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Although CRT is now an accepted therapeutic modality for patients with HF and conduction disturbances, a significant proportion of patients remain non-responders.Some studies have suggested that the anatomical position of the left ventricular (LV) lead may be relevant in this respect.In early, acute, studies, the lateral LV free wall appears to be the optimal pacing site in terms of the rate of rise of LV pressure (dP/dt).The subjacent rationale would be lateral LV free wallis usually the point of maximal electrical activation delay in patients with LBBB.