His-Bundle Corrective Pacing in Heart Failure

Inclusion Criteria: * Age 18 years or older (no upper age limit) * Optimal medical therapy for heart failure by current guidelines * Class IIa or IIb guideline-based indication for CRT-D implant in RBBB patients, including one of the following: * New York Heart Association (NYHA) class II HF symptoms, LVEF ≤ 30% and QRS≥ 150 ms (IIb); OR * NYHA class III-IV a HF, LVEF ≤ 35%, and QRS duration ≥ 150 ms (IIa); OR * NYHA class III-IV a HF, LVEF ≤ 35%, and QRS duration 120-149 ms (IIb) Exclusion Criteria: * Unable to obtain most recent imaging data from echocardiogram within 1 year prior to date of randomization * Left bundle branch block (LBBB) or intraventricular conduction delay (IVCD) ECG morphology * Unable or unwilling to follow study protocol * Less than 12 months life expectancy at consent * Pregnancy or planned pregnancy during duration of the study * On heart transplant list or likely to undergo heart transplant