Right ventricular (RV) pacing-induced dyssynchrony may precipitate heart failure (HF) with impaired left ventricle (LV) systolic function in susceptible patients. LV pacing via coronary sinus or endocardially via transseptal approach has its limitations due to anatomy and requirement for long term anticoagulation respectively. His pacing is promising, as it engages the natural conduction system. However, in patients with LBBB, His pacing may be able to normalize LBBB in about 50% of patients.
