Rapid advances in device technology and implantation techniques are redefining how clinicians approach bradyarrhythmias and conduction system disease, making Cardiac Pacing Innovations a dynamic area of practice. This session examines emerging strategies such as His-bundle pacing, left bundle branch area pacing, leadless pacemakers, and novel algorithms for rate response and arrhythmia detection. Participants will review the limitations of traditional right ventricular pacing and explore how new approaches aim to preserve or restore physiological activation, reduce pacing-induced cardiomyopathy, and improve long-term outcomes.

As device choices multiply, clinicians and device specialists increasingly search for a cardiology conference that distills evidence into practical guidance. This session reviews indications and patient selection for standard and advanced pacing therapies, including single- and dual-chamber systems, conduction system pacing, and leadless devices. Attendees will learn about implant techniques, fluoroscopy and imaging support, and strategies for confirming capture at the His bundle or left bundle branch area. Case-based discussions will highlight how to manage complex anatomy, prior leads, and upgrade scenarios in patients who have developed pacing-related heart failure.

A major focus is integrating physiologic cardiac pacing into broader rhythm and heart failure management. Participants will explore how pacing strategies intersect with cardiac resynchronization therapy, ICD therapy, and atrial fibrillation management. The session addresses programming considerations such as minimizing unnecessary ventricular pacing, optimizing AV timing, and using diagnostic data to adjust settings over time. Attention is also given to troubleshooting lead performance issues, battery longevity challenges, and approaches to re-intervention when capture thresholds rise or clinical response is suboptimal.

Future directions include sensor-based rate adaptation, fully extravascular systems, and the convergence of pacing with neuromodulation and remote automation. Attendees will consider training requirements, learning curves, and the role of proctorship and simulation in safely adopting new techniques. By the end, participants will have a clearer understanding of where pacing innovations fit within contemporary device therapy and how to bring these options to patients in a structured, evidence-informed way.