9. Conclusion
Classic RV pacing may induce the systolic and diastolic dysfunction of both ventricles with consequent adverse clinical endpoints. CSP is a method that maintains physiologic ventricular activation. It has a correct pathophysiological basis, and for a long time, the scientific community has been interested in circumventing its anatomical and technical difficulties. The knowledge is there, and as the interest is there, the only thing missing is the right tool so that it is possible to access this area whenever needed, with satisfactory pacing parameters, without complications, and of course, with indisputable proof of its good clinical outcomes. Thus, after coronary artery bypass grafting, which revolutionized the field of coronary artery revascularization, electrical lesions in the conduction system might be dealt with a corresponding “electrical bypass” feasible for all indications and in all patients who need this pacing treatment.