{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,30]],"date-time":"2026-09-30T00:29:51Z","timestamp":1790728191251,"version":"4.1.0"},"reference-count":66,"publisher":"Oxford University Press (OUP)","issue":"10","license":[{"start":{"date-parts":[[2025,7,29]],"date-time":"2025-07-29T00:00:00Z","timestamp":1753747200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2025,10,7]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>Biventricular pacing remains the cornerstone of cardiac resynchronization therapy (CRT) in patients with heart failure, with well-established benefits. Left bundle branch pacing (LBBP) offers a physiologic alternative by engaging the native conduction system to restore synchrony and has generated significant enthusiasm. However, the growing adoption of LBBP should be tempered by recognition that a one-size-fits-all approach may not address the underlying substrate, particularly in those with intraventricular conduction delay. While a less-than-optimal LBBP implant may be sufficient in bradycardia patients, its adequacy in heart failure patients, who may require more precise consideration of conduction disease, remains uncertain. This review gives a comprehensive framework for integrating LBBP into CRT, including pre-implant, intraprocedural, and post-implant assessment. It also provides practical guidance on when to pursue LBBP alone, when to supplement with a coronary sinus lead, and when to consider conventional biventricular pacing, with an emphasis on a personalized approach to the underlying conduction substrate for maximal therapeutic benefit.<\/jats:p>","DOI":"10.1093\/europace\/euaf154","type":"journal-article","created":{"date-parts":[[2025,7,25]],"date-time":"2025-07-25T11:44:24Z","timestamp":1753443864000},"source":"Crossref","is-referenced-by-count":15,"title":["Left bundle branch pacing in patients with structural heart disease: personalizing cardiac resynchronization therapy"],"prefix":"10.1093","volume":"27","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0956-688X","authenticated-orcid":false,"given":"Jacqueline","family":"Joza","sequence":"first","affiliation":[{"name":"Department of Medicine, McGill University Health Centre , 1001 Decarie Boulevard, Montr\u00e9al, Qu\u00e9bec ,","place":["Canada, H4A 3J1"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9598-2286","authenticated-orcid":false,"given":"Justin","family":"Luermans","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Cardiovascular Research Institute Maastricht (CARIM), Maastricht University Medical Center , Maastricht ,","place":["The Netherlands"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6014-0131","authenticated-orcid":false,"given":"Vartan","family":"Mardigyan","sequence":"additional","affiliation":[{"name":"Department of Medicine, Jewish General Hospital , Montreal ,","place":["Canada"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4393-5338","authenticated-orcid":false,"given":"Haran","family":"Burri","sequence":"additional","affiliation":[{"name":"Cardiac Pacing Unit, Cardiology Department, University Hospital of Geneva , Geneva ,","place":["Switzerland"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3318-6601","authenticated-orcid":false,"given":"Marek","family":"Jastrz\u0119bski","sequence":"additional","affiliation":[{"name":"First Department of Cardiology, Interventional Electrocardiology and Hypertension, Jagiellonian University, Medical College , Krakow ,","place":["Poland"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2230-100X","authenticated-orcid":false,"given":"Pugazhendhi","family":"Vijayaraman","sequence":"additional","affiliation":[{"name":"Geisinger Heart Institute, Geisinger School of Health Sciences , Wilkes-Barre, PA ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8818-5964","authenticated-orcid":false,"given":"Kevin","family":"Vernooy","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Cardiovascular Research Institute Maastricht (CARIM), Maastricht University Medical Center , Maastricht ,","place":["The Netherlands"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2025,7,29]]},"reference":[{"key":"2025101613264448800_euaf154-B1","doi-asserted-by":"crossref","first-page":"euaf050","DOI":"10.1093\/europace\/euaf050","article-title":"European Society of Cardiology (ESC) clinical consensus statement on indications for conduction system pacing, with special contribution of the European Heart Rhythm Association of the ESC and endorsed by the Asia Pacific Heart Rhythm Society, the Canadian Heart Rhythm Society, the Heart Rhythm Society, and the Latin American Heart Rhythm Society","volume":"27","author":"Glikson","year":"2025","journal-title":"Europace"},{"key":"2025101613264448800_euaf154-B2","doi-asserted-by":"crossref","first-page":"euad168","DOI":"10.1093\/europace\/euad168","article-title":"The evolving state of cardiac 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