TABLE 2.

Comparison of advantages and disadvantages between LBBP and BVP.

	LBBP	BVP
Anatomy	Wide target zone underneath the endocardium of left side of IVS	Coronary sinus anatomy variation and venous malformation limits LV lead implantation
Safety	Safer for operators and patients with shorter operation and fluoroscopy time	Prolonged operation and X-ray exposure time
Costs	Fewer costs because of a dual chamber system in CRT-P, yet comparable costs with BVP in scenario that needs a CRT-D	Greater costs for a triple chamber system
Technical difficulty	Relatively easier	A little more difficult due to various coronary sinus anatomy
Delivery tools and leads	Limited and still using leads designed for HBP	Numerous as endocardial LV pacing, multi-point LV pacing developing
Success rate	85–100% (4)	85–95% (4)
Respond rate	Not clear	Around 70% (6, 11)
Pacing parameters	Lower and stable threshold, high R wave sensing	Higher threshold via CS lead
Cardiac synchrony	Better electromechanical synchronization with a narrower QRS	A degree of LV dyssynchrony because of non-physiological pacing with a wider QRS
Indication range	Wider, including HFmrEF and HF with narrow QRS such as AF patients with atrioventricular node ablation	Narrower, with wide QRS (≥130 ms) and usually those whose LVEF ≤35% in most cases
Complications	Comparable, septal perforation	Comparable, phrenic nerve stimulation

LBBP, left bundle branch pacing; BVP, biventricular pacing; CRT-P, cardiac resynchronization therapy-pacemaker; CRT-D, cardiac resynchronization therapy-defibrillator; HBP, his bundle pacing; LV, left ventricle; RV, right ventricle; CS, coronary sinus; IVS, interventricular septum; LVEF, left ventricular ejection fraction; HFmrEF, heart failure with mildly reduced ejection fraction.