Conduction System Pacing in Cardiac Amyloidosis: Current Evidence, Outcomes, and Knowledge Gaps

Cardiac amyloidosis (CA) is frequently complicated by conduction system disease. Conventional right ventricular (RV) pacing may exacerbate ventricular dyssynchrony, while biventricular pacing is limited by anatomical and electrical constraints. Conduction system pacing (CSP) has emerged as a physiological alternative; its feasibility and outcomes in CA remain unclear. We aimed to systematically review the literature describing CSP in CA and summarise procedural feasibility, electrical performance, and reported clinical outcomes.