T-Wave Oversensing in Patients With Left Bundle Branch Pacing: A Report of Three Cases and Review of Literature.

T-Wave oversensing (TWOS) is a type of pacemaker malfunction that can result in inappropriate tachyarrhythmia detection and loss of pacing, attenuating potential benefits of cardiac resynchronization therapy (CRT). We present a case series of TWOS after left bundle branch pacing (LBBP) in the First Affiliated Hospital of Nanjing Medical University from 2020 to 2024. By analyzing underlying mechanisms and summarizing feasible solutions, we highlight the particularity and complexity of TWOS. It can occur immediately after procedure or be detected after a relatively long period of time. The harm of TWOS should be dealt with in a timely manner.