What type of mapping is primarily used in Conduction System pacing?

In Conduction System pacing, unipolar mapping is primarily utilized. Unipolar mapping is characterized by the use of a single electrode placed in the heart, which allows for the measurement of electrical potential between that electrode and a distant reference electrode. This technique is particularly effective in identifying the precise location of the conduction system components, such as the His bundle, which is essential for placing lead systems in the conduction system.

The advantage of unipolar systems in this context is that they offer higher sensitivity to detect smaller electrical signals generated by the conduction pathways. This is crucial because conduction system pacing aims to achieve physiological pacing through the native conduction pathway, making accurate localization imperative.

In contrast, while bipolar, hexapolar, and quadripolar mappings may have their specific applications in cardiac pacing and electrophysiology, they do not serve as the primary mapping method for conduction system pacing. Bipolar mapping employs two closely spaced electrodes and can provide localized signals, but it doesn't offer the same level of sensitivity for the small electrical signals associated with the conduction system as unipolar mapping does. Hexapolar and quadripolar mappings are often used in different contexts, such as in lead evaluation or where multiple sites need to be assessed simultaneously, but they are not