A technique for cardiac resynchronization therapy using left bundle branch area and left ventricular pacing

Cardiac resynchronization therapy(CRT)via biventricu-lar pacing(BVP)is known to improve clinical outcomes and decreases all-cause mortality,particularly in patients with left bundle branch block(LBBB)and reduced left ventricular(LV)function.[1]Recently,several groups have shown the feasibility of left bundle branch area pacing(LBBAP)as an alternative choice to His bundle pacing in patients with LBBB by pacing the left bundle branch(LBB)region beyond the block site with a stable threshold and a short QRS duration(QRSd).[2,3]However,it is unknown whether the clinical efficacy of LBBAP with an appropriate atrioventricular(AV)delay would be the same as or better than that of LV epicardial pacing or CRT.