Pacing-induced cardiomyopathy (PIC) is a condition that leads to increased morbidity and mortality. Unfortunately, it is not uncommon after implantation of a pacemaker with a right ventricular lead. Right ventricular pacing creates a delayed electrical activation, leading to dyssynchronous contraction, and it is a known risk factor for PIC. Left bundle branch area pacing (LBBAP) is a form of pacing that delivers a physiological activation of the left ventricle. The lead is implanted deep in the septum and captures the left bundle branch of the conduction system. This allows for a synchronous electrical activation of the ventricles. LBBAP has shorter ventricular activation time and less dyssynchronous contraction compared to right ventricular pacing. Recently, studies have shown that the long-term electrical parameters are comparable to right ventricular leads. Randomized trials are underway to compare LBBAP with right ventricular pacing and biventricular pacing.