1. Pacing indications differ in male and female, thus separate indications are suggested.
  2. Pacing indications evaluation criteria have been modified. Carotid massage is recommended in patients for syncope, where other pathological causes are ruled out.
  3. Noninvasive modalities like 12 lead ECG monitoring, exercise testing, multimodality imaging to remain the mainstay for diagnosis
  4. Obstructive Sleep apnea to be considered for asymptomatic brady arrhythmias or cardiac conduction diseases.
  5. Compared to the 2013 guideline, CRT indications for HFrEF patient in sinus rhythm (SR) in the 2021 guideline raised the lower QRS duration threshold from 120ms to 130ms
  6. Device programming tailored to specific requirements of HBP is recommended in this current guideline
  7. Permanent pacing is recommended in patients with complete or high-degree AVB that persists for 24-48h or with new-onset alternating BBB after TAVI (Class I) compared to 7 days of clinical observation for reversibility in the 2013 guideline