Table 2.

Comparison between different types of CSP based on current evidence.

	His bundle pacing (HBP)	Left bundle branch pacing (LBBP)	Left ventricular septal pacing (LVSP)
Hemodynamic response	Superior to BiVP; similar to LBBAP in improving hemodynamics	Comparable to HBP; effective in LV synchronization, potentially becoming standard for CRT	Comparable outcomes in LVEF recovery and HF hospitalization rates, especially in CRT settings
Electrical synchrony	Better total ventricular synchrony than LBBP and LVSP	Equivalent LV synchrony but less total ventricular synchrony compared to HBP	Produces less effective electrical synchrony and reverse remodeling than both HBP and LBBP
Myocardial work index (MWI)	No significant differences compared to LBBP in myocardial work	Comparable to HBP in mechanical performance; efficient synchronization	Not directly assessed but implied to be less effective than HBP/LBBP
Technical challenges	Difficult His engagement, variable capture thresholds, low sensing amplitude	Easier implantation, higher sensing, lower capture thresholds	No specific challenges challengers but high thresholds may be encountered
Learning curve	Steeper; starts to plateau after 30 cases	Shorter; plateaus after the first 10 cases	Shorter than HBP
Procedural time	Longer due to complexity locating the His and achieving a stable position with an acceptable threshold	Shorter procedural time and fewer lead-related complications	Generally comparable to LBBP in procedural simplicity
Lead extractability	High success rate (>95%); mostly removed by simple traction	Similar feasibility of extraction with few complications reported	Less data available on extraction; feasibility dependent on specific lead types used