston University Aston Triangle Birmingham UK

Cardiac Pacing and Electrophysiology Department of Cardiovascular Medicine Heart Vascular and Thoracic Institute Department of Cardiovascular and Metabolic Sciences Lerner Research Institute Cleveland Clinic Cleveland Clinic Lerner College of Medicine of Case western Reserve University Cleveland OH USA

Cardiac Pacing and Electrophysiology Heart and Vascular Institute Cleveland Clinic Cleveland OH USA

Cardiac Pacing Unit Cardiology Department University Hospital of Geneva Geneva Switzerland

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

Cardiology Department Amsterdam UMC Amsterdam The Netherlands

Cardiology Department St Antonius Hospital Nieuwegein The Netherlands

Cardiology Division Department of Medicine Queen Mary Hospital School of Clinical Medicine LKS Faculty of Medicine The University of Hong Kong Hong Kong SAR

Centro de Investigaciones Biomédicas en RED en Enfermedades Cardiovasculares Madrid Spain

Clínica Las Vegas Universidad CES Medellín Colombia

Department of Cardiology Aarhus University Hospital and Department of Clinical Medicine Aarhus University Aarhus Denmark

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

Department of Cardiology Ghent University Hospital Ghent Belgium

Department of Cardiology School of Medical Sciences Faculty of Medicine and Health Örebro University Örebro Sweden

Department of Cardiology The 1st Affiliated Hospital of Wenzhou Medical University Wenzhou China

Department of Medical Science Uppsala University Uppsala Sweden

Department of Medicine Cardiology Diabetology and Nephrology Bethel Clinic Bielefeld Germany

Department of Medicine McGill University Health Centre Montreal Canada

ESC Patient Forum Sophia Antipolis France

European Association of Patient with Cardiovascular Diseases Serce na Banacha Poland

European Society of Cardiology Sophia Antipolis France

Faculty of Medicine Hebrew University Jerusalem Israel

Geisinger Commonwealth School of Medicine Geisinger Heart Institute Wilkes Barre PA USA

Hasselt University Ziekenhuis Oost Limburg Genk Belgium

Heart and Lung Center Helsinki University Hospital Helsinki Finland

Institut Clínic Cardiovascular Barcelona Catalonia Spain

Internal Medicine Clinic 3 Cardiology Angiology and Intensive Care Medicine Saarland University Hospital Homburg Saar Germany

Jesselson Integrated Heart Center Shaare Zedek Medical Center 12 Shmuel Beit Street 9103102 Jerusalem Israel

Liverpool Heart and Chest Hospital Liverpool UK

National Heart and Lung Institute Imperial College London London UK

Santa Maria della Misericordia Hospital Rovigo Italy

Service de Cardiologie et Maladies Vasculaires Université de Rennes CHU Rennes INSERM LTSI UMR 1099 F 35000 Rennes France

Unidad de Arritmias Hospital Universitari i Politècnic La Fe Valencia Spain

University Hospitals Birmingham Queen Elizabeth Mindelsohn Way Birmingham UK

Western University London Ontario Canada

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