Participants \[patients over 18 years old with an indication to receive a definitive pacemaker/intracardiac defibrillator implant\] will receive a permanent cardiac pacing implant as requested according to European Society of Cardiology (ESC) guidelines; the investigators will evaluate procedural efficacy and safety of different implantation approaches. conditions: Arrhythmias, Cardiac conditions: Atrioventricular Block conditions: Reduced Systolic Function conditions: Atrial Fibrillation conditions: Bradyarrhythmia conditions: Ventricular Tachycardia conditions: Ventricular Dysfunction conditions: Ventricular Fibrillation conditions: Ventricular Arrythmia conditions: Atrioventricular Nodal Disease conditions: Atrioventricular Conduction Defects conditions: Atrioventricular Block Complete conditions: Atrioventricular Block Incomplete conditions: Atrioventricular Junctional Rhythm conditions: Bundle-Branch Block conditions: Left Bundle-Branch Block conditions: Heart Failure, Systolic conditions: Block;Atrioventricular conditions: Block; Arrhythmic conditions: Block; Mobitz conditions: Block, Heart conditions: Block, Fascicular conditions: Block Branch Bundle Left conditions: Heart Failure，Congestive conditions: Heart Arrhythmia studyType: OBSERVATIONAL observationalModel: COHORT timePerspective: PROSPECTIVE count: 8400 type: ESTIMATED name: Cardiac pacing - Conventional RV pacing name: Cardiac pacing - Conduction System Pacing name: Cardiac pacing - Cardiac resynchronization therapy (pacing - CRTP - or defibrillation - CRTD) name: Cardiac pacing - Epicardial pacing name: Cardiac pacing - Leadless pacing measure: 30 days efficacy measure: Rate of hospitalizations for heart failure at 12 months measure: All cause death at 12 months measure: All cause and cardiovascular death at 1, 3, 5, 10 years measure: Onset/worsening of heart failure measure: Onset/worsening of atrial tachyarrhythmias measure: Onset/worsening of ventricular tachyarrhythmias measure: Procedural time measure: Fluoroscopy time measure: Radiation exposure measure: Success rate of CRT in heart failure measure: Cardiac perforation rate measure: Hemothorax rate measure: Pneumothorax rate measure: Pocket hematoma rate measure: Pericardial effusion rate measure: Lead dislocation rate measure: Lead fracture rate measure: Cardiac Implantable Electronic Devices infections rate measure: Reintervention rate sex: ALL minimumAge: 18 Years stdAges: ADULT stdAges: OLDER_ADULT facility: Azienda Ospedaliero-Universitaria di Ferrara status: RECRUITING city: Ferrara state: FE zip: 44124 country: Italy name: Matteo Bertini, MD, PhD role: CONTACT phone: +390532236269 email: brtmtt2@unife.it lat: 44.83804 lon: 11.62057 facility: Ospedale San Donato status: RECRUITING city: Arezzo country: Italy name: Pasquale Notarstefano, MD role: CONTACT lat: 43.46276 lon: 11.88068 facility: Azienda Ospedaliero-Universitaria S.Orsola-Malpighi Bologna status: RECRUITING city: Bologna zip: 40138 country: Italy name: Mauro Biffi, MD role: CONTACT lat: 44.49381 lon: 11.33875 facility: spedale Maggiore di Bologna status: RECRUITING city: Bologna country: Italy name: Valeria Carinci, MD role: CONTACT lat: 44.49381 lon: 11.33875 facility: Ospedale Bernardino Ramazzini status: RECRUITING city: Carpi country: Italy name: Elia De Maria, MD role: CONTACT lat: 44.78237 lon: 10.8777 facility: Ospedale SS Annunziata status: RECRUITING city: Cento country: Italy name: Biagio Sassone, MD role: CONTACT lat: 44.73099 lon: 11.28716 facility: Ospedale Bufalini status: RECRUITING city: Cesena country: Italy name: Paolo Sabbatani, MD role: CONTACT lat: 44.1391 lon: 12.24315 facility: Ospedale San Giuseppe status: RECRUITING city: Empoli country: Italy name: Attilio Del Rosso, MD role: CONTACT lat: 43.71795 