AI-Guided Left Bundle Branch Area Pacing

Inclusion Criteria * Age: 18 years or older. * Left Ventricular Ejection Fraction (LVEF): \<50% within 6 months prior to enrollment. * QRS Duration: Resting QRS duration ≥ 130 ms on ECG OR anticipated right ventricular pacing \> 40% OR device in place with right ventricular pacing \> 40% within 6 months prior to enrollment. * Medical Therapy: Optimized on guideline-directed medical therapy for heart failure. * AI-ECG probability of low LVEF: \>0.5 Exclusion Criteria * Age less than 18 years old * Inability to follow-up * Pregnancy