In conduction system pacing, what structure is primarily stimulated?

In conduction system pacing, the primary focus is on stimulating the His bundle or bundle branches. This structure is a critical component of the heart’s intrinsic conduction system. By pacing at the level of the His bundle or bundle branches, the electrical impulses that regulate heartbeat can be more effectively coordinated, allowing for better synchronization between the atria and ventricles.

Stimulating the His bundle allows the pacing impulse to travel through the normal conduction pathways of the heart, preserving the physiological sequence of activation that typically occurs when the heart functions normally. This can lead to improved timing of contractions, enhancing cardiac efficiency and function, especially in patients with certain types of heart block or other conduction abnormalities.

While the left atrium, ventricular myocardium, and right atrium are important structures involved in cardiac function, they do not serve the same purpose as the His bundle or bundle branches in the context of conduction system pacing. Stimulating these areas would not provide the benefits associated with preserving the natural conduction pathway and may lead to less effective pacing strategies.