Novel Approach to Conduction System Pacing With Use of Ultrasound

Inclusion criteria: Patients meeting the following criteria are eligible for the study: 1. Male or female ≥18 years of age 2. Eligible to have a single or dual chamber pacemaker implanted for LBBAP 3. Confirmed diagnosis of conduction tissue disease 4. The participant can understand the written informed consent/assent, provides signed and witnessed written informed consent/assent, and agrees to comply with protocol requirements. 5. Good imaging quality determined on routine echocardiography Exclusion Criteria: Patients will be excluded if any one of the following criteria is met: 1. Any medical or psychiatric condition that, in the investigator's opinion, could jeopardize or compromise the participant's ability to participate in the study. 2. Any acute active malignancy requiring treatment or life expectancy is deemed less than 1 year. 3. Clinically significant disease that increases their risk of bleeding (hematological disorders, dialysis patient - anticoagulation does not apply) 4. History of alcohol or drug (other than caffeine) use disorder within 12 months of pacemaker implantation. 5. Hepatic impairment defined as ALT/AST \>3 × ULN and/or total bilirubin \>ULN, at Screening. 6. The participant has any clinically significant illness, in the opinion of the investigator, prior to their pacemaker implantation 7. Any other issues which, in the opinion of the investigator, will make the participant ineligible for study participation. 8. CRT and ICD implants. 9. Pregnancy or female of childbearing age (if negative pregnancy test not provided).