2023 HRS/APHRS/LAHRS guideline on cardiac physiologic pacing for the avoidance and mitigation of heart failure

. Author manuscript; available in PMC: 2024 May 2.

Published in final edited form as: Heart Rhythm. 2023 May 20;20(9):e17–e91. doi: 10.1016/j.hrthm.2023.03.1538

Recommendations for non-LBBB, QRS duration <150 ms, NYHA class I–IV symptoms

COR	LOE	Recommendations	References
2b	B-NR (CRT)	1. In patients who have LVEF ≤35%, sinus rhythm, a non-LBBB pattern with QRS duration 120–149 ms, and NYHA class III or IV symptoms on GDMT, the usefulness of CPP is not well established.	CRT^94,96,140 HBP, LBBAP^42,46,47,108
2b	C-LD (HBP, LBBAP)		CRT^94,96,140 HBP, LBBAP^42,46,47,108
3: No Benefit	B-R	2. In patients with LVEF ≤35%, NYHA class II-IV symptoms on GDMT, and QRS duration <120 ms, CRT with BiV pacing is not recommended.	^141–144
3: No Benefit	B-R	3. In patients who have LVEF ≤35%, sinus rhythm, a non-LBBB pattern with QRS duration <150 ms, and NYHA class I or II symptoms on GDMT, CRT with BiV pacing is not recommended.	^94,96,139