Abstract Funding Acknowledgements Type of funding sources: None. Background The aim was to evaluate efficacy and feasibility of left bundle branch area pacing (LBBAP) with right ventricle outflow tract pacing(RVOP), as well as describing the learning curve. Methods Prospective single-center observational study, including 200 patients that required pacemaker implantation. Two groups: LBBAP and RVOP with 100 patients each. Our aim was to compare safety and efficacy as well as the procedure and fluoroscopy times and to describe the LBBAP-learning curve. Results Success and acute complication rate were similar in both groups(p=0.56,p=0.65). Time for ventricular lead placement was higher in LBBAP group(18 [13-28] vs 11[7-17]min, p<0.001). Fluoroscopy time was lower in LBBAP, (2.8[1.3-3.7] vs 3.1[2-5.9]min, p=0.02). Paced-QRS was narrower in LBBAP group (122.9±13.7ms vs 145.7±17.6ms, p=0.002). There were no differences related to pacing parameters. In LBBAP group, procedure time was lower in the last quartile (Q4) compared to the first quartile (12 [10.5-15] vs 32[28.5-38.5]min, p<0.001) as well as fluoroscopy time (2[1-4.6] vs 5.1[3.4-12]min, p<0.01). Procedure time was similar between LBBAP-Q4 and RVOP (12[10.5-15] vs 11[7-17]min, p=0.33). Conclusions LBBAP is as safe as RVOP and it achieved a narrower paced-QRS than RVOP. It requires a longer procedure time and a shorter fluoroscopy time, with a rapid learning curve.