After completing this chapter, participants will be able to:  

• Understand the general principles of pacemaker therapy, cycle timings of single and dual chamber pacemaker and principles of specific functions such as hysteresis, refractory periods and upper rate behaviour. 
• Understand the general principles of cardiac resynchronization therapy, the basic technical aspects of the implant procedure, the methods to optimize the therapy and the principles of patient follow-up. 
• Understand the rationale behind conduction system pacing, the basic technical aspects of the implant, ECG interpretation, and the pros and cons of His bundle pacing versus left bundle branch pacing. 
• Understand the basic definitions in lead extraction, the typical indications for the procedure and the basic technical related issues as well as procedural outcomes and potential complications.  
• Understand the general principles of in-office and remote cardiac device monitoring, the routine steps for device follow-up and the basic principles of device troubleshooting. 
• Understand how lead positioning influences ECG pacing patterns, how to interpret ECG during biventricular pacing and how is the appropriate technique to achieve a particular lead position.  
• Understand what is selective and non-selective capture during conduction system pacing, what does QRS transition mean during the threshold test, what are the QRS based metrics of physiological activation of the ventricles and how CSP can achieve correction of block in His bundle. 
• Understand how to select patients for single and dual chamber ICD implantation and which additional information can be obtained from monitoring the atrial channel.