Table 3.

Summary of current guidelines recommendations for CSP in HFrEF and electrical dyssynchrony.

Guideline	Recommendation for CSP	Level of evidence
2018 ACC/AHA/HRS Guidelines on Bradycardia and Conduction Delay	Recommends HBP as a pacing option for bradycardia and conduction delays but does not recommend it as a primary therapy for heart failure patients	-
2019 ESC Guidelines on Supraventricular Tachycardias	Recommends CSP as an alternative strategy for bradycardia pacing but not explicitly recommended for HFrEF and electrical dyssynchrony	-
2021 ESC Guidelines on Cardiac Pacing and CRT	Recommends HBP as a rescue therapy when coronary sinus lead implantation for CRT is unsuccessful	-Class IIa, Level B
2023 HRS/APHRS/LAHRS Guidelines on Physiologic Pacing	-Recommends CSP as an initial strategy for patients with sinus rhythm, LVEF ≤ 35%, LBBB with QRS ≥ 150 msec, and NYHA Class II–IV -Recommends CSP as an alternative to BiVP if CRT with BiVP is not effective based on anatomical/functional criteria	-Class IIb, Level C -Class IIa, Level C