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(A) Before pacing, early right ventricular (yellow arrow) and late left ventricular (red arrow) free wall activation with a right-to-left delay of 260 milliseconds was observed. (B) Major improvement in interventricular synchrony after left ventricular pacing. (C) Native 12-lead electrocardiogram with left bundle branch block. (D) Atrial synchronized left ventricular pacing leading to amelioration of the left bundle branch block pattern.
