2021 ESC Guidelines on cardiac pacing and cardiac resynchronization therapy

Pacing is an important part of electrophysiology and of cardiology in general. Whereas some of the situations requiring pacing are clear and have not changed over the years, many others have evolved and have been the subject of extensive recent research, such as pacing after syncope, pacing following transcatheter aortic valve implantation, cardiac resynchronization therapy (CRT) for heart failure (HF) and for prevention of pacing-induced cardiomyopathy, and pacing in various infiltrative and inflammatory diseases of the heart, as well as in different cardiomyopathies.

Other novel topics include new diagnostic tools for decision-making on pacing, as well as a whole new area of pacing the His bundle and the left bundle branch. In addition, attention has increased in other areas, such as how to systematically minimize procedural risk and avoid complications of cardiac pacing, how to manage patients with pacemakers in special situations, such as when magnetic resonance imaging (MRI) or irradiation are needed, how to follow patients with a pacemaker with emphasis on the use of remote monitoring, and how to include shared decision-making in caring for this patient population.