Studies have shown that left bundle branch area pacing (LBBaP) is not inferior to biventricular-cardiac resynchronization therapy (BIV-CRT) in the treatment of heart failure with cardiac electromechanical activity asynchrony. The patient in this report was a 72-year-old heart failure patient needing cardiac resynchronization therapy (CRT). The LBBaP approach was attempted firstly, but it failed to achieve cardiac electromechanical activity synchronization. Then, the BIV-CRT strategy was selected and performed successfully. The patient’s heart function has greatly improved at the postoperative follow-up. Therefore, BIV-CRT remains an irreplaceable treatment for certain patients.