Left Bundle Branch Area Pacing for Pacing-Induced Cardiomyopathy: A Case ReportMengqi Yeh1,Shunsong Chen1,Shanshan He1,Ke Liu1,Kai Yang1,Jiang Wang1,Zhiying Zhao1,Feiyan Shang1,Jinrui Guo11Fuwai Yunnan Hospital, Chinese Academy of Medical Sciences, Affiliated Cardiovascular Hospital of Kunming Medical University, Kunming, 650102, China.Corresponding author: Jinrui Guo. Email: Sailor2k@163.comFunding:  The authors received no specific funding for this work.Keywords:  Left Bundle Branch Area Pacing; Right Ventricular Pacing; Pacing-Induced Cardiomyopathy; Permanent Pacemaker Implantation.Summary: High-burden right ventricular pacing induced cardiomyopathy in a 47-year-old male; upgrading to left bundle branch area pacing resolved symptoms and restored cardiac function.Abstract : Long-term high-burden right ventricular pacing (RVP) is a recognized cause of pacing-induced cardiomyopathy (PICM). We present a case of a 47-year-old male with third-degree atrioventricular block and >99% RVP burden, who developed PICM five years after dual-chamber pacemaker implantation, manifesting as exertional dyspnea and a reduced left ventricular ejection fraction (LVEF) of 35%. After upgrading to left bundle branch area pacing (LBBAP), his symptoms resolved, and significant improvements in echocardiographic parameters and NYHA functional class were sustained at 2-month, 6-month, and 1-year follow-ups.