Elencwajg B, López-Cabanillas N, Fischer A, et al. - In a real-world setting, researchers assessed the long-term consequence of endocardial cardiac resynchronization therapy (eCRT) performed using the Jurdham procedure. In patients who failed a coronary sinus (CS) implant or failed to respond to cardiac resynchronization therapy (CRT), or in selected patients needing lifelong oral anticoagulation (OAC), eCRT was performed. A long-term follow-up (FU) was performed, during which, they evaluated left ventricular ejection fraction, New York Heart Association functional class (NYHA FC), and left ventricular stimulation parameters. During FU, an improvement in NYHA FC was noted, from 2.9 preimplant to 1.3. At 60 months, all-cause mortality was estimated to be 30.5%. In anticoagulated patients, the safety, as well as the efficacy of eCRT using the Jurdham procedure, was evident. For patients with failed CS implants or nonresponders to CS CRT, this approach could afford an attractive choice. Also for patients needing lifelong OAC, it might serve as a reasonable first option for treatment.