{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,27]],"date-time":"2026-10-27T23:36:05Z","timestamp":1793144165503,"version":"4.5.0"},"reference-count":25,"publisher":"MDPI AG","issue":"1","license":[{"start":{"date-parts":[[2025,12,26]],"date-time":"2025-12-26T00:00:00Z","timestamp":1766707200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Background\/Objectives: Biventricular pacing (BVP) to deliver cardiac resynchronization therapy (CRT) is a standard intervention for heart failure, yet suboptimal response remains common due to challenges in left ventricular (LV) lead placement. Left bundle branch area pacing (LBBAP) has emerged as a promising alternative, offering physiological activation via direct conduction system engagement. However, comparative data on electrocardiographic (ECG) and procedural outcomes between LBBAP-CRT and BVP-CRT are limited. Methods: This retrospective, single-center study compared LBBAP-CRT and BVP-CRT in 114 patients with left bundle branch block and LV ejection fraction \u2264 35%. LBBAP-CRT was performed using a Medtronic SelectSecure\u2122 3830 lead via a fixed-curve sheath Medtronic C315HIS, with successful capture confirmed by ECG criteria (Qr\/qR in V1, LV activation time &lt; 100 ms). BVP-CRT involved coronary sinus LV lead placement. Outcomes included QRS duration, pacing thresholds, complications, and procedural metrics. Statistical analysis employed logistic regression to identify predictors of optimal pacing thresholds (\u22641.0 V at 0.5 ms). Results: LBBAP-CRT yielded greater degree of QRS narrowing than BVP-CRT (136.7 \u00b1 13.5 ms vs. 147.2 \u00b1 14.6 ms, p &lt; 0.001) and lower pacing thresholds (p &lt; 0.05). Complications occurred in 18.1% of BVP-CRT patients (phrenic nerve stimulation, lead dislocation) versus none in LBBAP-CRT (p = 0.011). According to the multivariable analysis LBBAP-CRT was associated with an optimal thresholds (p = 0.007), alongside lower E\/e\u2032 ratio and lead impedance. Conclusions: LBBAP-CRT was associated with superior electrical resynchronization, fewer complications, and better pacing thresholds compared to BVP, suggesting its potential as a preferred CRT strategy. Larger randomized trials are needed to validate long-term outcomes.<\/jats:p>","DOI":"10.3390\/jcm15010200","type":"journal-article","created":{"date-parts":[[2025,12,29]],"date-time":"2025-12-29T00:50:42Z","timestamp":1766969442000},"page":"200","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Left Bundle Branch Area Pacing in Cardiac Resynchronization Therapy: How Does It Compare to Biventricular Pacing in Terms of Electrocardiographic Parameters and Procedural Outcomes?"],"prefix":"10.3390","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2645-4142","authenticated-orcid":false,"given":"Tariel","family":"Atabekov","sequence":"first","affiliation":[{"name":"Cardiology Research Institute, Tomsk National Research Medical Center, Russian Academy of Sciences, Kievskaya St., 111a, 634012 Tomsk, Russia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8121-8287","authenticated-orcid":false,"given":"Sergey","family":"Krivolapov","sequence":"additional","affiliation":[{"name":"Cardiology Research Institute, Tomsk National Research Medical Center, Russian Academy of Sciences, Kievskaya St., 111a, 634012 Tomsk, Russia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1415-3932","authenticated-orcid":false,"given":"Roman","family":"Batalov","sequence":"additional","affiliation":[{"name":"Cardiology Research Institute, Tomsk National Research Medical Center, Russian Academy of Sciences, Kievskaya St., 111a, 634012 Tomsk, Russia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9050-4493","authenticated-orcid":false,"given":"Sergey","family":"Popov","sequence":"additional","affiliation":[{"name":"Cardiology Research Institute, Tomsk National Research Medical Center, Russian Academy of Sciences, Kievskaya St., 111a, 634012 Tomsk, Russia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2025,12,26]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"1539","DOI":"10.1056\/NEJMoa050496","article-title":"Cardiac Resynchronization-Heart Failure (CARE-HF) Study Investigators. 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