Defining left bundle branch block according to the new 2021 European Society of Cardiology criteria

Correctly diagnosing left bundle branch block (LBBB) is fundamental, as LBBB occurs frequently in heart failure and may trigger a vicious cycle of progressive left ventricular dysfunction. Moreover, a correct diagnosis of LBBB is pivotal to guide cardiac resynchronisation therapy. Since the LBBB diagnostic criteria were recently updated by the European Society of Cardiology (ESC), we assessed their diagnostic accuracy compared with the previous ESC 2013 definition. We further discuss the complexity of defining LBBB within the context of recent insights into the electromechanical pathophysiology of LBBB.