lon: 10.94758 facility: Ospedale di Vaio status: RECRUITING city: Fidenza country: Italy name: Paolo Pastori role: CONTACT lat: 44.86694 lon: 10.06039 facility: Azienda Ospedaliero-Universitaria Careggi status: RECRUITING city: Firenze country: Italy name: Giuseppe Ricciardi, MD role: CONTACT lat: 43.77925 lon: 11.24626 facility: Ospedale San Giovanni di Dio status: RECRUITING city: Firenze country: Italy name: Iacopo Bertolozzi, MD role: CONTACT lat: 43.77925 lon: 11.24626 facility: Ospedale Santa Maria Annunziata Bagno a Ripoli status: RECRUITING city: Firenze country: Italy name: Maria Giaccardi, MD role: CONTACT lat: 43.77925 lon: 11.24626 facility: Azienda Ospedaliero-Universitaria "Ospedali Riuniti" status: RECRUITING city: Foggia country: Italy name: Pier Luigi Pellegrino, MD role: CONTACT lat: 41.45845 lon: 15.55188 facility: Ospedale Morgagni-Pierantoni status: RECRUITING city: Forlì country: Italy name: Alberto Bandini, MD role: CONTACT lat: 44.22177 lon: 12.04144 facility: Ospedale Santa Maria della Misericordia Grosseto status: RECRUITING city: Grosseto country: Italy name: Gennaro Miracapillo, MD role: CONTACT lat: 42.76296 lon: 11.10941 facility: Ospedale della Versilia status: RECRUITING city: Lido Di Camaiore country: Italy name: Gianluca Solarino, MD role: CONTACT lat: 43.90012 lon: 10.2269 facility: Ospedali Riuniti di Livorno status: RECRUITING city: Livorno country: Italy name: Federica Lapira, MD role: CONTACT lat: 43.54427 lon: 10.32615 facility: Ospedale San Luca status: RECRUITING city: Lucca country: Italy name: Davide Giorgi, MD role: CONTACT lat: 43.84369 lon: 10.50447 facility: Nuovo ospedale Apuano Massa status: RECRUITING city: Massa country: Italy name: Giuseppe Arena, MD role: CONTACT lat: 44.03541 lon: 10.13927 facility: Azienda Ospedaliero-Universitaria Policlinico di Modena status: RECRUITING city: Modena country: Italy name: Giuseppe Boriani, PhD role: CONTACT lat: 44.64783 lon: 10.92539 facility: Ospedale Sant'Agostino Estense Modena Baggiovara status: RECRUITING city: Modena country: Italy name: Mauro Zennaro, MD role: CONTACT lat: 44.64783 lon: 10.92539 facility: Ospedale Civico, azienda Ospedaliera di Palermo status: RECRUITING city: Palermo country: Italy name: Giuseppe Sgarito, MD role: CONTACT lat: 38.13205 lon: 13.33561 facility: Policlinico Paolo Giaccone status: RECRUITING city: Palermo country: Italy name: Giuseppe Coppola, MD role: CONTACT lat: 38.13205 lon: 13.33561 facility: Azienda Ospedaliero-Universitaria Maggiore status: RECRUITING city: Parma country: Italy name: Francesca Maria Notarangelo, MD role: CONTACT lat: 44.79935 lon: 10.32618 facility: Ospedale Guglielmo da Saliceto Piacenza status: RECRUITING city: Piacenza zip: 29100 country: Italy name: Luca Rossi, MD role: CONTACT lat: 45.05242 lon: 9.69342 facility: Azienda Ospedaliero-Universitaria pisana Cisanello status: RECRUITING city: Pisa country: Italy name: Giulio Zucchelli role: CONTACT lat: 43.70853 lon: 10.4036 facility: Fondazione Toscana Gabriele Monasterio status: RECRUITING city: Pisa country: Italy name: Andrea Rossi, MD role: CONTACT lat: 43.70853 lon: 10.4036 facility: Ospedale Santa Maria delle Croci status: RECRUITING city: Ravenna country: Italy name: Alessandro Dal Monte role: CONTACT lat: 44.41344 lon: 12.20121 facility: ASMN Reggio Emilia status: RECRUITING city: Reggio Emilia country: Italy name: Fabio Quartieri, MD role: CONTACT lat: 44.69825 lon: 10.63125 facility: Ospedale degli Infermi Rimini status: RECRUITING city: Rimini country: Italy name: Davide Saporito, MD role: CONTACT lat: 44.05755 lon: 12.56528 facility: Azienda Ospedaliero-Universitaria Senese status: RECRUITING city: Siena country: Italy name: Amato Santoro, MD role: CONTACT lat: 43.31822 lon: 11.33064 hasResults: False