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Left bundle branch pacing (LBBP) was successfully performed, but during the follow\u2010up 6\u2009weeks later, the electrocardiogram (ECG) showed a sinus rhythm tracked by ventricular pacing with a ratio of approximately 2:1 due to T\u2010wave over\u2010sensing, which might be caused by the changes in T\u2010wave morphology due to electrotonic modulation and hyperkalemia or by the lower sensitivity threshold set by the auto sensing algorithm of the ICD. Shortening post\u2010ventricular atrial refractory period (PVARP) restored the ventricular pacing tracking of the atrium, and the T\u2010wave changes improved as time went by.<\/jats:p>","DOI":"10.1111\/anec.70083","type":"journal-article","created":{"date-parts":[[2025,4,28]],"date-time":"2025-04-28T07:00:58Z","timestamp":1745823658000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["A Case Report: Electrotonic Modulation\u2010Related T\u2010Wave Over\u2010Sensing After Left Bundle Branch Pacing"],"prefix":"10.1111","volume":"30","author":[{"given":"Linlin","family":"Li","sequence":"first","affiliation":[{"name":"Division of Cardiology, Xiamen Cardiovascular Hospital Xiamen University  Xiamen Fujian 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