Inclusion Criteria:  Meets American College of Cardiology (ACC)/American Heart Association (AHA)/Heart Rhythm Society (HRS) guidelines for bradycardia, or Meets ACC/AHA/HRS guidelines for cardiac resynchronization therapy (CRT).  Exclusion Criteria:  Age < 18 years Inability of patient capacity to provide consent for themselves either due to medical or psychiatric comorbidity Pregnancy Difficulty with follow-up