AI-Guided Left Bundle Branch Area Pacing

This study is testing an AI-guided approach to a type of heart pacemaker implantation called Left Bundle Branch Area Pacing (LBBAP). Traditional pacemakers often pace from the right side of the heart, which can weaken heart function over time. LBBAP aims to pace from a more natural location to preserve heart pumping strength, and this study uses AI to help guide the procedure. **You may be eligible if...** - You are 18 or older - Your heart's pumping function is reduced (ejection fraction below 50%) based on a test in the past 6 months - Your heartbeat is too wide on an ECG (QRS duration 130 ms or more), OR your current pacemaker paces from the right ventricle more than 40% of the time, OR your heart is expected to require right ventricular pacing - You are on optimized, guideline-recommended heart failure medications - An AI-based ECG analysis suggests a high probability of reduced heart function **You may NOT be eligible if...** - You are under 18 years old - You are unable to come back for follow-up visits - You are pregnant Talk to your doctor to see if this trial is right for you.