biostudies-literatureChung MKBLRD VANHLBI NIH HHSe17-e91https://www.ebi.ac.uk/biostudies/studies/S-EPMC11062890biostudies-literatureUnknown20(9)Cardiac physiologic pacing (CPP), encompassing cardiac resynchronization therapy (CRT) and conduction system pacing (CSP), has emerged as a pacing therapy strategy that may mitigate or prevent the development of heart failure (HF) in patients with ventricular dyssynchrony or pacing-induced cardiomyopathy. This clinical practice guideline is intended to provide guidance on indications for CRT for HF therapy and CPP in patients with pacemaker indications or HF, patient selection, pre-procedure evaluation and preparation, implant procedure management, follow-up evaluation and optimization of CPP response, and use in pediatric populations. Gaps in knowledge, pointing to new directions for future research, are also identified.Heart rhythm2023 HRS/APHRS/LAHRS guideline on cardiac physiologic pacing for the avoidance and mitigation of heart failure.PMC11062890R01 HL158071P01 HL158502IK6 BX006185Parkash RChung EHCha YMTang WHWCygankiewicz ISeow SCShen WKSrivatsa UNChung MKStecker ECDandamudi GSlotwiner DJVarma NGold MRCronin EMKron JTanawuttiwat TGutierrez ATracy CMLink MSArora VSingh JPLau CPWorsnick SATapias CAGorodeski EZKarpawich PPCurtis ABVernooy KZeitler EPGopinathannair RGuzman JCPathak RKKutyifa VDal Forno ARJPatete MFKiehl ELPatton KKGoldberger ZDZareba WIndik JHPark SJSridhar ARMGlotzer TVSchoenfeld MHKarim SVijayaraman PEnsch DPAl-Khatib SMKhaykin YDubin AMRickard JShoda MMarine JEHuang WUpadhyay GAMullens WBirgersdotter-Green UMImrey PBPerona CAfalse2023 HRS/APHRS/LAHRS guideline on cardiac physiologic pacing for the avoidance and mitigation of heart failure.Cardiac physiologic pacing (CPP), encompassing cardiac resynchronization therapy (CRT) and conduction system pacing (CSP), has emerged as a pacing therapy strategy that may mitigate or prevent the development of heart failure (HF) in patients with ventricular dyssynchrony or pacing-induced cardiomyopathy. This clinical practice guideline is intended to provide guidance on indications for CRT for HF therapy and CPP in patients with pacemaker indications or HF, patient selection, pre-procedure evaluation and preparation, implant procedure management, follow-up evaluation and optimization of CPP response, and use in pediatric populations. Gaps in knowledge, pointing to new directions for future research, are also identified.2023-01-01T00:00:00Z2023 Sep2026-05-03T03:28:59.91Z2026-04-07T18:48:03.24ZS-EPMC110628903728327110.1016/j.hrthm.2023.03.1538