Which part of the heart's conduction system is typically targeted in conduction system pacing?

In conduction system pacing, the His-Purkinje system is the primary focus because it plays a crucial role in the coordinated electrical activation of the ventricles. This system includes the bundle of His, the left and right bundle branches, and the Purkinje fibers, which are integral to ensuring that electrical impulses travel rapidly and efficiently through the ventricles, leading to effective contraction and pumping of blood.

Targeting the His-Purkinje system allows for more physiological pacing compared to traditional methods of pacing that may stimulate the heart muscle in a less coordinated manner. When pacing at the level of the His-Purkinje system, the conduction is more akin to the heart's natural rhythm, improving synchronous contraction of the ventricles and potentially enhancing cardiac output and overall heart function.

The sinoatrial node is responsible for initiating the heart's natural rhythm, but it is not the focus in conduction system pacing since pacing here does not directly involve the His-Purkinje pathway. The atrioventricular node is involved in the conduction pathway but is not the target for pacing aimed at optimizing ventricular activation. The coronary arteries are blood vessels and do not play a role in the electrical conduction system, making them irrelevant in the context of pacing.